Washington Health Benefit Exchange
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1 Washington Health Benefit Exchange Exchange Revenue Sources Exchange Board Meeting October 30, 2014 Bob Nakahara, CFO Molly Voris, Policy Director
2 Exchange Budget Request Overview $59M Budget $76M Budget $79M Budget CY 2015 CY 2016 CY 2017 Current Biennium (Jan 1 - June 30, $29M Budget SFY 2015 Supplemental Budget $29M (a) State Biennial Budget (July 1, June 30, 2017) $69M Budget $78M Budget SFY 2016 SFY 2017 Biennial Budget $147M (a) HBE appropriation was $20M for Jan 1 - June 30, 2015 (6 mos) - seek $9M increase 2
3 CY2015 CY2017 Projected Cash Flow For Operations CY CY2017 HBE Operating Budget Funding Sources Calendar Year Funding Request Medicaid Reimbursement Net Budget Premium Tax Receipts Expected Issuer Assessments (a) Additional Funding Needed (b) 2015 $59,200,000 $21,300,000 $37,900,000 $22,814,000 $10,531,000 $4,555, $75,700,000 $27,300,000 $48,400,000 $27,885,000 $14,983,000 $5,532, $79,400,000 $28,600,000 $50,800,000 $33,650,000 $17,497,000 None (a) The 2015 Issuer Assessment was $4.19 PMPM and $.33 PMPM for QHP and QDP, respectively. The aforementioned assessment fee is expected to generate approximately $10.5M in 2015 based on projected enrollment figures & 2017 Issuer Assessment Fees have not yet been finalized, thereby for illustrative purposes only the 2015 PMPM fees were used to calculate both 2016 & 2017 assessment amounts. (b) There may be various funding sources available, including but not limited to Issuer Assessments, etc. 3
4 Biennial Budget Request/Revenue Sources Biennial Request Reimbursement for Medicaid Services Premium Tax Carrier Assessment ($4.19 PMPM) Additional Funding Needed $69,174,000 SFY16 $25,183,000 $23,753,000 $13,349,000 $6,889,000 $77,767,000 SFY17 $28,312,000 $30,150,000 $16,240,000 $3,065,000 $146,941,000 TOTAL $53,495,000 $53,903,000 $29,589,000 $9,954,000 4
5 Exchange Request to Legislature Biennial Budget Request of $146.9M Requesting authority to spend revenue generated from three sources ($136.9M for biennium) Requesting authority to raise and spend an additional $10M for the biennium Supplemental Budget Request of $28.9M Requesting authority to spend an additional $8.9M for the first 6 months of
6 Proposed Revenue Sources: Biennium (assumes $147M) Premium Assessment $53,903,000 Medicaid Cost Allocation: Federal Share $37,446,500 Shortfall $9,954,000 Carrier Assessment $29,589,000 Medicaid Cost Allocation: State Share $16,048,500 6
7 Additional Revenue Sources Could be generated from a variety of sources Tax or assessment from Medicaid managed care plans Transferred funds leaving account by end of FY2015 Increased carrier assessment Others 7
8 Appendix 8
9 SFY HBE Budget Overview ($000 s) System Enhancements $45,968 - Healthplanfinder $36,995 Deloitte - Eligibility Services 2,718 DSHS/ESA - Other O&M License Fees 6,255 Various Call Center and Other Operational Services $41,255 - Customer Service Center $30,624 Faneuil - Print Services 8,442 KP Corp - Other Operational & Consulting Services 2,189 Various Marketing, Outreach and IPAs Various $12,686 SHOP Services Various $459 Financial, Policy, Exec and Legal Consulting $3,904 - Auditing/Accounting Services/Other $3,014 Various - Executive and Policy Services 469 Various - Legal Services 420 Other Costs $42,669 - Salaries and Benefits (145 FTE) $31,920 - Rent, Utilities, etc. 2,275 - Equipment, Travel, etc. 8,474 Total Request $146,941 9
10 SFY IT Budget Detail ($000 s) IT Operations and Enhancements $45,968 - Operations and Maintenance $14,636 Deloitte - HPF Support License Fee 3,195 Deloitte - HPF Releases/Enhancements 19,163 Deloitte - Eligibility License Fee 2,718 DSHS/ESA - Waiting Room Page 201 Akamai Tech - Plan Management/Provider Directory License Fee 3,437 ehealth - HPF Platform License Fee 2,300 Oracle - Professional Services/Support License Fee 317 Microsoft Other Costs $12,171 - Salaries and Benefits (43 FTE) $10,777 - Rent, Utilities, etc Equipment, Travel, etc. 724 Total $58,139 10
11 SFY Operations Budget Detail ($000 s) Call Center and Other Operational Services $41,255 - Customer Service Center $30,624 Faneuil - Print Services 8,442 KP Corp - Document Management System 1,612 HCA - Translation 577 LinguaLinx, Inc Other Costs $7,407 - Salaries and Benefits (34 FTE) $6,304 - Rent, Utilities, etc Equipment, Travel, etc. 573 Total $48,662 11
12 SFY Communications Budget Detail ($000 s) Marketing and Outreach - Media Buy - Exchange Marketing GMMB $6,304 Contracts - IPA/Navigators Various $6,382 Other Costs $3,872 - Salaries and Benefits (17 FTE) $3,322 - Rent, Utilities, etc Equipment, Travel, etc. 285 Total $16,558 12
13 SFY Finance & Admin Budget Detail ($000 s) Financial and Audit Services $3,014 - External Audit - A-133 $627 Moss Adams - Carrier Assessment Invoicing 209 BMI - Legislative Mandated Performance Audit 1,537 State Auditor's Office - Financial System O&M 418 TBD - Other 223 Other Costs $10,961 - Salaries and Benefits (22 FTE) $4,231 - Rent, Utilities, etc Equipment, Travel, etc. 6,387 Total $13,975 13
14 SFY Policy Budget Detail ($000 s) Consulting $330 - Actuarial $105 Milliman - Consumer Rating System 105 TBD - Quality Assurance 14 NCQA - Consumer Survey 105 TBD Other Costs $2,615 - Salaries and Benefits (10 FTE) $2,291 - Rent, Utilities, etc Equipment, Travel, etc. 169 Total $2,945 14
15 SFY SHOP Budget Detail ($000 s) Consulting $459 - Agent/Broker CSR $306 Ciber - Agent/Broker CSR 153 Teksystems Other Costs $2,417 - Salaries and Benefits (9 FTE) $2,126 - Rent, Utilities, etc Equipment, Travel, etc. 151 Total $2,876 15
16 SFY Legal Budget Detail ($000 s) Legal Services $420 - Presiding Officers (4) $211 Various - Attorney General's Office 105 AGO - Outside Legal Counsel 105 TBD Other Costs $1,631 - Salaries and Benefits (7 FTE) $1,404 - Rent, Utilities, etc Equipment, Travel, etc. 118 Total $2,051 16
17 SFY Executive Office Budget Detail ($000 s) Consulting - Executive Consulting $139 TBD $139 Other Costs $1,595 - Salaries and Benefits (4 FTE) $1,465 - Rent, Utilities, etc Equipment, Travel, etc. 67 Total $1,734 17
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