Idaho Health Insurance Exchange DBA Your Health Idaho Your Health Idaho Tribal Technical Work Group Meeting Minutes May 7, 2014 Your Health Idaho Representatives Present: Alberto Gonzalez, Your Health Idaho (YHI) Operations Manager Jennifer Visser, Gallatin Public Affairs, Tribal Outreach and Education Coordinator Tribal Representatives Present: Pam Reisdorph, Nez Perce Tribe, CHS Supervisor Phyllis Nash, Nez Perce Tribe, Finance Manager Tina Bullock, Nez Perce Tribe, Billing Office Manager/Interim Executive Director Eva Hayes, Nez Perce Tribe, Patient Advocate Artrette Sampson, Nez Perce Tribe, Benefits Coordinator Vesta Moe, Nez Perce Tribe, Billing and Account Receivable Specialist Jenifer Williams, Nez Perce Tribe, Billing Technician Darren Williams, Nez Perce Tribe, Staff Attorney Sam Penney, Nez Perce Tribe, Nez Perce Tribal Executive Committee Wanda Dixey, Shoshone-Bannock Tribes, CHS Administrative Assistant Morionna Washakie, Not-TsooGah-Nee Indian Health Center, Business Office Manager Dora Truchot, Not-TsooGah-NeeIndianHealthCenter, Business Office, Benefits Coordinator Verona Blossom, Shoshone-Paiute Tribes, Benefits Manager Others Present: JamieLou Delavan, IDHW, Minority Health Coordinator and Cultural Liason Joyce Broadsword, IDHW, Regional Director and Tribal Programs Manager Kathy Skippen, IDHW, SUDS Program Specialist Elaine Dado, Northwest Portland Area Indian Health Board, Executive Administrative Assistant (208) 991.4911 714 W. State Street, Boise, Idaho 83702 www.YourHealthIdaho.org Introductions The meeting began at 9:05am at the Nimiipuu Health Center at 111 Bever Grade, Lapwai, ID 83540 with introductions and a welcome around the room and then with those on the conference line. Update on YHI Alberto Gonzalez then gave an high level overview of what the Idaho Health Exchange is, how it started, what it has accomplished and where it is headed in the future. He reviewed the initial challenges YHI faced (timeline, Federal platform failure and selecting IPAs rapidly) and well as the new vendors YHI has hired to create an Idaho technology platform. A part of this discussion was an overview of Idaho’s enrollment numbers (76,000 statewide). Joyce Broadsword asked what percentage of the population that enrolled was tribal. Alberto answered that according to verbal tracking accomplished by in-person assistors (IPAs) 178 of those were tribal. This number is an estimate and will be better determined under the new Idaho operating system. He additionally mentioned that he hoped that number would increase going forward with Tribal IPAs trained. JamieLou Delavan then asked when the Idaho technology platform would be ready. Alberto mentioned that YHI purchased an off-the-shelf product but that there would be a number of changes that need to be made in order for the system to work for Idaho. Development continues this summer to ensure functionality for GoLive. Vesta Moe also asked how many carriers are currently on the exchange. Alberto answered that there are now six carriers on the Idaho exchange with 146 products to choose from. Update on Your Health Idaho Tribal Policy Jennifer Visser gave an overview of each Tribe’s tribal consultation policy. This reviewed what YHI committed in the each policy (regular TTWG meetings and Tribal input). Verona Blossom asked about the status of signatures on the tribal consultation policies with each of the Tribes. Jennifer explained that the tribal consultation policies have been signed by the Coeur d’Alene Tribe, Kootenai Tribe and Nez Perce Tribe. The Shoshone-Bannock Tribes consultation policy has been pre-approved by legal counsel but needs final signature and approval from the Business Council.Wanda Dixey confirmed this status. The Shoshone-Paiute Tribes consultation policy is currently still under legal review. Update on TTWG The group then discussed who would be the tribal representative for each Tribe on the TTWG. Tina Bullock mentioned that she would like to serve at the Nez Perce TTWG representative with assistance from Eva Hayes and Artrette Sampson. These representatives will be formally approved by the Nez Perce HR Subcommittee. Wanda stated that she was in the process of being approved as the Shoshone-Bannock Tribes TTWG representative. This would be approved along with the tribal consultation policy. Verona Blossom stated that she anticipated that Anthony Marshall would be the TTWG representative for the Shoshone-Paiute Tribes. YHI will be following up with him on this possibility and next steps for accomplishing this. Following this discussion the group considered TTWG meeting scheduling. The present group thought that coordinating with the DHW quarterly meeting was helpful for all to attend; however, it may be best to have both meetings on one day if both groups can cover their respective topics in a half day time period. This will also be discussed with the Coeur d’Alene Tribe and Kootenai Tribe before a decision is made. At this time, YHI committed to send out a monthly newsletter/communication to TTWG members and those in the TTWG database. This communication would include updates about YHI and recent action taken. Update on IPA Agreements The next topic covered was an overview of IPAs and the status of these agreements with each tribe. Alberto explained that in the next open enrollment period there would be navigators, inperson assistors and certified application counselors. These individuals and groups will be going through a new training program that will be specific to the Idaho technology platform. Currently YHI has signed IPA agreements with the Coeur d’Alene Tribe and the Nez Perce Tribe. The Kootenai Tribe will not be receiving IPA funding from YHI at the Tribal Council’s choice (leadership did not believe they had a large enough population to serve). IPA agreements are still under legal review with the Shoshone-Bannock Tribes and the ShoshonePaiute Tribes. All tribes, excluding the Shoshone-Bannock Tribes, have at least one trained inperson assistor. Training for the Shoshone-Bannock Tribes is in the process of being scheduled. Eva mentioned that the training and testing for IPAs wasn’t very accurate or helpful. Alberto acknowledged this and stated it had been fixed and would be better implemented during thenext open enrollment. He also stated that the Tribal information in the IPA and agent and broker training system would come before the TTWG before approval for the next training module. The group also discussed if tribal IPAs would be required to serve non-tribal members. Eva mentioned that they had done so at the Nez Perce clinic but that they needed better tools to assist individuals. Eva shared some examples of informational sheets that they have used at their clinic. YHI will create branded tribal materials with relevant information from those flyers and other resources. Those documents will come before the TTWG for approval. It was also mentioned that certified IPAs would be listed on the consumer connector locator on the YHI website. Jamie asked how that system worked and Alberto explained that it searches the local area by zip code and in random order displays local assistance. Break The group took at 20 minute break and then reconvened. Tribal Impacts Tribal impacts that will come before the formal TTWG were reviewed. No decisions were made on any of these topics. Network Adequacy for QHPs Part of certifying QHPs is for Department of Insurance and YHI to ensure that the provider networks for each plan meet adequacy standards as defined by YHI. In cases where narrow networks exist, YHI would like to ensure that clear understanding of networks is disclosed. Benchmark Plan Selection Benefits are based on the second level base year plan. Alberto will bring more information about this to the next formal TTWG meeting. Tribal Sponsorship Program/Payment Processes for I/T/U for QHPs Each Tribe has the opportunity to do this for its members. YHI would create a mechanism for tribes to accomplish this if any tribe seeks to do so. It is possible that the existing SHOP function in the technology solution may be leveraged to serve as a portal for tribal sponsorship. Wanda stated that the Shoshone-Bannock Tribes will be doing a trial of this program with ten of their tribal members. Darren Williams mentioned that it would be ideal if the tribe could send money directly to the carrier in this system. Tina discussed the need to be able to analyze premiums and tax exemptions for patients if the Nez Perce Tribe were to implement this system. Creating a mechanism for tribal sponsorship programs is a top priority in YHI’s tribal initiatives. Alberto mentioned that he would like to have a demo of the overall Idaho technology solution for the TTWG at the next meeting. Vesta asked if pre-existing conditions still impacted insurance eligibility and Alberto explained that they are no longer a determining factor for insurance eligibility. Processes and Procedures for AI/AN Benefits and Protections YHI will need to ensure that plan designs and calculations will understand AI/AN specific situations (waivers, special enrollment, no penalties for non-insurance). Enrollment Assistance/Call Center Training/Tribal Materials Enrollment assistance consists of ensuring that call center,IPAs and agents and brokers training includes knowledge of AI/AN processes and procedures, tribal IPAs are trained, tribal specific materials are created (after approval from TTWG members) and education and enrollment events are held with each tribe. There was brief discussion about when tribal enrollment events should be held. It was determined that each tribe would coordinate with YHI to find a date before October 2014 to hold an enrollment event for tribal and community members at each tribes’ reservation. It was mentioned evenings during the work week may be the best time to maximize attendance along with coordinating events with local health fairs. Tribes will inform YHI about these events in advance so that enrollment events can be coordinated. Final Questions Artrette asked who IPAs should call for enrollment assistance and Alberto recommended the Idaho call center. Joyce recommended sharing the tribal specific processes and procedures with DOI so that the information can again be shared with certified agents and brokers. It was determined that acceptable forms of tribal verification needed to be addressed at the next TTWG meeting. Meeting Tasks YHI Action Items YHI will set a call with the Kootenai Tribe and Coeur d’Alene Tribe to review the first TTWG meeting and receive organizational input YHI will send a monthly newsletter/communication to update members of the TTWG and those in the TTWG database YHI will coordinate with each tribe to host an education and enrollment event on each reservation YHI will schedule an IPA training for the Shoshone-Bannock Tribes YHI will follow up with Anthony Marshall to determine/confirm TTWG representative for Shoshone-Paiute Tribes YHI will send the Nez Perce IPAs an IPA reporting form YHI will create a tribal informational handout YHI will send TTWG designees the past IPA training module YHI will seek more information on Essential Health Benefits for the next TTWG meeting YHI will have a trial of the Idaho technology solution at the next TTWG meeting, pending completion YHI and each Tribe will discuss tribal verification at the next TTWG meeting YHI will work to develop the mechanism for tribal sponsorship programs YHI will continue to update the TTWG contact database YHI will follow up with each tribe to confirm/determine formal TTWG designee Each Tribe Action Items Provide YHI with contacts that need to be in the TTWG database Provide YHI with list of trained IPAs Proved YHI with possible dates for tribal education and enrollment event Meeting Adjourned The meeting ended with a late lunch at 12:45pm.
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