1. Rosemarie Day Deputy Director and Chief Operating Officer Thursday, May 8, 2008 Operations Report Current Priorities and Future Plans

2. 2 Outline Operations Report I.Current Priorities A.Open Enrollment Highlights: Commonwealth Choice B.Open Enrollment Highlights: Commonwealth Care C.Contributory Plan D.Commonwealth Care Customer Service Contract E.MMCO Contract Audit F.Mandate Appeals Process II.Future Plans Long-term Policy and Strategy Issues

3. 3 I. Current Priorities A. Open Enrollment Highlights: Commonwealth Choice Non-group coverage:  July 1 st is one-year anniversary of coverage.  Renewal letters sent to ~1,600 subscribers in April and early May.  Members are renewed in their equivalent Seal of Approval (SoA) plans and are also given option to choose another SoA plan.  Ongoing process: renewal letters will be sent each month to correspond with coverage anniversary dates.  Future state: renewals will be done online.

4. 4 I. Current Priorities A. Open Enrollment Highlights: Commonwealth Choice  Working with 6 carriers to collect new and old rates  Developing new forms and procedures  Drafted letters to members  Meeting DOI guidelines  Updated website  Adjusting billing procedures and systems  Training call center staff

5. 5 I. Current Priorities A. Open Enrollment Highlights: Commonwealth Choice Voluntary Plan:  Working with employers to promote open enrollment in Voluntary Plans.  Contacting many of our VP employers (~1,100 have 7/1/08 anniversary date)  Renewal letters being sent to currently enrolled VP employees  Making it easy for employers:  Web tutorial  Sample open enrollment materials (posters, letters, etc.)  Offer to participate in health fairs  Ongoing process corresponding with S. 125 Plan anniversary dates.

6. 6 I. Current Priorities B. Open Enrollment Highlights: Commonwealth Care  Renewal letters are being sent to all Commonwealth Care members this week.  Includes notice of premium and co-pay changes.  Premium-paying members will receive new invoices with premium changes by end of May.  Health Plans sent marketing materials last week.  Call center is staffed to handle peak loads.

7. 7 I. Current Priorities C. Contributory Plan  On-track to launch on July 1 st for coverage effective September 1 st.  Working with carriers, brokers, SBSB and CSC to develop and implement the product.  Phase I of launch will be limited to 100 employers/1,000 employees so that product can be evaluated.

8. 8 I. Current Priorities C. Contributory Plan – Timeline Part I: March - May

9. 9 I. Current Priorities C. Contributory Plan – Timeline Part II: June – Sept.

10. 10 I. Current Priorities D. Commonwealth Care Customer Service Contract New Vendor Procurement:  Request for Proposals issued in March  Proposals received in mid-April  Procurement team of Connector staff is evaluating proposals (technical, programmatic and price)  Interviews will be held in early June  Will negotiate with recommended vendor  Board vote in July

11. 11 I. Current Priorities D. Commonwealth Care Customer Service Contract Transition Planning:  Goal is for new vendor to be fully operational by 12/08.  Work closely with Maximus and EOHHS to coordinate the transition to new vendor  New call center platform  Premium-billing data conversion

12. 12 I. Current Priorities E. MMCO Contract Audit Key components:  Claims payment and reporting  Management of provider network  Effectiveness of care management programs Timetable:  Solicit vendor (May – June 2008)  Conduct audit (July – September 2008)  Review results (September – October 2008)

13. 13 I. Current Priorities F. Mandate Appeals Process  Connector is working closely with DOR to process mandate appeals  DOR collects appeals info from taxpayer  DOR shares info with Connector via secure website  Connector staff review the appeals and make a determination  Connector has contracted with independent hearing officers to hold hearings for denied appeals  Officers have been trained  Hearings process will be fully underway by June

14. 14 II. Future Plans Long-term Policy and Strategy Issues  Staff will conduct analysis and work with Board members to address issues such as:  Affordability Schedule proposals  Value-based benefits design  Timetable: summer to fall 2008  Will present more detailed proposal at June Board meeting