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Maryland Health Benefit Exchange
Board Meeting
IT Updates
Tuesday, March17, 2015
Presented by:
Subramanian Muniasamy CIO, MHBE
A service of Maryland Health Benefit Exchange
Agenda
• Status
• Enrollment Updates
• Maintenance & Operations (M&O) Releases
• Enhancement Updates
• Redeterminations & Verifications
• Q&A
1
Status of MD HBX Activities
M&O Releases
APR
FEB
JAN
January
February
JUN
April
AUG
June
August
Planning
Planning
Planning
Planning
Planning
Requirements
Requirements
Requirements
Requirements
Requirements
Design / Dev.
Design / Dev.
Design / Dev.
Design / Dev.
Design / Dev.
Testing
Testing
Testing
Testing
Testing
Implementation
Implementation
Implementation
Implementation
Implementation
Complete
On-Track
Planned
At Risk
JUL
Enhancements
Status
SEPT
Functionality – 1095 & Renewals
• Develop the functionality to support the automated
generation of 1095 forms for consumers who have
Requirements
enrolled in a qualified health plan (QHP) through
Maryland’s State Based Marketplace
Design / Dev.
• Streamline and update the renewal process to
Testing
promote the retention of active QHP/Advanced
Implementation Premium Tax Credit (APTC) consumers who are
enrolled in a QHP/APTC through Maryland’s State
Based Marketplace
Planning
Status
Planning
Requirements
Design / Dev.
Testing
Implementation
Functionality – Dental
• Develop new Health Benefit Exchange
screens to support side-by-side comparison
of stand-alone dental plans for consumers
during open enrollment
• Develop and implement dental plan
templates for completion by qualified dental
providers including creating and updating
SERFF templates
• Send 834 to dental carriers
Special Projects
Lower Environment Migration
•
•
•
•
Training & UAT environment setup are
100% complete
Foglight monitoring setup for the Training
& UAT environment is in progress
Setup of integration system and
development are in progress
Target completion by 3/31
MHBE Network Upgrade
• Enhancement to the MHBE VPN,
active directory, telephone etc., will be
completed prior to open enrollment for
2016
1095 & MA Database Transition
• 1095 & 8001 data has been provided by QSSI
and loaded into the new environment in the HBX
• 1095 Template is being constructed in SSRS
and change processes are being documented
Passive Renewals
• Approach completed and recorded scripts to load
required data
• Passive renewals for Care First are in progress
and passive renewals for Kaiser Permanent are
complete
• All passive renewals to be completed by 4/3
Legacy HIX Decommissioning
•
•
Development, testing, and production servers have
been powered off and backups are underway for
data preservation
Target completion by 3/31
Enrollment Overview
APTC
85,518
28.14%
QHP
35,282
11.61%
Medicaid
183,053
60.24%
As of: 3/11/2015
2
Enrollment Updates
In February Maryland residents who initiated health insurance enrollment
applications prior to February 15th were given an extension until February 28th
to complete the application
Special Enrollment Period
•
On February 20th, Centers for Medicare
& Medicaid Services (CMS) announced
a special enrollment period (SEP) for
individuals and families who did not have
health coverage in 2014
•
This special enrollment period will allow
those individuals or families to enroll for
health insurance and avoid paying a
penalty
•
The SEP commenced on March 15th and
runs through April 30th
Open Enrollment 2016
•
Open enrollment for 2016 will commence
on November 1st 2015 and run through
January 31st 2016
•
Activities to support open enrollment for
2016 have been initiated including
preparing for renewals and the
integration of dental services
3
Maintenance & Operations
(M&O) Releases
M&O releases are underway and occur approximately every eight (8) weeks
and the content of each release are prioritized across stakeholder groups
January & February 2015
•
•
Deployed into production
environment on 1/21 and 2/26 and
included 39 fixes
April 2015
•
Includes fixes for 17 defects
•
Key updates include:
o
Key updates included:
o
508 compliance
o
Language and tool tip
o
Special enrollment business rules
o
834 enrollment file updates
o
Notice and verification
o
Language preferences for brokers
o
o
o
Leveraging information from the
Maryland Automated Benefits
System (MABS) database for
monthly income verification
Updated plan and benefits template
for Kaiser Permanente
Updated Summary of Benefits
Coverage (SBC) for Evergreen
Health
MA eligibility determinations based
on 2015 FPL limits
March 2015 Hot Fixes
•
March hot fixes includes updates to the Spanish notice template, functionality to support the
special enrollment period and anonymous browsing capabilities for the special enrollment
period changes
4
Enhancement Updates
Jul.
31st
Jul.
31st
1
2
Renewals
• Streamline and update the renewal process to promote the retention of
active QHP/APTC consumers who are enrolled in a QHP/APTC through
Maryland’s State Based Marketplace
• Update the consumer portal to allow consumers to auto-enroll in
coverage for the next calendar year (2016)
• Develop functionality to auto-generate multiple renewal notices for
active QHP/APTC consumers 45 days and 15 days prior to the start of
the open enrollment period for the following calendar year
1095-A Reporting
• Automate the creation and distribution of 1095-A forms for each
individual enrolled in a qualified health plan (QHP) through Maryland’s
State Based Marketplace
• Develop the functionality to support the automated generation of 1095
forms for consumers who have enrolled in a QHP through Maryland’s
State Based Marketplace for 2015 and for all future enrollments
Dental
Sept.
25th
3
• Provide consumers access to the same policies and expertise of
a typical employer plan available in the commercial marketplace
• The dental shopping process will follow the current QHP plan
shopping and will facilitate single sign on
• Household plans will be displayed on the explore your options
page with various filters to enhance shopping experience
5
Redetermination & Verification
Activities
•
•
•
Redeterminations will
migrate approximately one
million Medicaid
consumers from three
systems into the current
health benefits exchange
Maryland Health Benefits
Exchange (MD HBE),
Department of Human
Resources (DHR), and
Department of Health &
Mental Hygiene (DHMH)
are collaborating to
manage and process the
increase of
redeterminations and
verifications
Forecasted Redeterminations
Actual
CARES
Legacy HIX/PAC
Forecasted Verification Checklists Generated
The MD HBE team also
expects a corresponding
increase in verification
checklist list (VCL)
activities
6
Q&A
7