1. Business Concept Introduction & Update November 14, 2011

2.  August 22 – Discussion Draft  September 9 – Board Study Session  November 14 – Board Meeting Discussion  November 21 – Concept Revised  November 28 – Board Endorsement  January 2012 + Revisions During Implementation

3. 1. Background 2. Some Primary COHBE Principles 3. Mission and Startup Objectives 4. Core Functions and Business Partner Functions 5. What Can COHBE Accomplish? 6. Feedback from Board Study Session 7. Recommendation

4.  Stakeholder Discussions  Colorado SB-200  Federal Grant Requirements  Exchange Workgroups  Learning from other States  Dialogue with Companies

5.  New, Quasi-Governmental Entity  No State General Fund Resources  Planning and Implementing Simultaneously  Shortage of Comparison Models  Appeal of Simple Solutions  Challenging Economic Conditions  Keeping the Focus on Colorado

6. (high level) Individuals Insurer #2 COHBE Core Management Partner Agencies Business Partners Insurer # 1 Small Businesses Medicaid/ CHIP Brokers Outreach/Marketing Health Plan Choices Comparison Tools Streamlined Eligibility Enrollment/Purchase SHOP Functions Navigators

7.  Must Be Customer-Driven  Must Succeed with Existing Markets  Add Value to Markets…at the Lowest Cost  Maximize the Use of Existing Technology  Must Meet Business Requirements  Depends on Collaboration  Must Adapt to Change

8. “The mission of The Colorado Health Benefits Exchange is to increase access, affordability and choice for individuals and small employers purchasing health insurance in Colorado.”

9. 1. Apply for and receive federal funds to build the exchange operation 2. Build or otherwise acquire the capabilities necessary to meet federal exchange certification by January, 2013 3. Open for business by October, 2013, selling health insurance coverage to individuals and small business for an effective date of January 1, 2014 4. Offer a competitive choice of carriers, plan designs and services in the exchange.

10.  Outreach, Community Engagement and Marketing  Overall Organizational Design/Management:  State and Federal Relationships  Business Partnerships/Outsourcing  Health Insurance Market Relationships  Information Technology Planning  Financial Management and Planning  Compliance

11.  Web Portal  Eligibility System  Plan Comparisons/Decision Support Tools  Broker Support  Insurance Company Interface  Premium Collection and Remittance  Others…  (Transactions)

12. (high level) Individuals Insurer #2 COHBE Core Management Partner Agencies Business Partners Insurer # 1 Small Businesses Medicaid/ CHIP Brokers Outreach/Marketing Health Plan Choices Comparison Tools Streamlined Eligibility Enrollment/Purchase SHOP Functions Navigators

13.  Create an Expanded Health Benefits Marketplace  Invest in Colorado’s Economic Development  Be a Catalyst for Positive Change…  Simplify Health Insurance Purchasing  Increase Consumer Engagement  Stimulate New Solutions for Colorado

14.  Emphasize COHBE commitment to sustain community engagement across Colorado  Update Value Proposition, add Medicaid  Include consumer support: health literacy and decision-making  Include exchange’s role in enabling transparency and consumer understanding of coverage  Identify the positive role of the Exchange in health insurance change and health system improvement

15.  Market Research Report from Dr. Jon Gruber  Mid-November  Initial Projections for Exchange Size  Development of Financial Model  Market Feedback: Timeframes Growing Shorter  Disciplined timeframe needed to acquire/implement systems and business functions  Coordinate with state eligibility system changes  Provide carrier partners & others adequate time to link and test

16.  Colorado will build a “marketplace” model health insurance exchange,  With the stated Mission and Startup Objectives.  The operating model is based on:  Core Functions  Business Partnerships  Based on Added-Value to exchange participants,  Emphasizing cost and efficiency,  Customer-driven,  Adapting to markets as they change.

17.  “The Exchange will create a “world class” customer experience, attracting consumers to shop for insurance coverage, compare plans and enroll, plus have access to federally-financed tax credits and cost- sharing reductions to make their coverage more affordable.  By improving the consumer’s purchasing process, and by offering affordable health Insurance products, COHBE can substantially increase the number of individuals buying coverage. For insurance carriers, as suppliers of these products, this will help moderate overall marketplace risk and create new growth opportunities.”

18.  “COHBE will operate alongside existing carrier and broker sales and distribution channels. The Exchange will complement existing market capabilities and bring a similar “world class” experience tailored to serve small businesses.  The value to small employers will be driven primarily by service. Tax credits are available to qualified small employers. In addition, support services that make it simpler and easier for employers to offer coverage can be developed and provided through the Exchange.  The exchange can potentially reduce the expense of marketing to the very small (fewer than 10 employees) employer segment, provide more efficient administration and potentially maintain or increase the size of this market.”