Maryland Health Benefit Exchange
Implementation Advisory Committee
Meeting
September 18th, 2014
A service of Maryland Health Benefit Exchange
Welcome & Approval of Minutes
Michele Eberle
Acting Director, Plan & Partner Management
Maryland Health Benefit Exchange
A service of Maryland Health Benefit Exchange
HBX System Updates/Rate and
Benefit Extracts
Dennis Glorioso, MHBE PMO
A service of Maryland Health Benefit Exchange
Glossary
SIT – System Integration Testing
UAT – User Acceptance Testing
EDI – Electronic Data Interchange
Release 1 – Plan Management
Release 2 – Eligibility & Enrollment
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Agenda
System Implementation Timeline
Release 1 UAT
Release 2 SIT & UAT
Meetings
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System Implementation Update - Timeline
Today
UAT
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Release 1
Received feedback on rate and benefit extracts
Received updated plan templates
Correcting the major defects on our side identified with internal
review and your feedback
Loading the latest and greatest tomorrow morning
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EDI Testing
Ongoing EDI 834 testing
– Please reach out if you have concerns
Completion by October 3
– Receive all 999s and 834 effectuations
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Off-site testing
Thank you for taking the time to meet with us individually to review
anonymous browsing
Details on plan shopping validation will be emailed tomorrow
Require updated templates by COB Friday, September 26
– Focus on plan display Monday, Tuesday, & Wednesday of next week
– Reach out with any issues you encounter
– Plan Services has a documented plan update process for production
Off-site testing will include additional functionality
–
–
–
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Ability to create an application
Generate an 834
Complex scenarios
Require close coordination with our team. Details will be sent separately
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On-site Testing
October 13 – October 17: structured carrier UAT testing
– Full access to end-to-end system – hitting the FDSH, identity proofing, generating
834s, etc.
– MHBE-defined & ad-hoc scripts
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Plan Management Items
Plan Services
A service of Maryland Health Benefit Exchange
2015 Individual Market Plans
Individual Market Plans Available for 2015
Participating Medical Carrier/Lices
Number of
Plans
Metal Levels Available
All Savers (United Healthcare)
8
2 Bronze, 4 Silver, 1 Gold, 1 Catastophic
CareFirst of Maryland Inc.
4
1 Bronze, 1 Siver, 1 Gold, 1 Platinum
CareFirst BlueChoice, Inc.
11
3 Bronze, 3 Silver, 3 Gold, 1 Platinum, 1 Catastrophic
Cigna Health and Life
3
1 Bronze, 1 Silver, 1 Gold
Evergreen Health Cooperative
12
4 Bronze, 3 Silver, 3 Gold, 1 Platinum, 1 Catastrophic
Group Hospitalization and Medical Services, Inc.
(GHMSI)
4
1 Bronze, 1 Silver, 1 Gold, 1 Platinum
Kaiser Permanente
10
3 Bronze, 3 Silver, 2 Gold, 1 Platinum, 1 Catastrophic
OPM on behalf of CareFirst of Maryland (Multi-State
Plan)
2
1 Silver, 1 Gold
OPM on behalf of GHMSI (Multi-State Plan)
2
1 Silver, 1 Gold
United Healthcare of the Mid-Atlantic, Inc.
5
2 Bronze, 2 Silver, 1 Gold
2015 Individual Market Plans
Number of Plans by Metal Level
Bronze
17
Silver
18
Gold
13
Platinum
5
Catastrophic
4
State Benchmark Plans
Eighteen different silver level plans will be offered this year on the
Maryland Health Connection
Of these eighteen plans, three will serve as benchmark plans for the
2015 plan year.
Rating Areas 1 and 2 :
– Evergreen Health HMO Silver HSA/HRA 1700 Plan
Rating Area 3:
– BlueChoice HSA Silver $1300 Plan
Rating Area 4:
– KP MD Silver 1750/25%/HAS/Dental/Ped Dental
Premium Payment Guide - Reminder
Written Direction For Consumers
Copy at carrier’s discretion but must include:
Methods of acceptable payments and payment
dates
Modes of invoicing
Relevant Departments and Phone Numbers
Directions for logging into member portals
or A URL with this information
Instructions for when a consumer has not yet
received an invoice
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Carrier Webinar & Presentation Due Dates
All carriers will give their Navigator presentations on 9/19
Editing and production phase 9/22 through 9/26
Carrier review will occur concurrently
Final product 10/1
Please submit presentation materials by: 9/22
Carrier Handoffs – Warm Transfer Table
The Warm Transfer table describes the scenarios whereby
the MHBE Call Center would connect a consumer to a
specific customer service resource at a respective carrier.
This information is built into Call Center Representative
training.
The number of warm transfer resources are at a carrier’s
discretion.
Carrier Name
Reason for Warm
Transfer to Carrier
Phone
Number
Business
Hours
Special Instructions
for Callers
MHBE will distribute last year’s document to the carriers
New carriers are required to add language to the document
Please submit edits and updates by 9/26
Producer Appointment/Broker File Point of Contact
Carriers must provide MHBE a point of contact (or
instructions) for:
1. Producer Appointments
2. Producer Demographic File (Broker File)
Please submit information by 9/26
Provider changes to record for CRISP
MHBE will rely on carrier to submit changes, i.e. source of truth.
Life Events Update
Nabila Rahman, Optum
A service of Maryland Health Benefit Exchange
QDP Renewals & SADP Shopping
Michele Eberle, MHBE Plan Management
A service of Maryland Health Benefit Exchange
MHBE Communications
Michele Eberle, MHBE Plan Management
A service of Maryland Health Benefit Exchange
SHOP Update
Stephanie Lee, MHBE Plan Management
A service of Maryland Health Benefit Exchange
PUBLIC COMMENTS?
NEXT MEETING:
October 2nd, 2014
2:00 – 4:00PM
UMBC Tech Center
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