Arkansas Health Insurance Marketplace Key Decisions Inventory. April 9, 2014

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2 I. Introduction and Methodology Introduction Over the next six weeks, Public Consulting Group (PCG) will assemble an inventory of key decisions that the Board and the Executive Director may use to establish the framework for the Arkansas Health Insurance Marketplace (AHIM) work plan. This inventory will be organized around the following five questions to be posed for each Blueprint functional area: Assuming we are back at the starting point of 2010, what are the key decisions a state makes in determining its approach to a state based marketplace? As of today, which of those decisions have already been made in Arkansas? What were those decisions (including context of how and why they were made)? Can those decisions be changed? What is the timeline for making each of the key business decisions? The following document provides an example of how PCG will present this information to the Board. These summary presentation documents will be backed up by a more detailed set of reference documents the Executive Director can use to assess existing Arkansas Marketplace functionality by core area. Methodology To complete this deliverable, PCG will perform background research, interview appropriate stakeholders, and assess other states approach to the establishment of a State-Based Marketplace. This will involve meeting with staff from the Department of Human Services, Arkansas Insurance Department and others. We will further utilize our experience supporting other state implementation projects and publicly available databases to supplement this effort with information on approaches taken by other states. A proposed work plan to complete this deliverable is included below: Page 2

3 Table 1: Proposed Key Decision Inventory Work Plan Task Start Date End Date Confirm deliverable content and approach with AHIM Board 4/9/2014 4/9/2014 Perform background research 4/9/2014 4/25/2014 Provide draft Key Decision Inventory 4/28/2014 5/2/2014 AHIM Board Review of draft Key Decision Inventory 5/5/2014 5/9/2014 Present draft deliverable to AHIM Board 5/7/2014 5/7/2014 Finalize Key Decision Inventory and provide to Board 5/12/2014 5/16/2014 The below example is for the Plan Management Function of the Blueprint. Page 3

4 Plan Management Starting Point Key Decisions This section will contain a summary of the most important decisions that need to be reached for this Marketplace area. 1. What essential health benefits package will carriers use? 2. How will the carriers submit their plan form and rate filings? Arkansas Decisions Made to Date This section will contain a thorough accounting of key decisions that have been made to date for this Marketplace Area. 1. Arkansas chose a benchmark plan HMO Partners, Inc. Open Access POS to define its essential health benefits package 2. Arkansas decided to use the National Association of Insurance Commissioners (NAIC) System for Electronic Rate and Form Filings (SERFF) software and the Center for Medicare and Medicaid Services (CMS) Standard Qualified Health Plan (QHP) filing templates to receive carrier form and rate filings. Content of those Decisions, How and Why They Were Made This section will contain details and supporting information about the decisions that were reached, the process that was used to reach those decisions, which entity made the decision, and the rationale for the decision. 1. A small group plan, the HMO Partners Open Access POS, as opposed to state or federal employee benefit plan was selected as the benchmark in the interest in keeping premiums low. This decision was recommended by the Plan Management Advisory Committee after a detailed assessment of options and was accepted by the Insurance Commissioner. 2. The Arkansas Insurance Department decided to use SERFF since the software was already used for rate and form filing reviews conducted by compliance examiners and Arkansas carriers were familiar with it. Page 4

5 Capacity to Change Decisions Already Made This section will contain an analysis of whether previously made decisions can be changed and if they can be changed, the pros and cons of making changes. 1. States may review their choice of essential health benefits every two years, with the next opportunity being prior to Plan Year AHIM has the flexibility to define different business processes and technology for the submission of rate and form filings. Timeline Requirements for Key Business Decisions This section will provide an analysis of the sequencing and timing of the key decision points to establish the state-based marketplace as well as options and considerations. Page 5

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