Connector Board Hires Consultants, Discusses Small Business Coverage

Today, the Connector Board voted to approve consultant contracts for project management assistance to transform the Connector into an ACA-compliant Exchange and to provide analysis and strategy guidance around implementing ACA-required reinsurance, risk adjustment, and risk corridor programs. Connector staff also gave a comprehensive overview of the improved Business Express program.

Materials from the meeting are here; our full report is after the flip.

Executive Director’s Report (Glen Shor)
The FY13 Commonwealth Care MCO procurement is well underway, with RFPs released on February 16th, a bidders’ conference scheduled for February 27th and proposals due on March 16th. The Connector Board will discuss and vote on the procurement results at their April meeting.

In addition, current CommCare Bridge members will be reinstated into full Commonwealth Care coverage effective March 1st. Bridge members have the opportunity to switch plans during a special open enrollment period that ends tomorrow. The Connector is also working to prepare for the transition of the “waitlist” population currently receiving care through the Health Safety Net. This population will begin receiving notices informing them of their Commonwealth Care eligibility after March 26th.

Yesterday, the Connector received news from CMS that they were awarded an $11.6 million Level 1 Exchange Establishment Grant; some of these funds will go towards consulting contracts discussed below.

National Health Care Reform Transition Planning: Continuation of Project Management Assistance (Kaitlyn Kenney & Roni Mansur)
In the fall of 2011, the Connector entered into a contract with Deloitte for project management assistance to develop the Connector’s internal structure to become an ACA-compliant exchange in 2014. Phase 1 of the contract ends in June 2012 and Deloitte successfully completed all deliverables. Connector staff recommended to the Board extending the contract with Deloitte through Phase 2 of this work. The Board unanimously voted to approve the contract extension.

Phase 1

  • Conduct a multi-component current-state assessment and recommend transition governance
    model
  • Establish a Project Management Office (PMO)
  • Develop a “Health Connector 2.0” roadmap

Phase 2

  • Maintenance and facilitation of the transition governance model
  • Execution and operation of the PMO
  • Support of the “Health Connector 2.0” roadmap

Dolores Mitchell posited, “If this is complicated for us, what is happening in the rest of the country?” Jon Gruber responded that other states do not have to make a lot of the detailed policy decisions the Connector had to in the in beginning, for example, determining affordability, subsidy levels, and minimum creditable coverage. It is possible that different states may end up implementing the ACA at different paces. Gruber also emphasized how important it will be to get the front-end eligibility processes right as the new health coverage options under the ACA roll out.

Procurement for Consulting Assistance in Reinsurance, Risk Adjustment and Risk Corridor (“3R”) Planning (Jean Yang & Daniel Apicella)
The Affordable Care Act requires that states implement three risk mitigation programs in the small and non-group market – reinsurance, risk adjustment, and risk corridors – collectively referred to as the “3 R’s.” The primary objective of the 3 R’s is to stabilize premiums in the small and non-group market post-ACA implementation.

Nancy Turnbull asked whether Massachusetts might be able to opt out of creating a reinsurance program; while state law permits the Connector to establish a reinsurance program, it has not done so. There was lively discussion about this point, and Jean Yang said that the consultants will analyze the ACA and other available guidance to determine whether Massachusetts can opt out of implementing a reinsurance program.

The Health Connector and the Division of Insurance co-chair an interagency workgroup charged with developing the 3R implementation strategy for Massachusetts. The workgroup plans to have ongoing communication with carriers and other interested stakeholders.

An early milestone of the interagency workgroup is to engage a consultant to conduct comprehensive analysis of the state’s 3R implementation options and identify a preferred strategy. Through a procurement process, Connector staff identified Milliman, Inc. as the top choice. Milliman will subcontract with Mintz Levin LLC for regulatory and legal analysis. The Board voted to approve the contract with Milliman.

Business Express Re-Launch (Roni Mansur & Scott Devonshire)
Last week, the Connector re-launched Business Express, and embarked on an extensive marketing and outreach campaign to promote the program. Business Express allows small businesses to make “apples to apples” comparisons among health plans and choose one to cover their employees. The program has expanded to offer plans from the eight top Massachusetts carriers.

Key components of Business Express include:

  • Easy to use website
  • Choice of 53 health insurance plans and 6 levels of coverage
  • Wellness Track
  • No annual membership fees for small businesses
  • Rolling renewals (compared to one common anniversary date)

Wellness Track is a free program available to small businesses enrolled in a health plan through Business Express; some employers may be eligible for a 15% discount on their share of the premiums.

There was a discussion about limited and tiered network offerings within Business Express. Glen Shor responded that some limited network plans are offered, but no tiered networks. Tiered co-pay products have implications for the standardization of benefits in the program, but the Connector is open to looking at this, particularly in the 2013 Seal of Approval process.

The next Connector Board meeting is scheduled for Thursday, March 8th from 9-11am at One Ashburton Place, 21st floor.
-Suzanne Curry

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