Exh C -CindyCroneInsurance
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Report to Joint House and Senate Public Health Committees Health Benefits Exchange Partnership Division Arkansas Insurance Department (AID) May 23, 2013 Since early 2012, the Arkansas Insurance Department’s Health Benefits Exchange Partnership Division has been working with state and federal partners—public and private--to design Arkansas’s State Partnership Marketplace (SPM). First Data Government Solutions serves a critical project management role, helping to coordinate and track multiple project activities, vendors, staff, advisory groups, interdependencies, deliverables, and progress. Based on background research, continuous monitoring and accelerated learning, the Arkansas project has built a solid foundation for Arkansas’s Partnership Marketplace while serving as a leader in state-led Plan Management and Consumer Assistance functions. Key Partnership Dates in 2013 January - AR was granted conditional approval from U.S. DHHS as a State Partnership Marketplace February – Level One “C” funding application submitted; Arkansas Health Connector logo developed; Direct mail/newspaper outreach to recruit In-Person Assister Guide applicants March – Released In-Person Assister Guide Entity and Outreach/Education vendor solicitations April – Awarded Level One “C” funding by DHHS Centers for Medicaid and Medicare Services (CMS), Center for Consumer Information and Insurance Oversight (CCIIO) for $16.5 million (MFG appropriation review 5/28/13); Arkansas Team met with CMS about Private Option; Outreach & Education anticipation to award announced May – Staff attended a CCIIO meeting with other SPM states; Contracted with Arkansas Department of Higher Education (ADHE) and Arkansas Association of Two Year Colleges (AATYC) for In-Person Assister Training for 637 Guides; Pending contracts with 30 “Guides” organizations (see attachment) and Mangan Holcomb Partners for statewide campaign June – Arkansas Team to attend CCIIO Implementation Review in Baltimore on June 19; Qualified Health Plan (QHP) applications due to AID June 30; IPA Guide Training begins (Phase I); Arkansas Health Connector Resource Center readies for increased activity July – Statewide multi-media campaign and Arkansas Health Connector Speakers’ Bureau (Arkansas Department of Health (ADH), Arkansas Minority Health Commission, U of A Partners for Inclusive Communities) to be launched; Arkansas Partnership to submit approved QHPs to DHHS for final review and approval; Evaluation vendor request for proposal (RFP) to be released August – Guides, Navigators, Certified Application Counselors, and Licensed Producers federal training is complete (Phase II) and certified QHPs check their plans on federal website September - QHPs sign contracts for Marketplace participation; Arkansas specific (Phase III) IPA training is complete and IPAs licensed; “Get Enrolled” campaign begins October 1 – March 31, 2014 – QHP Open Enrollment with full coverage beginning January 1, 2014 1 Consumer Assistance The Arkansas Health Connector logo will be on all promotional and educational materials distributed to the public, specifically potential consumers. Familiarity with this logo will serve as consumer protection as well as marketing function. The Arkansas Health Connector Resource Center will assist consumers with questions and connecting with appropriate resources. The AID is working to contract with 30 vendors across Arkansas to hire 637 “Guides” to serve uninsured residents in all 75 counties. One hundred (100) of these Guides will target Private Option eligible Arkansans with funding provided through Arkansas DHS. Each vendor will receive funding for a specific number of Guides who are expected to be trusted members of their community and provide accurate and unbiased information to eligible families and small business employees in ways they can understand as it is critical that uninsured Arkansans learn about their coverage options. Consultants from Public Consulting Group (PCG) helped with Arkansas Guide Program development. We are partnering with the ADHE and the AATYC to provide training for the 637 Guides and other “assisters” that will be needed to reach all areas of the state. Phase I and Phase III training will occur at 22 community colleges and one 4 year college throughout the state as well as through the Internet, and lead to the Navigator/Non-Navigator licensure as set forth by Act 1439 of 2013. Phase II, also required for Arkansas licensure, is provided via Internet training by the federal Marketplace. IPA Type Agents/Brokers Navigators Guides Phase I (State) June/July Certified Application Counselors X Phase II (Fed) July/August X X X X Phase III (State) August/Sept X X X X The Arkansas Health Connector advertising and marketing campaign is part of the State Partnership Marketplace outreach and education effort. Mangan Holcomb Partners, the primary vendor, is awaiting contract approval for this program. The firm’s marketing plans include targeting individuals, families, and small businesses to build a support network for people to learn about the Marketplace. Their approach is “local and personal” and includes a message of personal responsibility. The simple, direct, and consistent theme is . 2 Plan Management Issuers planning to provide QHPs in the Arkansas Partnership Marketplace will file a Letter of Intent by June 3rd declaring which service area(s) (see table below) they plan to cover. Beginning in 2014, newly determined and actuarially sound geographic rating areas will match service areas in the new Marketplace. Full QHP applications with rate and form filings are due June 30th, a date later than in most states. Arkansas delayed our application deadline due to the new opportunity provided to Issuers by the Healthcare Independence Act of 2013. On July 31, the Commissioner must recommend the Arkansas certified QHPs to the federal government for placement on the federal Health Insurance Marketplace portal. The federal government will contract with Issuers for the Arkansas Partnership Marketplace on September 4th. Open enrollment will run from October 1, 2013 – March 31, 2014, with full coverage beginning January 1, 2014. Arkansas Rating and Service Areas by Region Central Rating Area 1 Cleburne Lonoke Pulaski Yell Clay Fulton Jackson Randolph Woodruff Baxter Madison Washington Conway Perry Saline Faulkner Pope Van Buren Grant Prairie White Craighead Greene Lawrence Sharp Crittenden Independence Mississippi St. Francis Cross Izard Poinsett Stone Benton Marion Boone Newton Carroll Searcy South Central Rating Area 4 Clark Pike Garland Hot Spring Montgomery Southeast Rating Area 5 Arkansas Cleveland Jefferson Phillips Calhoun Lafayette Ouachita Ashley Dallas Lee Bradley Desha Lincoln Chicot Drew Monroe Columbia Little River Sevier Hempstead Miller Union Howard Nevada Crawford Scott Polk Franklin Sebastian Johnson Logan Northeast Rating Area 2 Northwest Rating Area 3 Southwest Rating Area 6 West Central Rating Area 7 3 An increased number of Issuers in Arkansas would help stabilize the Marketplace, give consumers choice, and decrease costs. In an effort to recruit new Issuers into the State, Commissioner Bradford and other health leaders have hosted multiple meetings with Issuers-- listening to their concerns and communicating the rules and regulations for the new Marketplace. Six issuers have attended multiple outreach sessions: Blue Cross Blue Shield of Arkansas, Coventry, NovaSys/Celtic, QualChoice, United Healthcare and United Security Life and Health Company. In addition, Arkansas is likely to get one and maybe two U.S. Office of Personnel Management (OPM) multi-state plans in 2014. In preparing for the QHP certification process over the past year, AID leaders have worked with multiple stakeholders to establish QHP certification standards and processes specific to Arkansas needs. Public Consulting Group (PCG) serves as our primary plan management planning vendor. Key decisions have included Arkansas’s plan to operate under an Open Marketplace (Certification vs. Competitive Bidding) business model. Robust stakeholder involvement has resulted in state specific standards which often differ from the federal default standard. Examples where Arkansas chose our own standards include: o o o o o Essential Health Benefits Benchmark Plan – different than the federal default plan Habilitative Services Definition – different than the default where issuers determine the definition Seven Rating Areas – different than the number of federal default rating areas Seven Service Areas – and requiring at least two Issuers in every county Tobacco Rating Upcharge of 1.2: 1 – different than the federally allowed 1.5: 1. Coordination continues among the Insurance Department, Department of Human Services, and the Arkansas Center for Health Improvement around the start of the Arkansas Healthcare Independence Program, otherwise known as the Private Option. AID was supportive of this legislation as a solution for decreasing the negative impact of consumers moving between Medicaid coverage and private plan coverage for low income Arkansans eligible for premium tax credits and other cost reduction subsidies. Contractors Manatt Health Solutions and Optumas have been instrumental in helping Arkansas study options and develop Arkansas’s response to covering more Arkansans through Medicaid Premium Assistance rather than growing the state Medicaid program. Federal Cooperation On June 19 in Baltimore, Insurance Department officials will meet with leaders from the Center for Consumer Information & Insurance Oversight for the Implementation Review of Arkansas’s Marketplace planning efforts. We have every reason to be confident that our federal partners will continue to be supportive of the progress in Arkansas. The federal government requires that, in advertising and educational materials, Partnership states include the logo (below) indicating their participation in the Federally-Facilitated Marketplace for eligibility determination and enrollment. For more information contact Cynthia Crone at 501-683-3634 or Cynthia.Crone@Arkansas.Gov 4 IPA Guide Entities by County County Arkansas Arkansas Arkansas Arkansas Entity Arkansas Dept of Health Community Health Centers of Arkansas Tri-County Rural Health Network Tri-County Rural Health Network Ashley Ashley Ashley Arkansas Dept of Health Tri-County Rural Health Network Tri-County Rural Health Network Baxter Baxter Arkansas Dept of Health Arkansas Dept of Health Benton Benton Benton Benton Benton Benton Arkansas Dept of Health Bost Inc. Bost Inc. Community Health Centers of Arkansas Mental Health Council of Arkansas The Hispanic Women's Organization of Arkansas Boone Boone Boone Boone Boone Boone Arkansas Dept of Health Arkansas Guide Organization Bost Inc. Bost Inc. Friendship Community Care, Inc Mental Health Council of Arkansas Bradley Bradley Bradley Arkansas Dept of Health Arkansas Dept of Health Options for Life Services Calhoun Calhoun Arkansas Dept of Health Community Health Centers of Arkansas Carroll Carroll Carroll Carroll Carroll Arkansas Dept of Health Arkansas Guide Organization Bost Inc. Bost Inc. Community Health Centers of Arkansas Chicot Chicot Chicot Arkansas Dept of Health Tri-County Rural Health Network Tri-County Rural Health Network Clark Clark Clark Arkansas Dept of Health Community Health Centers of Arkansas Community Health Centers of Arkansas 5 County Entity Clay Clay Clay Arkansas Dept of Health Covenant Medical Benefits, Inc Covenant Medical Benefits, Inc Cleburne Cleburne Cleburne Arkansas Dept of Health Arkansas Dept of Health Mental Health Council of Arkansas Cleveland Cleveland Cleveland Arkansas Dept of Health Community Health Centers of Arkansas Community Health Centers of Arkansas Columbia Columbia Columbia Arkansas Dept of Health Arkansas Dept of Health Options for Life Services Conway Conway Conway Arkansas Dept of Health In Affordable Housing, Inc In Affordable Housing, Inc Craighead Craighead Craighead Craighead Arkansas Dept of Health Covenant Medical Benefits, Inc Covenant Medical Benefits, Inc Mental Health Council of Arkansas Crawford Crawford Crawford Crawford Crawford Crawford Crittenden Crittenden Crittenden Crittenden Crittenden Crittenden Arkansas Dept of Health Bost Inc. Bost Inc. Community Health Centers of Arkansas Harbour House Mental Health Council of Arkansas Arkansas Dept of Health Arkansas Minority Health Choccross Community Health Centers of Arkansas Tri-County Rural Health Network Tri-County Rural Health Network Cross Cross Cross Cross Arkansas Dept of Health Covenant Medical Benefits, Inc Covenant Medical Benefits, Inc Choccross Dallas Dallas Dallas Arkansas Dept of Health Arkansas Dept of Health Options for Life Services Desha Desha Desha Desha Arkansas Dept of Health Arkansas Minority Health Tri-County Rural Health Network Tri-County Rural Health Network 6 County Entity Drew Drew Drew Drew Arkansas Dept of Health Community Health Centers of Arkansas Tri-County Rural Health Network Tri-County Rural Health Network Faulkner Faulkner Faulkner Faulkner Faulkner Faulkner Faulkner Faulkner Franklin Franklin Franklin Fulton Fulton Arkansas Dept of Health Arkansas State Chamber of Commerce Arkansas Health Care Access Foundation Central Arkansas Library System Future Builders Future Builders In Affordable Housing, Inc Living and Affected Corporation Arkansas Dept of Health Bost Inc. Bost Inc. Arkansas Dept of Health Arkansas Dept of Health Garland Garland Garland Garland Garland Garland Arkansas Dept of Health Arkansas State Chamber of Commerce Future Builders In Affordable Housing, Inc Living and Affected Corporation Quapaw House, Inc. Grant Grant Grant Grant Grant Arkansas Dept of Health Future Builders In Affordable Housing, Inc Southeast Arkansas Behavioral Healthcare System, Inc. Arkansas State Chamber of Commerce Greene Greene Greene Greene Arkansas Dept of Health Community Health Centers of Arkansas Covenant Medical Benefits, Inc Covenant Medical Benefits, Inc Hempstead Hempstead Hempstead Hempstead Arkansas Dept of Health Community Health Centers of Arkansas Community Health Centers of Arkansas Options for Life Services Hot Spring Hot Spring Hot Spring Arkansas Dept of Health Arkansas Dept of Health Arkansas Health Care Access Foundation Howard Howard Howard Arkansas Dept of Health Arkansas Dept of Health Options for Life Services 7 County Independence Independence Independence Entity Arkansas Dept of Health Arkansas Dept of Health Mental Health Council of Arkansas Izard Izard Arkansas Dept of Health Arkansas Dept of Health Jackson Jackson Jackson Arkansas Dept of Health Covenant Medical Benefits, Inc Covenant Medical Benefits, Inc Jefferson Jefferson Jefferson Jefferson Jefferson Jefferson Jefferson Jefferson Jefferson Jefferson Arkansas Dept of Health Arkansas Health Care Access Foundation Central Arkansas Library System Future Builders Living and Affected Corporation Options for Life Services Southeast Arkansas Behavioral Healthcare System, Inc. Tri-County Rural Health Network Wilkins Training and Development, LLC Wilkins Training and Development, LLC Johnson Johnson Johnson Arkansas Dept of Health Bost Inc. Bost Inc. Lafayette Lafayette Lafayette Arkansas Dept of Health Community Health Centers of Arkansas Options for Life Services Lawrence Lawrence Lawrence Lawrence Arkansas Dept of Health Community Health Centers of Arkansas Covenant Medical Benefits, Inc Covenant Medical Benefits, Inc Lee Lee Lee Lee Arkansas Dept of Health Choccross Tri-County Rural Health Network Tri-County Rural Health Network Lincoln Lincoln Lincoln Lincoln Arkansas Dept of Health Community Health Centers of Arkansas Tri-County Rural Health Network Tri-County Rural Health Network Little River Little River Little River Arkansas Dept of Health Arkansas Dept of Health Options for Life Services Logan Logan Logan Arkansas Dept of Health Bost Inc. Bost Inc. 8 County Logan Entity Community Health Centers of Arkansas Lonoke Lonoke Lonoke Lonoke Lonoke Lonoke Madison Madison Madison Arkansas Dept of Health Arkansas State Chamber of Commerce Central Arkansas Library System Future Builders In Affordable Housing, Inc In Affordable Housing, Inc Arkansas Dept of Health Arkansas Guide Organization Arkansas Guide Organization Marion Marion Marion Marion Arkansas Dept of Health Arkansas Guide Organization Arkansas Guide Organization Community Health Centers of Arkansas Miller Miller Miller Miller Arkansas Dept of Health Arkansas Dept of Health Mental Health Council of Arkansas Options for Life Services Mississippi Mississippi Mississippi Mississippi Arkansas Dept of Health Covenant Medical Benefits, Inc Tri-County Rural Health Network Tri-County Rural Health Network Monroe Monroe Monroe Arkansas Dept of Health Choccross Tri-County Rural Health Network Montgomery Montgomery Montgomery Arkansas Dept of Health Arkansas Dept of Health Community Health Centers of Arkansas Nevada Nevada Nevada Arkansas Dept of Health Arkansas Dept of Health Options for Life Services Newton Newton Newton Arkansas Dept of Health Bost Inc. Community Health Centers of Arkansas Ouachita Ouachita Ouachita Ouachita Arkansas Dept of Health Arkansas Dept of Health Arkansas Minority Health Community Health Centers of Arkansas Perry Perry Perry Arkansas Dept of Health Future Builders Phillips Arkansas State Chamber of Commerce Arkansas Dept of Health 9 County Phillips Phillips Phillips Phillips Entity Arkansas Minority Health Community Health Centers of Arkansas Tri-County Rural Health Network Tri-County Rural Health Network Pike Pike Arkansas Dept of Health Arkansas Dept of Health Poinsett Poinsett Poinsett Poinsett Arkansas Dept of Health Community Health Centers of Arkansas Covenant Medical Benefits, Inc Covenant Medical Benefits, Inc Polk Polk Polk Polk Arkansas Dept of Health Arkansas Dept of Health Community Health Centers of Arkansas Harbour House Pope Pope Pope Pope Arkansas Dept of Health Bost Inc. Bost Inc. Friendship Community Care, Inc Prairie Prairie Arkansas Dept of Health Arkansas Dept of Health Pulaski Pulaski Pulaski Pulaski Pulaski Pulaski Pulaski Pulaski Pulaski Pulaski Pulaski Pulaski Pulaski Pulaski Pulaski Pulaski Pulaski Pulaski Pulaski Arkansas Dept of Health Arkansas Dept of Health Arkansas State Chamber of Commerce Arkansas Health Care Access Foundation Arkansas Minority Health Arkansas Voices for the Children Left Behind Better Community Development, Inc Central Arkansas Volunteers In Medicine Clinic, Inc Central Arkansas Library System Community Health Centers of Arkansas Community Health Centers of Arkansas Future Builders Future Builders Hope Restoration In Affordable Housing, Inc Living and Affected Corporation Mental Health Council of Arkansas Wilkins Training and Development, LLC Women's Council on AA Affairs Randolph Randolph Randolph Arkansas Dept of Health Community Health Centers of Arkansas Covenant Medical Benefits, Inc 10 County Randolph Entity Covenant Medical Benefits, Inc Saline Saline Saline Saline Saline Saline Scott Scott Arkansas Dept of Health Arkansas State Chamber of Commerce Central Arkansas Library System Future Builders Future Builders Living and Affected Corporation Arkansas Dept of Health Arkansas Dept of Health Searcy Searcy Searcy Arkansas Dept of Health Arkansas Guide Organization Community Health Centers of Arkansas Sebastian Sebastian Sebastian Sebastian Sebastian Sebastian Sebastian Arkansas Dept of Health Bost Inc. Bost Inc. Community Health Centers of Arkansas Harbour House Living and Affected Corporation Mental Health Council of Arkansas Sevier Sevier Sevier Sevier Sevier Arkansas Dept of Health Arkansas Minority Health Community Health Centers of Arkansas Community Health Centers of Arkansas Mental Health Council of Arkansas Sharp Arkansas Dept of Health Sharp Sharp Covenant Medical Benefits, Inc Covenant Medical Benefits, Inc St Francis St Francis St. Francis St. Francis East Arkansas Enterprise Community East Arkansas Enterprise Community Arkansas Dept of Health Arkansas Minority Health Stone Stone Stone Arkansas Dept of Health Arkansas Dept of Health Friendship Community Care, Inc Union Union Union Union Union Union Arkansas Dept of Health Arkansas Dept of Health Arkansas Minority Health Community Health Centers of Arkansas Mental Health Council of Arkansas Options for Life Services Van Buren Van Buren Arkansas Dept of Health Community Health Centers of Arkansas 11 County Van Buren Entity In Affordable Housing, Inc Washington Washington Washington Washington Washington Washington Washington Washington Arkansas Dept of Health Bost Inc. Bost Inc. Community Health Centers of Arkansas Economic Opportunity Agency of Washington County Friendship Community Care, Inc Mental Health Council of Arkansas The Hispanic Women's Organization of Arkansas White White White White Arkansas Dept of Health In Affordable Housing, Inc In Affordable Housing, Inc Mental Health Council of Arkansas Woodruff Arkansas Dept of Health Woodruff Tri-County Rural Health Network Yell Yell Yell Yell Arkansas Dept of Health Bost Inc. In Affordable Housing, Inc In Affordable Housing, Inc Color Purpose Health Care Independence Act (HCIA) Positions for DHS Central Health Region Northwest Health Region Northeast Health Region Southeast Health Region Southwest Health Region 12 DHHS/ CCIIO Funding to Date Name of Grant Contract Number Original Planning Grant HBEIE100001-01-00 Administrative Supplement HBEIE100001-01-02 Level 1 A HBEIE120108-01-00 Level 1 B HBEIE120136-01-00 1A No Cost Extension 1B No Cost Extension Level 1 C pending 1 HBEIE130160-01-00 Dates Amount 9/30/2010-09/29/2011 4/1/2012-9/29/2012 02/22/2012-02/21/2013 09/27/2012- 09/26/2013 Extends Level 1 A through 2013 Through 12/31/2013 7/1/2013-6/30/2014 Totals Salaries Fringe Travel Supplies Equipment Other $140,920.00 $38,346.00 $32,102.00 $4,407.00 $1,186.00 $6,996.00 $336,690.00 $142,303.00 $65,618.00 $550,580.00 $174,647.00 $121,186.00 $29,073.00 $52.00 NA $21,560.00 $46,107.00 $17,761.00 $24,563.00 $717,235.00 $6,711.00 $181,576.00 $37,740.00 $28,948.00 $7,032,624.00 $47,900.00 $202,461.00 $17,452,191.00 $0.00 $0.00 $16,470,852.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $708,898.00 $224,314.00 $96,201.00 $0.00 $0.00 $34,040.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $104,047.60 $163,018.28 $15,084,763.00 $43,932,334.56 $1,741,495.00 $580,796.00 $322,103.00 $130,832.00 $189,687.60 $425,701.28 $40,468,389.00 Future Grants Level 1 D TBD 8/15/13- 8/15/14 Current/ Pending Contracts Contractor Statement of Work Dates Contract Amount Level 1 A ACHI ACHI DIS UA Partners L&E Actuary CAI INA Contract $1,000,000.00 $200,927.56 $7,665,483.00 $18,595,072.00 APCD+ Outreach Education Campaign Program Manager Stakeholder Engagement Actuary Consultant Evaluation Consultant IT Development - Software Licensing 06/01/2012 - 01/31/2014 08/20/2012 - 02/28/2013 5/14/2012 - 05/13/2013 Pending approval 8/9/2012 Upcoming RFP Under negotiation $ $ $ $ $ $ $ 500,051.22 1,515,743.76 150,420.00 100,000.00 203,000.00 704,000.00 400,000.00 IT Development - Contract, Application, and Learning Management System Legal Consultation Web Designer 03/08/2013 -02/21/2013 5/15/2013 12/5/2012 $ $ $ 1,150,000.00 5,000.00 10,200.00 13 Contractor Statement of Work Dates Contract Amount Level 1 B First Data Procurement Development, Planning Coordination and Integration, Overall Project MGT Consultant 1/1/2013 - 12/31/2013 $ 726,750.00 PCG Navigator Program Development 2/22/2013 - 09/30/2013 $ 93,894.00 PCG QHP Consultant 2/22/2013 - 09/30/2013 $ 219,000.00 Manatt IPA Contracts Reinsurance Program Development In-Person Assister Entities to assist enrollment 10/2/2012 - 09/30/2013 Under negotiation $ $ 1,200,000.00 7,258,388.00 Ark Dept of Health Regional IPA Specialists 01/26/2013 - 09/26/2013 $ 351,450.00 Mangan Holcomb Partners Outreach Education Campaign Pending ALC approval $ 4,300,000.00 Contractor Statement of Work Dates Contract Amount Arkansas HomeTown Health PCG IPA Contracts L&E Actuary Procurement Development, Planning Coordination and Integration, Overall Project MGT Consultant Continuation of Plan Management Continuation of existing contracts Continuation of Actuarial Services $ $ $ $ 333,073.00 227,000.00 9,020,500.00 157,500.00 Data Mgt & Systems Integration Continuation of Data Mgt & Systems Integration $ 150,240.00 To Be Determined Continuation of Outreach Education Campaign $ 5,196,450.00 Level 1 C 14
