SHOP Advisory Group June 14, 2012 Agenda Welcome & - PowerPoint PPT Presentation

SHOP Advisory Group June 14, 2012

Agenda − Welcome & Introductions 5 min − Standard Operating Procedures 10 min  Distribute & Discuss  Assign Recorder − SHOP AG Charter Review 10 min − Policies 40 min  Employer & Employee Choice Architecture 40 min  Single Streamlined (Uniform Enrollment) Application − Open Forum 10 min − Wrap-up 5 min 2

SHOP Advisory Group Charter Inform the business processes, tools, and support functions available in the Small Business Health Options Program (SHOP). The group may address the following issues: − Inform the design of the COHBE shopping portal, choice architecture and work flow that will guide employers and employees through the health plan selection process − Inform business processes and technologies needed to support broker participation in the Exchange. − Review broker compensation models that could be used by the Exchange. − Discuss the impacts of changing the way business groups of one are defined. − Provide feedback on employer and employee rights and responsibilities. − Define roles of brokers and navigators in the Exchange. 3

Topic Summary & Board Target Decision Dates Employer & Employee Choice Architecture 7/9 Single Streamlined Application TBD Standard Comparative Plan Information 6/25 Broker Relationship & Compensation 7/9 Certification, of Health Issuers & QHP’s 6/25 Customer Service Center 8/27 Consumer & Employer Rights & Responsibilities 8/27 4

SHOP Policy & Process Topics Topic Employer & Employee Choice Architecture Essential Question: What is the proper balance between employer/ employee choice and financial viability of plan offerings on the SHOP exchange? Should the exchange specify minimum participation and contribution rates? Target Decision Date – July 9, 2012 5

Employer & Employee Choice Architecture Essential Question: What is the proper balance between employer/employee choice and financial viability of plan offerings on the SHOP exchange? Should the exchange specify minimum participation and contribution rates? Sub-questions − Should there be restrictions on the number of plans employers can choose from in the Exchange? − Should employers have the choice to provide a defined contribution to their employees? − Will there be a minimum contribution level for traditional plans offered by the employer in the Exchange? 6

Employer/Employee Choices • What are the Exchange options for a framework to effectively connect employers and health plans in the SHOP? • What are the Exchange options for a framework that will enable employees to select a health plan through the SHOP? • What rules and structure does the Exchange need to consider regarding employer contributions and participation rates? • How are these options and decisions interrelated? 7

Selection of Plans 8

Defined Contributions 9

SHOP Policy & Process Topics Topic – Single Streamlined Application previously called Uniform Enrollment Essential Question: Is there an advantage to Colorado to create a customer enrollment form, or should COHBE use a standard enrollment form that will support multi-state interoperability & partnership? Target Decision Date – TBD 10

Single Streamlined Application Essential Question: Is there an advantage to Colorado to create a customer enrollment form, or should COHBE use a standard enrollment form that will support multi-state interoperability & partnership? Sub-questions − Will the Exchange use the current Colorado Mandated Uniform Application? − What changes, if any, should be made? 11

SHOP Policy & Process Topics Topic – Standard Comparative Plan Information Essential Question: What is the appropriate information to be displayed to consumers when they are shopping for and comparing qualified health plans? Target Decision Date – June 25, 2012 12