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Board Meeting Agenda I. Call to Order
• Roll Call / Quorum
II. Chair’s Comments
III. Review and Approval of Agenda (10/24/14) and Approval of Minutes (10/3/14) – (DECISIONS)
IV. Public Comment
V. Executive Director and Staff Report
VI. Committee Reports
• Governance Committee Report • Board Officers • Commi4ee Assignments
VII. Contracts (DECISIONS)
VIII. Adjourn 1
Executive Director’s Summary
• Process – Each department leader will present status update • Summary:
• Open Enrollment -‐ the first priority • Renewal no@ces sent to consumers (10/15) • System tes@ng • Training Kokua
• CGI services • Five year plan for sustainability • Enhanced use of TurningPoint services for Independent
Verification and Validation (IV&V)
2
Executive Director’s Summary CGI Update: Amendment 6
• Reduced Maintenance & Opera@ons (M&O) costs and shortened dura@on of agreement
• Iden@fied remaining CGI development work to achieve a compliant system (e.g., 1095 IRS repor@ng)
• Applied to CMS for release of funds
3
Department Updates
Operational Improvements (Robin)
IT Status & Risks (Sunny/Robin)
Independent Validation and Verification (Corinna)
Marketing Update (Kevin)
Finance (Diane/Jeff)
Oversight & Policy (Eric)
4
Consumer Experience
• Improved consumer experience
• Contingency planning
• Streamlined application process
• Shorter wait times
• Usability upgrades and added functionality
• Higher capacity online and contact center capability
• Individual “in person” assistance for any customer
6
2014/2015 Comparison Func%onality 2014 2015
ü Complete an Applica@on Online, on the phone, or through a navigator ü Yes ü Yes
ü Create a secure user login for online access ü Yes ü Yes
ü Review your eligibility and appeal it by calling or wri@ng to us ü Yes ü Yes
ü Shop and compare plans online, by phone, or with a Navigator ü Yes ü Yes
ü Update your informa@on by calling us or through a Navigator ü Yes ü Yes
ü Reset your password by calling us ü Yes ü Yes
ü Send and receive messages by email, or web chat ü Yes ü Yes
ü Send us verifica@on documents by fax or mail ü Yes ü Yes
ü Extra layer of iden@ty protec@on for user logins x No ü Yes
ü Upload your own verifica@on docs online x No ü Yes
ü Send and receive messages through the portal x No ü Yes
ü Reset your password yourself x No ü Yes
ü Change in Circumstance self-‐service x No ü Yes
ü Submit an appeal, complaint or exemp@on online x No ü Yes
ü Employee Roster Self-‐Service x No ü Yes
ü Renew & Change Plans online x No ü Yes 7
I/F Usability Upgrades, 50
I/F New Func%onality,
10
SHOP Usability Upgrades, 75
SHOP New Func%onality,
12
Improvements for 2015
8
Staffing Plan
0
10
20
30
40
50
60
70
Full Time Em
ploy
ees RE
QUIRED
OPEN ENROLLMENT HEADCOUNT FORECAST
Worst Case Target Case Best Case
ü Hawaii-based Online Agents Increased ü Added California Overflow (Up to 25) ü 29 Operations Support Staff Ý 15 Temp ü Over 100 Kōkua & 50 Certified Brokers
ü Independent Call Center Review ü Shared Knowledge Among Front-Facing Staff ü 100% Playbooks and SOPs Delivered ü Operational QA, QC, and Contingency Plans
Hired Inbound Agents
8 Temp Data Entry and 7 Temp Enrolling Processing Staff
9
2015 Challenges • Training, coaching, testing and orienting new staff
• Contingency planning and workarounds
• Process changes to accommodate new circumstances
• “Change in Circumstance”, Renewals, and Exemptions are new in 2014
• First renewal cycle of plans
• Defects management process
• Improved SHOP functionality, but loss of issuer
• Supporting for Medicaid eligibility in two systems
Stage 1 Steady State
Stage 2 Vigilance
Stage 3 Con@ngency
Stage 4 Sunset & Monitor
Planning, and Control Promote Success
10
New Functionality: Renewals & Exemptions
• Renewals
Programmatic redetermination and renewal for non- financial and financial consumers
Supporting “Change in Circumstance”
• Exemptions
Online self-service or entering data of exemption applications
Special Enrollment Period automatically opens for Catastrophic Plan Selection
Issuing Certificate of Exemptions
11
SHOP Employer Experience
• Application process time reduced
• Continuing to provide both online and assisted service
• Focusing on 2015 Consumer Experience
• Fillable paper forms supported by data entry specialists
• Developing an Employer and Employee packet for customer service by navigators and brokers
• In-depth training for all customer-facing teams
12
Systems Update Metric October ’13 March ’14 September ’14
Page Refresh 1-‐2 minutes, then @ming out 3-‐7 seconds 1 second
End user Response %mes 1-‐3 minute range 20-‐30 seconds 2.76 seconds
Concurrent End Users 40 – 50 100 – 120 400+
Time to enroll 4-‐5 hours with mul@ple calls
2 hours – employer 75 mins / Employee 30 – 40 mins
14
Systems Update
Date Type Descrip%on
July 27, 2014 Release 3 229 Requirements, primarily in areas of Renewals, Change in Circumstance, 834s, and Repor@ng
Ongoing Defect Fixes Resolved 93 defects from Release 3 through 10/15
Ongoing Performance Enhancements
Installed New Relic system monitoring tool, enabling HHC to iden@fy trends and performance issues before they affect the customer experience
Installed Splunk to analyze log file data to help iden@fy root causes of defects
Configura@on and system tuning to enhance performance and stability
15
System Update
• User Acceptance Testing (UAT) and Issuer testing has been delayed from the originally-planned 10/6 start date
Release 3.2
• Improves individual and family plan display and processing enrollments
• Improves employer roster and employee enrollment
• Automates batch process for renewals
16
System Status From 2014 Open Enrollment period, the Connector has adopted various process improvements, as illustrated below:
• Additional defects may be found in future releases
17
9
0
1 5
5
Ac%ve
Insufficient Informa%on
Ready for Prod
Resolved Pending Confirma%on
Re-‐test for future Build
System Performance Test • With the rollout of the latest major release (Release 3) the system
will go through Performance Testing to measure load and performance capacity for responsiveness and stability under varying volumes
• Performance testing is scheduled to start on 10/27 and continue through 11/7 at the Disaster Recovery (alternate processing) site in Philadelphia
• During testing, the system configuration parameters will be adjusted based on the test outcome to achieve optimal system performance
18
IV&V Overview
ü Validation - The assurance that a product, service, or system meets the needs of the customer and other identified stakeholders. It often involves acceptance and suitability with external customers. Goal: Validate the planned solution is being built.
ü Verification - The evaluation of whether or not a product, service, or system complies with a regulation, requirement, specification, or imposed condition. It is often an internal process. Goal: Verify the solution is correct.
ü Verification and validation processes performed by an organization with technical, managerial, and financial independence from the system integration and development organization. Ø IV&V Goal - Independent review of correctness and adherence to plan.
19
Consolidated HHC IV&V Framework
20
Currently in place to provide technical and programmatic reviews that measure program health and identify risk for the following functional areas:
• Project Management • Functional and Technical
Requirements Development • COTS Specification, Evaluation
and Selection • Interface Specification • Design, Development,
Customization • Hardware and Infrastructure
• Quality Assurance • Independent Testing • Implementation and Integration • Training • Migration and Transition • Maintenance and Sustainment • Operational Oversight
IV&V Status
Ø Monthly Assessments and Status Reports are submitted to ConnectHawai’i. Assessments are also sent to CMS and posted on CALT.
Ø There are 305 closed findings since IV&V has been on the project. Ø There are 43 open findings to date, 6 new as of this last assessment
cycle submitted October 8th, and 29 findings which have been open for more than 6 months.
Ø All findings over 3 months old have been rolled into Corrective Action Plans for follow-up and closure.
–
21
High, 120
Med, 151
Low, 34
305 Closed Findingsby Risk Level
High
Med
Low
High, 15
Med, 23
Low, 5
43 Cumulative Open Findingsby Risk Level
High
Med
Low
Marketing Goals
24
Increase Awareness
• Individuals and Families who are uninsured, underinsured or who may experience a life change (e.g., job loss) who need coverage
• Small Businesses, with focus on qualifying firms
Educate on the Value and Services Provided
• Increase understanding and correct misinformation
Drive Action
• Meet a Kokua/Broker
• Call the contact center
• Or visit the website 23
Target Audiences
Individuals & Families 1. Subsidy Eligible: 138-‐400% of Federal Poverty Limit (FPL) 2. Exis@ng Members: Renewals 3. Others: Pre-‐exis@ng Condi@ons, Ineligibles, Job Loss, etc.
Small Businesses 1. Firms with 25 or fewer Full Time Employees (FTEs) 2. Firms with 25-‐50 FTEs 3. Influencers: CPAs, Tax Prep, Advisors
Other Audiences 1. Stakeholders 2. Press & Media
25
24
Marketing Proposition: Families
What we do
• The Easiest Way to Access the most affordable Healthcare Insurance
How we do it
• Inform, Educate and Guide
Why its valuable
• Increase well-‐being at the best price
25
Marketing Proposition: Small Business
What we do
• Help small businesses qualify for tax credit while complying with the state and federal health insurance laws
How we do it
• HHC provides unbiased informa%on and guidance
Why its valuable
• Users comply with the law, get free assistance doing so, and qualify for tax credits, which makes insurance through HHC the most affordable on the market
26
Financial Overview Detailed Budget to Follow
Diane Reich
Chief Financial Officer – Presented by Jeff Kissel
27
Grant Funding Update from November 29, 2011 - September 30, 2014
Grant Funding: • Spent $ 112,400,000 • Obligated 35,300,000 • Unobligated 52,500,000
$ 200,200,000
28
Expenditures to Date Inception to 9/30/14
Expenditures: • Personnel Costs $ 7,179,600 • IT Contracts 83,015,400 • Other Professional Expenses 16,450,400 • Operating Expenses 5,737,400
$112,382,800
29
Oversight
Treasury Inspector General • Scope of Audit (Internal Revenue Service) • Data Inconsistencies • 2014 Plan Year Plan
Government Accountability Office • Scope of Audit (State-‐based Marketplaces)
31