Washington Coalition of Medicaid Organizations SEPTEMBER 2017
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1 Washington Coalition of Medicaid Organizations SEPTEMBER
2 Open Enrollment Readiness 2018 Healthplanfinder QHP/Individual Market 2017 HBE Health Insurance Literacy Survey and HBE Actions OE 5 Outreach and Communications Plan Other System and Program Improvements in the works 2
3 2018 Healthplanfinder QHP/Individual Market Carrier filings reflect uncertainty at the federal level No decision on Cost Sharing Reductions Uncertain if individual mandate will be enforced Fewer carriers in many counties (many with one option) No carriers offering SHOP for 2018 Carriers filed plans, but they are still pending HMOs predominant, no PPOs 3
4 Washington Response to Market Instability OIC Commissioner engaged at state and federal level in advocating for CSR s and improvements to stabilize the market OIC multi-disciplinary initiative to stabilize Washington market Reinsurance State statutes to retain EHBs and other customer protections 4
5 Anticipated Individual Market for Carriers (9 in 2017) No bare counties Regence and CHPW withdrew from the Exchange 42 proposed QHPs (98 in 2017) 9 Counties with one carrier Chelan Douglas Ferry Grays Harbor Island Pend Oreille San Juan Skagit Skamania 5
6 Exchange Service Area Changes Kaiser of WA and Kaiser NW No changes Coordinated Care added Columbia and Kittitas Counties Carrier withdrawals Premera/Lifewise withdrew from 3 counties Molina withdrew from 6 counties Bridgespan withdrew from 12 counties serving only Klickitat Regence/CHPW withdrew 6
7 Outside Market Service Area Changes 10 counties with no carrier offerings off the Exchange (all have coverage on Exchange) Clallam Ferry Grays Harbor Jefferson Lincoln Pacific Pend Oreille Skamania Stevens Wahkiakum Bridgespan/Regence withdrew from entire I-5 corridor Remaining only in Southeast Washington in 6 counties 7
8 8
9 Proposed Rate Increases by Metal Level 9
10 Health Insurance Literacy Survey OPEN ENROLLMENT 4 4 July
11 Survey Goal - Purpose Understand continued health insurance literacy challenges of Washington Healthplanfinder s customers Use the survey results to guide future health insurance literacy efforts Identify and prioritize system and program improvements improvements July
12 Q1: I am a (688 respondents) QHP WAH Broker CSRs HBE Staff Navigators Customers 58 July
13 Q2: In one word, what is most challenging? July
14 Q2: Top 5 challenges, by respondent group CUSTOMER SUPPORT 1. HPF issues 2. Income 3. Insurance concepts 4. Affordability 5. Cost CUSTOMERS 1. Choosing a plan 2. Process is complex, complicated, confusing 3. HPF issues 4. Comparing plans 5. Call Center July
15 Q2: Choosing a plan themes Choices* Not sure that I picked the right plan Getting the plan details Understanding if certain services are covered Understanding the plans Finding if my doctor is covered Comparing the plans *Later question addresses if it is the amount of options that is overwhelming. July
16 Q3: Rank what is the most challenging to do Renewing coverage Reporting changes Tax credits/irs requirements Notices/correspondence Insurance concepts Choosing a plan Document upload Completing tax filing/income questions Creating an account Customers Customer Support July
17 Q4: Most problematic insurance concepts Customer Support Customers July
18 Q5: Renewing customers are More informed about their coverage each year Know about as much about their coverage as before Still needs lots of refresher training when they renew N/A Customers Customer Support July
19 Q6: What would make the enrollment process easier? Educational videos More resources and materials More focused training for customer support Simplifying text on HPF Simplifying notices Other Customers Customer Support July
20 Q6: Other themes Offer more in-person help & more consistent call center help Simplify online process Fix provider directory Make signing in easier Simplify on-screen text July
21 Q7: Rank how confident you are to: Review a SBC Compare the network of QHPs Calculate cost-sharing for services Compare key features of QHPs Customers Customer Support July
22 Q8: What would make choosing a health plan easier? Fewer plan options Adding more than one doctor to the provider search Seeing if certain medications are covered Other Customers Customer Support July
23 Q8: Other themes More plan options to choose from More in-person help More affordable plans Better plan comparison Better plans (benefits/network) Plans shouldn t change from year to year July
24 HBE Response Adjustments to messaging in-person help Increase usage of direct communication (mobile, ) Plan comparison tools Provider directory improvements Efforts to simplify and clarify text in Healthplanfinder 24
25 Outreach and Communications OPEN ENROLLMENT 5 25
26 HBE Outreach Goals for OE 5 Increase subscriptions and download of mobile app Highlight that local, in-person help is available Reinforce positive messages Statewide coverage New shopping tools 26
27 Customer Communications 27
28 Mobile App Over 10,000 downloads and growing!! 28
29 WAPlanfinder Update Impacted users: individual users Added functionality to WAPlanfinder Anonymously browse for health and dental plans and capture customers selection In-person search functionality for brokers and navigators My Profile actions Notification Preference (existing with WAPlanfinder release) (new) Security Questions (new) Password (existing with WAPlanfinder release) 10/2/
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32 Healthplanfinder v5 Release September 2017 Sunday Monday Tuesday Wednesday Thursday Friday Saturday Navigator Washington Healthplanfinder will go down for maintenance on Friday, September 22 nd, 10 p.m. PST and is tentatively scheduled to go live Sunday, September 24 th, 4 p.m. PST System Update Webinar pm 3:30 pm Fall Training starts System Update 18 Webinar am 10:30pm /2/
33 Plan Comparison Tools - Smart PlanFinder Consumer Decision Support Tool Smart Planfinder Available from anonymous browse and on the shopping page Recommends Smart Choices for consumers Does not filter out any options in the display When in use, displays Smart Choices first Customer inputs Providers/facilities Prescriptions Number of doctor visits 33
34 What goes into Smart Choice? Total estimated out of pocket cost to the consumer (including premium) Coverage for the consumer s prescription drugs In-network doctor/facility Deductible amount 10/2/
35 Smart Choice flag Links to details Access Smart Choice tool (or from anonymous browse) 35
36 Lesson 1.3 Questionnaire Screen August 31, 2017 WASHINGTON HEALTH BENEFIT EXCHANGE 36
37 QHP Auto-Renewal November 1 Transmit to Carriers early to avoid enrollment and payment issues Mapped to best match Auto-Renew with same plan and carrier If existing plan no longer available Customer can shop 37
38 Other improvements for OE 5 Enhanced User assistance in real time Enhanced User group is GROWING! Provider directory Navigator in-service training Simplified renewal flow for customers with no changes Streamlined look and feel Enrollment data sent to Carriers earlier and numerous improvements to file transmission processes 38
39 Questions? 39
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