Washington Health Benefit Exchange. 5.0 Washington Healthplanfinder System Release

Transcription

1 5.0 Washington Healthplanfinder System Release September, 2017

2 5.0 System Release Outage September 2017 September 2017 Sunday Monday Tuesday Wednesday Thursday Friday Saturday 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 Readiness Webinar: 9am 10:30 am September

3 Provider Directory integrated with Washington Healthplanfinder Users: individuals, navigators/brokers and account workers Customer plan and provider data has historically been pulled from a database vendor called ehealth This change integrates BetterDoctor (new vendor) to store and feed provider/facility data to the Explore Your Options shopping page for Qualified health, dental and Apple Health plans Washington Healthplanfinder stores Apple Health, Qualified health and dental plan data (integrated in July 2017) 2 entry points for provider and facility search Explore Your Options who s shopping section and from Smart Planfinder button Enhanced provider and facility search tool ability to see more text or map view of results through Explore Your Options September

4 What do they do? Provider Directory Vendor BetterDoctor works with health plans and state Exchanges to update provider directories on a regular basis. BetterDoctor outreaches to provider offices for the most up-to-date and valid information Who do they work on behalf of? BetterDoctor works with several health plans. Recently contracted with Washington Healthplanfinder in order to keep the provider and facility directory valid and up-to-date Why are they involved? BetterDoctor acknowledges the time and effort it takes for health plans and Exchanges to outreach to provider s offices and validate their information. BetterDoctor created an alliance model to reach out to provider s offices, on behalf of several health plans, in order to avoid provider fatigue and validate provider directory information in accordance with state and federal mandates September

5 Explore Your Options Page Provider Directory Select Search to access only provider and facility search Apple Health clients can only add one provider or facility Qualified health plan clients can add up to 5 providers and facilities September

6 Provider Directory in Washington Healthplanfinder Users can add providers and facilities on the Explore Your Options to view plans that accept that provider/facility Apple Health clients can only add one provider or facility Qualified health plan clients can add up to 5 providers and facilities User updates radio button to Provider or Facility to search Update search criteria: By zip code for providers/facilities near the zip code By provider/facility name September

7 Provider Directory in Washington Healthplanfinder Results will list once Search is selected Users select Add to add that provider/facility to their search criteria List of providers/facilities can be viewed by List or Map view September

8 Provider Directory in Washington Healthplanfinder Selecting a provider/facility name will open more details on that provider Select Back to return to provider/facility search Once providers/facilities are added you will see the ability to remove and the number remaining to add Apple Health customers can only add one provider or facility Select Confirm and Shop to add providers/facilities to your plan shopping September

9 More Information on Plan Simple Fracture Cost Tab Simple Fracture tab is available when More Information on this plan is selected from Explore Your Options page Tab offers estimated costs for a simple fracture September

10 More Information on Plan In Network and Out of Network Coverage Summary provides In Network and Out of Network Columns When Smart Planfinder tool is utilized customer Estimated Yearly Cost, Your Provider & Facility and Your Prescriptions will display in coverage summary September

11 Smart Planfinder Users: individuals, navigators/brokers and account workers Customers access a Consumer Decision Support Tool from the Explore Your Options page in Washington Healthplanfinder. The tool is called Smart Planfinder and was developed to rank Qualified health plans that best meet a customers need Smart Planfinder button takes customers to page with 4 questions relative to their health plan usage (can answer any or all to drill down their needs) Smart Planfinder available for Qualified health plans during the anonymous browsing and postapplication shopping, for new and renewing customers Once the tool is applied up to 3 plans will have a badge that says Smart Choice Customer is given total estimated annual cost for their family Customer can filter/sort plans on the Explore Your Options page Provider/facilities/prescriptions added in search this will factor in the smart choice plan display Customer can view if that plan covers their prescriptions (if entered into the Smart Planfinder) September

12 Customer Decision Support Tool Users will select a button on the left side of the shopping page to use the tool 9/13/

13 Questionnaire Screen September

14 Questionnaire Screen (cont.) User adds up to 5 doctors or facilities Search is interactive as you type available providers/facilities will populate to select September

15 Questionnaire Screen (cont.) User adds up to 5 prescriptions Search is interactive as you type available prescriptions will populate to select Users will indicate the dosage for each prescription available Generic vs. Brand name prescriptions will be noted if a plan only covers generic that would show in the plan summary page once Smart Planfinder applied September

16 Questionnaire Screen (cont.) Once completed select Calculate Smart Choice Plans September

17 User will be routed to Explore Your Options with update order of plans User will see plans that cover their doctor, facility and prescription needs User will see plans sorted on Smart Choice for them For more details select More Information on this plan Once Smart Planfinder is applied, customer can filter based off of plans that accept their provider/facility Smart Choice Plan Display September

18 Visual cue to indicate estimated total Out-of- Pocket costs Full Out-of-Pocket cost estimate displayed on More Information on this Plan page Estimated Yearly Cost September

19 More Updates

20 Responsive Washington Healthplanfinder Example Computer/laptop browser: Mobile device browser: September

21 Forgot Username Messaging Impacted users: individuals, employers/employees, privileged users, account workers Update messaging for when a Washington Healthplanfinder user clicks Forgot Username Background: Update messaging on Forgot Username for Washington Healthplanfinder users. September

22 Review of Resources and Materials

23 Washington Healthplanfinder Manuals Washington Healthplanfinder Operations Manual is updated with each major system release and minor system releases as needed The Operator s Manual is intended for Washington Healthplanfinder Customer Support Center Staff, Exchange Account Workers, brokers and assisters as a detailed self-reference guide containing step-bystep instructions on how to perform complex tasks in the Washington Healthplanfinder system. Washington Healthplanfinder Troubleshooting Desk Aid This desk aid is intended for Washington Healthplanfinder Customer Service Representatives to troubleshoot system-related issues with customers. The desk aid is organized in logical groupings based on screen flow and issue type. September

24 WAPlanfinder

25 WAPlanfinder Version 2.0 Overview Impacted users: individual users Added functionality to WAPlanfinder Anonymously browse for health and dental plans and capture customers selection This ability links customers from WAPlanfinder to an in-app browser for Washington Healthplanfinder 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) September

26 How to Download WAPlanfinder Customers can download WAPlanfinder from their phones App Store or Google Play Store Customers may be prompted to download the app if they are on Washington Healthplanfinder web application through their mobile device Customers will see store links from the Sign in to your account screen in Washington Healthplanfinder Mobile Device Browser: Website: September

27 Browse Health and Dental Plans Individual customers can also search for in-person help prior to having an account created This allows them to connect with a navigator or broker in-person, via phone or prior to accessing Washington Healthplanfinder September

28 Browse Health and Dental Plans Individual customers can anonymously browse for Qualified health and dental plans through WAPlanfinder Search functionality will be identical to Washington Healthplanfinder web application, just resized for in-app browser Anonymously browse for health and dental plans and capture customers selection September

29 Find In-Person Help Find In-Person Help on WAPlanfinder from brokers and navigators Find In-Person Help can be utilized if an individual does/does not have a Washington Healthplanfinder user account In-Person Help will connect individuals to navigators and brokers available in their area or based off of their search criteria input September

30 Find In-Person Help Search Options Individuals can Find In- Person Help from a broker or navigator using WAPlanfinder Using their current location or inputting address data will populate brokers/navigators available in their area Location settings must be turned on to enable Use Your Location users phone will prompt them to turn on if they have not WAPlanfinder will pull from data and auto-fill the address as you type If no results are found an error message with 0 results will display September

31 Find In-Person Help Results Once location or address is used In-Person Search Results will display Results can be viewed by list or on map feature Search results are sorted based off of distance from location entered If no results found then No Search Results Found will display User will need to broaden their search criteria to find results e.g. more miles from where they are located, update search criteria to zip code, etc. September

32 Find In-Person Help Profile Broker/navigator information will display when their name is selected Selecting the phone number will call the broker/navigator using the phones native calling feature Selecting the address will open a to the user with the native feature Selecting the address will open the phones native map feature for directions Additional languages the broker/navigator speaks will be listed September

33 In-Person Help Search Filter Individuals can filter In-Person Help by: Distance (from their location or address input) Assistance type Brokers or Navigators or both Language Organization Once input select Apply to update results Language search field is responsive to typing (as user types letters of language options will appear) September

34 My Profile Actions My Profile actions Notification Preference (new) Security Questions (new) Password September

35 My Profile Actions Address Individual selects Address from My Profile Update address once entered Save will turn green to save Successful confirmation will display and individuals selects green Done September

36 My Profile Actions Security Questions Individual selects Security Questions from My Profile Current Security Questions will be selected by the green check To change uncheck and select a new All 3 must be checked to get to the next step September

37 My Profile Actions Security Question Answers Answers to security questions must be at least 5 characters long If incorrect length is input red messaging will warn of answer requirement Submit button will be grey until questions are answered September

38 My Profile Actions Security Question Answers Once questions are answered Submit button is green Select Submit Successful confirmation will display and individuals selects green Done September

39 Changes for Navigators and Brokers

40 Washington Healthplanfinder Screen & Open Enrollment Changes Customer Account Home Changes: Shop for Plan button on Account Home allows customers to update and shop for a new Qualified health and dental plan or update their Apple Health plan Qualified health and dental plans have Shop for a Plan option when: Washington Healthplanfinder is in normal Open Enrollment When a customer is eligible for a Special Enrollment Period Shop for a Plan button will always be available for Apple Health plans there is not a set Open Enrollment for Apple Health Ability to manually ID proof from the ID Proofing modal September

41 Customer Account Changes Shop for Plan button on customer Account Home allows ease of access to shop for new plans Messaging under Your Household Coverage Summary may vary depending on customers household If a customer is auto-renewed that would be noted here If a customer needs to take action that would be noted here Shop Plans will be available to Apple Health enrollees year round Shop Plans will be available to Qualified health plan enrollees during Open Enrollment and if they have a Special Enrollment Period open September

42 Plan Search Functionality Plan Management tab is available to account workers and privileged user This added tab allows users* to search for current year and upcoming year plan data for Qualified health and dental plans This tab allows zip code, plan start date, AI/AN, and household member(s) information to be listed *Brokers/navigators can only view published plan data September

43 Plan Search Functionality Privileged User Navigators/Brokers select Plan Management tab from their Account Home Select Individual plans and plan year Input customer details zip code, county, policy start date, if they are AI/AN, household member details Select Show Plans to display Qualified health plans September

44 Users will identify the plan type (Individual) and year (current or next) Input plan demographic information zip code, policy start date, county, AI/AN tier Input household information date of birth, relationship, tobacco use, individual coverage start date Plan Search Functionality September

45 Once search criteria is entered Qualified health plans display in alphabetic order The plan lists household members entered, age, date of birth, coverage start date, non-capped premium and capped premium (for households that have capped premiums) The plans listed do not include tax credits Scroll to the bottom and select Next for the next page Users can print this page Plan Search Functionality September

46 Demonstration for Plan Search Functionality

47 Trial Eligibility Enhancements Users: individuals, Navigators/Brokers and account workers Trial eligibility is for Qualified health and dental plan customers Trial Eligibility Batch 1 October 17, 2017 Trial Eligibility Batch 2 November 1, 2017 The enhancements and new functionality include: Enhanced Cross Mapping Rating Corrections Enhanced Correspondence Tags Multiple Successful Auto Renewal tags: Successfully auto renewed into the same QHP, same QDP (2) Successfully auto renewed into a different QHP, different QDP (2) Next steps after auto renewal Future APTC Eligibility Tag updated Consumer Communications September

48 Trial Eligibility Enhancements Key Takeaways Trial eligibility will be more robust and inclusive to get as many customers auto-renewed Trial eligibility options are on the customer Account Home Shop for Plans to change plans Auto-renew through Update and Renew Coverage link in Quick Links September

49 Expedited Renewal Flow Users: account workers, Navigators and Brokers Applies to Qualified health plan and Apple Health customer renewals Account workers, Navigators and Brokers may experience an expedited flow for customer coverage renewal when no changes are reported Account worker, Navigator or Broker is not forced to navigate through entire customer application during manual renewal ID proofing, Voter Registration answer, income/deduction pages and electronic signature is required Users can access customer account to complete renewal at the same time should not be occurring. Ensure if you are not completing a customer renewal or change reporting that you are out of the customer application review pages September

50 The Expedited Renewal Flow follows the below path: 1. Select Update and Renew Coverage 2. Routed to Application Review Screen review with customer with the exception of Income & Deductions a. If a change is required on any field (household, tax filing status, etc.) user selects Edit and goes through the full renewal flow b. User attests up front to Washington Healthplanfinder Privacy Policy c. Must ask and answer Voter Registration 3. Routed to Income & Deductions for review 4. Routed to Application Review Screen 5. esign 6. Eligibility Results Expedited Renewal Flow *For purposes of the scenario we will use the word User for account workers and privileged users September

51 Expedited Renewal Flow Scenario 1 User calls their broker and is up for renewal. They are currently Apple Health Enrolled and only have to update income User selects Update My Application and Renew from Quick Links User can also select link in notice to access renewal for customer *For purposes of the scenario we will use the word User for account workers and privileged users September

52 Expedited Renewal Flow Scenario 1 User is taken to Application Review screen Begin review process of customer account this customer has stated no changes except income Review all sections on the Review page to verify current household information per usual review process (verifying address, household, additional questions, etc.) In income section do not select Edit User attests up front to Washington Healthplanfinder Privacy Policy *For purposes of the scenario we will use the word User for account workers and privileged users September

53 Expedited Renewal Flow Scenario 1 User reviews Application Review screen through the end Read Voter Registration to customer and select Yes or No Select green Next button This customer has no changes except income increase for Rocco All other household details have been verified address, household relationships, tax filing, additional questions, voter registration, etc. *For purposes of the scenario we will use the word User for account workers and privileged users September

54 Expedited Renewal Flow Scenario 1 User is taken to customer Household Income page Review all income/deductions the household has This customer needs to report increased earnings for Rocco, no other edits to Income/Deductions screen select green Next *For purposes of the scenario we will use the word User for account workers and privileged users September

55 Expedited Renewal Flow Scenario 1 User is taken to customer Household Income Details page Review all income household has This customer has increased income so input their Gross Monthly amount review screen and select green Next *For purposes of the scenario we will use the word User for account workers and privileged users September

56 Expedited Renewal Flow Scenario 1 User is routed to Application Review screen Take note that the Privacy Policy check box and Voter Registration will keep original selection User selects green Next *For purposes of the scenario we will use the word User for account workers and privileged users September

57 Expedited Renewal Flow Scenario 1 User electronically signs on the customers behalf Select Submit My Application for renewal eligibility results *For purposes of the scenario we will use the word User for account workers and privileged users September

58 Expedited Renewal Flow Scenario 1 User is provided Eligibility Status screen with their upcoming plan years eligibility Select Next to move forward to plan selection Customers eligibility has changed with the increased income. Their Apple Health ends 11/30 and Qualified health plan begins 12/1 *For purposes of the scenario we will use the word User for account workers and privileged users September

59 Expedited Renewal Flow Scenario 2 User calls the call center and is up for renewal. They are currently Apple Health Enrolled and need to remove an individual from their household User selects Update My Application and Renew from Quick Links User can also select link in notice to access renewal for customer *For purposes of the scenario we will use the word User for account workers and privileged users September

60 Expedited Renewal Flow Scenario 2 User is taken to Application Review screen Begin review process of customer account this customer has stated they need to remove a household member User attests up front to Washington Healthplanfinder Privacy Policy Once on Household Member s Information section select Edit This will put user to the Do you have other household members or tax dependents page User will be removed from the expedited renewal flow and follow all screens through signature to complete customer renewal *For purposes of the scenario we will use the word User for account workers and privileged users September

61 Expedited Renewal Flow Key Takeaways Users (account workers/navigators/brokers) have access to an expedited Apple Health and Qualified health plan renewal flow Expedited flow will put user into Application Review screen Users should review all sections on Application Review to verify customer household, address, tax filing, additional question answers, citizenship, etc. are still current Once Next is selected from Expedited flow user will always go through Income and Deductions screens If Edit is selected ANY TIME during the expedited flow users will be put into the normal renewal flow where all screens will be reviewed and clicked through esignature September

62 Re-Rating Functionality Users: individuals, navigators, brokers and account workers Made back end corrections to how and when re-rating occurs New text will display to the customer on the Eligibility Status page (the text will not show if a customer clicks View Current Eligibility Status link in quick links) Indicates to customer that there is or might be a change to their premium on Eligibility Status Operational Process built for follow-up with carriers on rate change in case the carrier doesn t apply the rate change September

63 Re-Rating Functionality Eligibility Status Messaging in blue states: Based on the report changes you made to your application, your monthly plan premium about has changed. To see your updated month premium, click Next. September

64 Forgot Username Messaging Users: individuals, employers/employees, navigators/brokers and account workers Update messaging for when a Washington Healthplanfinder user clicks Forgot Username September

65 Account Worker Updates Customer Service Application Tool Impacted users: account workers with Customer Service Application Customer Service Application tool enhancements (Conditional Eligibility Verification Team): Ability to create document and update a document category Adding document categories and validation check to existing web services to be similar to how the Washington Healthplanfinder performs Non-conditional eligibility verification document categories Life events/exemptions cannot be updated through Washington Healthplanfinder Document management web services Customer Service Application tool enhancements Carrier name added to coverage on dashboard Added phone number search to Advanced search Carrier Name added to Coverage Tab Background: Customer Service Application tool updates to align with 5.0 System Release changes. September

66 Account Worker Updates Customer Service Application Tool Dashboard September

67 Account Worker Updates Customer Service Application Tool Dashboard September

68 Impacted users: account workers Allow dental eligibility records to exist without health eligibility records (this refers to family dental, not pediatric dental. Pediatric dental is still a required purchase for individuals under 19 years old) Certain account workers ability to update eligibility to allow overlapping between Qualified health and dental plans with Apple Health (No overlapping coverage for Qualified health plans and Qualified health plans with tax credits) Certain account workers can create Qualified health plan for current year even if eligibility doesn t exist Account Worker Updates File Changes Eligibility for next year should not be created unless a determination or segment exits for the next coverage year No changes to Washington Healthplanfinder application and current batch processes Remove or Override all business validations from existing web services Allow account worker creation or modification of eligibility records for past and next year Background: Update existing web services to ensure Customer Service Application tool is able to update & process records more efficiently September

69 Back End Account Worker Updates Impacted users: account workers Enrollment Worker 3 user role mapped to most actions of Enrollment Manager role (except Self-Service Tool override) Manual ID proofing is available to both roles Enrollment Manager role will be updated to include ID Proofing access - no other updates to Enrollment Manager Role Background: ability for account worker role Enrollment Worker 3 to mirror Enrollment Manager Role. September

70 Lesson 4 Correspondence Changes

71 Correspondence Changes Lesson Course Title 4.1 Correspondence Subject Line Updates 4.2 New Correspondences/Tags 4.3 Updated/Removed Correspondences/Tags September

72 Subject Line Updates Correspondence ID# Current Subject Line Post 5.0 Subject Line ADM001 Forgot Username Username Reminder ADM002 Contact Information Update Contact Information Updated ADM005 Password Expiration Reminder Password Expiring ADM007 Password Update Password Updated ADM008 Broker/Navigator Partnership Update In-Person Help Update EE001 Additional Verification Required Important Deadline to Submit Information EE002 Upcoming Enrollment Deadline Enrollment Deadline for Coverage EE003 Incomplete Application Complete Your Application EE006 Affordable Health Coverage for Employees Letter to Employer EE015 Updated Eligibility Decision Eligibility Results EE017 Open Enrollment Starts on <<OE Start Date>> Time to Renew Your Coverage EE019 Plan Confirmed! Plan Selection Confirmed EE020 Address Update Address Update Needed September

73 New Correspondences/Tags In-Person Help Update (ADM 008) will be triggered with a broker/navigator accepts, terminates or declines a partnership New trigger Conditions for In-Person Help Update 1. Broker/navigator accept partnership Updated Conditional Eligibility Verification tag language in existing Qualified health plan tags Remove Eligibility Decision (EE004) correspondence from system Use Updated Eligibility Decision (EE015) correspondence. This correspondence title will be updated to: Eligibility Results Add new shopping tag to Eligibility Results (EE015) Text tag added to Plan Selection Confirmed (EE019) triggered at esignature - when change reporting family to dependent and vice versa for those who lost a plan and did not re-enroll September

74 In-Person Help Update (ADM008) In-Person Help Update (ADM008) [Accepts Partnership] Message Text Your request to partner with a <<Broker or Navigator>>, <<First name Last name>>, has been accepted. September

75 Eligibility Letters Eligibility Results (EE015) Eligibility Decision (EE004) September

76 Updated/Removed Correspondences & Tags Update Coverage Termination (EE012) correspondence to list members who termed from coverage and not all members this typically only applies to family to dependent only coverage and vice versa Correspondence data for Time to Renew Your Coverage (EE017) and Contact Information Updated (EE002) updated to reflect for current year Open Enrollment Period Joint Appeals Tag combining the Health Care Authority & Health Benefit Exchange tag into a single tag (eliminate duplication and reduce paper) Washington Apple Health Renewal Review Only (EE008) and Washington Apple Health Renewal - Action Required (EE009) tag updated Removing the words Subject Line from subject line and stating the letter name Current State Subject Line Additional Verification Required Future state Additional Verification Required WA Apple Health Information Request (EE005) Info Request Reason tag updated and User Generated tag updated so customers know to contact the Health Care Authority directly September

77 Lesson 5 Summary and Close

78 Impact to Customers Open Enrollment is November 1, 2017 January 15, 2018 Customers have the ability to change their plan from Shop for Plans button on Account Home Qualified health & dental plans can shop during Open Enrollment or during a Special Enrollment Period Apple Health customers can shop year round Customer Account Home messaging will be re-ordered and current year enrollment will be moved to the bottom while next year enrollment is listed at the top More tablet and mobile device responsive Washington Healthplanfinder screens Plan Summary page accessible from Account Home plan name September

79 Impact to Customers NEW consumer tool Smart Planfinder allows customers to answer a questionnaire incorporating their providers/facilities, prescription and health care usage to rank plans Up to 3 plans will be ranked Could be less than 3 if a county has limited plans offered Ranking is the best estimate for the customer Provider/Facility is not 100% accurate, customer should still contact carrier directly if they want 100% accuracy Qualified health plan customers can add up to 5 doctors/facilities in provider directory search to plan search Additional Quality Rating Measures incorporated - September

80 WAPlanfinder Individual users can download a mobile application to manage and view their Washington Healthplanfinder coverage WAPlanfinder allows individuals to search for In-Person Help from registered navigators and brokers Individuals can update their address and security questions with WAPlanfinder Individuals can view and anonymously browse Qualified health and dental options with WAPlanfinder September

81 Impact to Account Workers & Privileged Users Expedited customer renewal flow available to account workers and privileged users Expedited flow will be stopped if user selects Edit on Application Review page If customer has only income change to report do not select edit on Application Review screen Expedited flow will always route to review Income and Deductions pages even if no income change occurred Plan Management tool to search for Qualified health plan on Washington Healthplanfinder September

82