HHC 141024-Board-Presentation-FINAL-PUBLIC-SESSION

Board Meeting October 24, 2014

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

Operational Improvements

Robin Weldon-Cope

Chief Consumer Engagement and Operations Officer

5

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

IT Status & Risks

Sunny Raheja presented by Robin Weldon-Cope

Chief Information Officer

13

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 Update

Kevin Hause

Business Development & Marketing

22

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 & Policy

Eric Alborg

Deputy Executive Director

30

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

Policy

Renewals •  Redetermina@ons  •  Medicaid  Renewals  

Stand-alone Dental Plan Guidance & FAQ

32

VI. Committee Reports

•  Governance Committee Report •  Board  Officers  •  Commi4ee  Assignments  

33

Contracts

•  IT Procurement •  Approval  of  IV&V  Contract  

34

Mahalo