J_HCE_2016A 06/09/2016 Committee Summary

09:01 AM -- Discussion of Carrier Transitions for 2017



Representative Primavera called the meeting to order. A copy of the meeting agenda was distributed (Attachment A). Kevin Patterson, Chief Executive Director, Connect for Health Colorado, discussed the insurance carriers that are leaving the individual market and those carriers that are reducing their offerings through the Colorado's health insurance exchange (exchange). United Healthcare and Humana Insurance will not offer individual plans in 2017, and Rocky Mountain Health Plans and Anthem Blue Cross and Blue Shield will reduce their offering on the individual market. Mr. Patterson stated that Bright Health Plans is possibly entering the individual market for 2017. Mr. Patterson said that seven carriers will offer plans on individual market through the exchange and four carriers will offer small group plans through the exchange. He said about 44,000 exchange customers will have to select new plans for 2017. He discussed how Connect for Health Colorado will communicate with clients about the changes occurring to the exchange options for 2017.



160609 AttachA.pdf





09:06 AM



In response to questions, Mr. Patterson stated that about 92,000 exchange customers will not be effected by the departure of carriers from the market. Steve ErkenBrack, Connect for Health Colorado Board Vice-chair and Rocky Mountain Health Plans President and CEO, responded to questions about why carriers are leaving or reducing offerings on the individual market. He discussed the impact of guaranty issue on the individual insurance market and medical loss ratio. He discussed the impact the individual plan clients are having on the other clients covered by Rocky Mountain Health Plans. Committee discussion with Mr. ErkenBrack about the individual marketplace and Rocky Mountain Health Plans ensued.



09:18 AM



Mr. Patterson answered questions about how the changes in the individual market will effect individuals, how Connect for Health Colorado monitors the number of plans that are offered in various parts of the state, and the rate increases that are expected for 2017. He discussed how the subsidy rates are calculated and the analysis that Connect for Health Colorado conducts related to the rates individuals pay for insurance premiums. Mr. ErkenBrack discussed how actuaries are involved in setting premium rates and the unknown factors related to premium stabilization funds. Committee discussion with Mr. Patterson about the individual market and Bright Health Plans ensued. In response to a question, Mr. ErkenBrack discussed Rocky Mountain Health Plans' Monument Health PPO Plan. Mr. Patterson answered a question about how to prevent other carriers from leaving the market.



09:35 AM -- Presentation of FY 2016-17 Budget and Strategic Plan Update



Mr. Patterson presented the Fiscal Year 2017 Draft Budget handout (Attachment B). He stated there is no new revenue assumed in the 2017 budget. He discussed the efforts to establish a Medicaid cost recovery model with the Department of Health Care Policy and Financing and the federal government. He discussed efforts to reduce wait times and manual technological work-arounds. He discussed establishing a capital reserve for future funding needs. Mr. Patterson reviewed the key fiscal year 2017 budget assumptions outlined on page 2 of the handout.



160609 AttachB.pdf



09:42 AM



Brian Braun, Chief Financial Officer, Connect for Health Colorado; Marguerite Salazar, Commissioner of Insurance; and Mr. Patterson answered questions about the premium tax credit. Peg Brown, Chief Deputy Insurance Commissioner, responded to questions about premium tax credits and referenced Section 10-22-110, C.R.S. Adele Flores-Brennan, Connect for Health Colorado Board Chair, answered questions about the requirements for the exchange to be self-sustaining. Ms. Flores-Brennan and Ms. Brown discussed House Bill 13-1245, concerning funding mechanisms for the Colorado health benefit exchange.



09:53 AM



Mr. Patterson continued discussion of the FY 2017 Budget, including the income from operations, cash balances, and forecasted quarterly financial positions. Mr. Patterson and Mr. Braun answered questions about how the exchange is addressing the losses in revenue outlined on page 3 of the handout. Mr. Patterson discussed the carrier fee revenue, special fee assessment revenue, and grant revenue. Mr. Patterson answered questions about how technology spending will be reduced and reductions in the marketing and outreach budget. In response to a question, Mr. Patterson stated that about 45 percent of the exchange's customers do not receive the advance premium tax credit. Mr. Patterson discussed the exchange's relationship with insurance brokers.









10:11 AM



Mr. Patterson discussed the potential additional revenue and expense impacts outlined on page 10 of the handout. Mr. Patterson answered questions about the public benefit corporation option, which might be gap coverage or vision insurance. He answered questions about the Medicaid cost recovery model.



10:19 AM



Mr. Patterson reviewed the 24 Month Projection on pages 11 through 13 of the handout. Mr. Braun answered questions about the carrier fees increase. Mr. Patterson reviewed the budget line components of customer services operations, technology, administration, marketing and outreach, and assistance network. Mr. Patterson answered questions about advance premium tax credits. Mr. Patterson discussed the relationship between Connect for Health Colorado, Centers for Medicare and Medicaid Services, and Department of Health Care Policy and Financing. He discussed the strategic plan formulation and the involvement of stakeholders in developing the strategic plan.



10:38 AM



The committee recessed.



10:46 AM -- Presentation on Small Business Health Options Program (SHOP)



Representative Primavera called the committee back to order. Mr. Patterson presented the Legislative Oversight Committee Small Business Health Options Program (SHOP) Update handout (Attachment C). According to the handout, there are 375 small groups currently enrolled in the SHOP, which equals over 2,800 covered lives. He reviewed the SHOP carriers, which are Kaiser Permanente, Rocky Mountain Health Plans, Anthem Blue Cross and Blue Shield, and Colorado Choice. Mr. Patterson discussed the efforts to improve the SHOP, which include improving the user interface, reducing the number of screens need for enrollment, and broker training on the SHOP.



160609 AttachC.pdf



10:50 AM



Ms. Brown answered questions about the rating for small businesses. She stated that in Colorado a small group is an employer group with up to 100 employees. Mr. Patterson answered questions about multi-carrier plans and the involvement of brokers in the SHOP. Discussion occurred about the low involvement of small businesses in the SHOP and the factors that may contribute to the low involvement, such as the low tax credit amounts and the limited carrier choices. In response to a question, Mr. Patterson said that carriers were not leaving the SHOP. Committee discussion continued with Mr. Patterson about the SHOP marketplace, including if there are ways to simplify the SHOP for small businesses.





11:04 AM



Mr. Patterson commented on the restructuring of the advisory groups outlined in the 2016 Meeting Organization Chart handout (Attachment D). He stated that the advisory groups and board meetings are open to the public. Senator Kefalas and Mr. Patterson discussed the groups that were created under House Bill 16-1148, concerning the oversight authority of the health insurance exchange oversight committee with regard to policies that affect consumers proposed by the health benefit exchange. Senator Kefalas referenced the House Bill 16-1148 and Senate Bill 16-008 Implementation Plan handout (Attachment E).



160609 AttachD.pdf160609 AttachE.pdf



11:07 AM



Ms. Flores-Brennan responded to questions about the advisory groups that were created by House Bill 16-1148. She explained that some of the advisory groups have been consolidated into one advisory group.



11:09 AM



In response to a question, Mr. Patterson discussed the exchange's sustainability and the issues around consolidating some exchange functions with the federal exchange.



11:14 AM



Mr. Patterson further discussed Attachment E and answered questions about the House Bill 16-1148 Implementation Plan.



11:20 AM -- Discussion of Future Meeting Dates



Amanda King, Legislative Council Staff, discussed the committee's meeting requirements, the timeline and deadlines for the committee to request legislation. A memorandum providing an overview of the committee (Attachment F) and a memorandum concerning the 2016 interim committee deadlines and procedures for proposing legislation (Attachment G) were distributed to the committee. Committee discussion about possible future meeting dates ensued.



160609 AttachF.pdf160609 AttachG.pdf



Committee members suggested presentation topics for future meeting, including what other states are doing to enhance enrollment, people dropping insurance coverage after receiving medical care, House Bill 16-1148 implementation, Colorado Commission on Affordable Health Care, the Division of Insurance's single geographic rating study, rural health insurance rates, All Payer Claims Database, the impact of reductions to uncompensated care, 2017 insurance rates, the possibility of establishing a group rate for the individual market, premium tax credit for insurance companies that contribute to the exchange, and the difference between projected enrollments and the actual enrollments on the exchange.





Ms. King said that staff would work with Representative Primavera to arrange the requested presentations and plan future meetings.



11:35 AM -- Public Comment



No one signed up to make public comments to the committee. Representative Primavera adjourned the meeting.