California Health Benefit Exchange Level 1.2 Establishment Grant -- Draft Narrative and Work Plan David Maxwell-Jolly Chief Operating Officer California Health Benefit Exchange California Health Benefit Exchange Board Meeting June 19, 2012

Level 1.2 Establishment Grant Narrative: Major Areas Covered 1.Background Research and Evaluation 2.Stakeholder Consultation 3.Governance, Legislative and Regulatory 4.Program Integration 5.Qualified Health Plan Management 6.SHOP 7.Eligibility and Enrollment 8.Consumer Assistance and Outreach 9.Information Technology 10.Operations and Financial Management

Level 1.2 Establishment Grant Narrative: Accomplishments in Last Year With public input, defined the mission, vision, and values of the Exchange and specific policy principles to inform activities in major core areas; Held regular, well-attended public Board meetings with extensive public participation; Defined the program elements, essential tasks and required system supports in major core areas including eligibility and enrollment, outreach and marketing, consumer assistance and qualified health plan management, and securing through competitive solicitations valuable expert resources and consultants to help advance decision-making, system design and implementation approaches in each area; In partnership with key state agencies, designed California Healthcare Eligibility, Enrollment and Retention System (CalHEERS), an IT system that will serve as consolidated support for eligibility and enrollment processes in the Exchange, Medi- Cal and Healthy Families, and secured through competitive bid expert resources to build, refine, and launch by mid Developed active partnerships and collaborations with state agencies, the Legislature, and key decision makers.

Level 1.2 Establishment Grant Work Plan Provides a look-forward view of the work to be under taken in the Grant Period Tracks the same Core Areas as the Narrative Identifies Key Milestones and Tasks Illustrates the timing for beginning and ending tasks Gives special attention to federally mandated milestones

California Health Benefit Exchange 4 Level I (Phase 2) Establishment Grant Funding Staff Responses to Significant Stakeholder Issues Partnerships with Other State Departments Stakeholder Comment: The Exchange should request for additional federal funding to establish partnerships through Interagency Agreements with the Department of Insurance (CDI) and/or other state departments. Different state departments may be able to assist the Exchange to monitor marketing materials and program integrity issues, etc. Staff’s Response: Recommend that requests for additional federal funding to establish partnerships with other state departments occur in a subsequent grant submission, since the Level 1 (Phase 2) is for a time period of August 15, 2012 – June 30, Staff will closely monitor the need to establish these partnerships who may provide additional support to the Exchange.

California Health Benefit Exchange 5 Horizontal Integration with Other Human Services Programs Stakeholder Comment: The Exchange should ensure that the Level 1 (Phase 2) Establishment Grant includes specific plans, actions and timeframes to integrate programs such as CalWORKS, CalFRESH, etc. Staff’s Response: As noted during the development of the California Healthcare Eligibility, Enrollment and Retention Systems (CalHEERS) solicitation process, the Exchange’s primary near-term focus must be to ensure that critical operations are implemented by The Exchange recognizes the importance of horizontal integration with other human services programs and this integration will be considered for Given this timeframe, building in specific deliverables for the period between August 2012 and June 2013 is inappropriate. Level I (Phase 2) Establishment Grant Funding Staff Responses to Significant Stakeholder Issues

1.Comments are invited:  Written comments by Friday, June 22, 2012  Submit comments to 2.Staff will make revisions and prepare final submission Questions/Comments? Level 1.2 Establishment Grant Narrative: Next Steps