Washington Health Benefit Exchange

Status UpdateFebruary 27, 2014

Pam MacEwan, Chief of StaffBeth Walter, Director of Operations

Brad Finnegan, Associate Director of OperationsNikki Johnson, Client Specialist Lead

Michael Marchand, Director of Communications

Status Updates

▪ Trends and Developments

▪ Enrollment

▪ Call Center

▪ Application issues

▪ Transfer of Data to Carriers

▪ Marketing and Outreach

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Trends/Developments

▪ Enrollment continues to climb, especially Medicaid

▪ System functionality improved

▪ Dealing with application errors and eligibility and enrollment problems. Triage system includes individual assistance, escalation, data fixes, and creative manual workarounds.

▪ Retroactive coverage implementation underway

▪ EDI file system improvements and transfer of information to carriers.

▪ Preparation for March 31

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Enrollment Update (as of 2/11/2014)▪ Web and Call Center Data

▪ Unique Visitors – 1,422,323

▪ Accounts Created – 416,514

▪ Call Center Volume – 36,873

▪ Average Wait Times after menu selection – 37 min.

▪ Enrollments Complete

▪ Qualified Health Plans – 90,723

▪ Medicaid Newly Eligible/Coverage Jan 1. – 184,783

▪ Medicaid Previously Eligible but not Enrolled – 91,480

▪ Medicaid redeterminations – 280,766

▪ In-Process Applications

▪ Qualified Health Plans Application (need to pay) – 85,372

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January Call Center Volumes and Staffing▪ Staffing:

▪ 409 CSRs

▪ Attrition rate of 7.1%

▪ Call Volumes:

▪ Approximately 741,000 calls received during operating hours

▪ 623,000 high volume messages played

▪ 107,000 handled

▪ 11,000 abandoned

▪ Daily totals average over 40,000

▪ Wait times are measured at two queues

▪ Initial wait times average less than 2 minutes

▪ Specialty queue wait times average 40 minutes

▪ Duplicate call rate was 68%

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Preliminary February Call Volumes

▪ 525 CSRs

▪ Overall volume of calls is holding at 8,000 to 9,000 a day

▪ The majority of calls are being answered

▪ Duplicate call rate is decreasing

▪ A total of 230 additional network circuits were installed to help decrease the number of calls that can’t get through

▪ Triage system is working well

▪ Calls are handled more efficiently

▪ Abandoned call rate is decreasing from 50% to 8%

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Where We Are - Enrollment DetailsAs of 02/18

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15,315Applications eSigned

but no Enrollment

391,000eSigned and Enrolled

Total QHP :

99,946

15,315

Total Washington

Apple Health :

291,054*

Note: An additional 297,780 individuals had previous Medicaid coverage and completed their

Washington Apple Health enrollment through HPF

Tracking Application Throughput

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100 applications

submitted on 2/14

1 Encountered an HPF

technical error

4 Encountered an

ES Eligibility

Determination Error

95 Receive Eligibility

and Can Enroll

When tracking a set of 100 applications submitted on Friday 2/14:

Client Specialist Team: View from the Front Lines

Role/Responsibilities of Client Specialist team:

1. Complicated and emotionally sensitive enrollment and eligibility issues. Improving the customer experience

2. Governors Office and Legislative Staff RequestsOther High Priority Requests

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Client Specialist Team: Cases Reviewed▪ Shift in Role/Responsibility for Client Specialist Team

▪ Mid November

▪ High Priority Cases

▪ Number of cases resolved:

▪ Internal Staff requests = 2,000 requests

▪ Issues received from call center/IPAs/brokers = 1,500

▪ Governor’s Office = 500

▪ Legislative staff = 250

▪ Partnering state agencies (HCA/OIC) = 300

▪ Leadership/Board = 150

▪ Over 8,000 calls to customers

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Transfer of Data to Carriers▪ The Healthplanfinder sends daily 834 enrollment files and

monthly 820 payment files to QHPs

▪ Over 30 different errors have been identified in the enrollment and payment files since December

▪ Many of these are the result of upstream defects

▪ Some carriers have also had difficulty processing files

▪ Conducted nearly 40 data and manual fixes to correct the data being set to carriers

▪ Correct system to prevent these issues (2/13 and scheduled 2/23)

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Communications▪ Lead Organization Meeting

▪ Improved performance

▪ Additional enhancements

▪ Programmatic future

▪ Advertising and Marketing for the Homestretch

▪ Ads start airing last week

▪ Other events, vehicles in play

▪ Readying for the final push

▪ Assessing Effectiveness

▪ Engaged Weekly

▪ Review of outreach and marketing efforts

▪ Analyses to drive future activity

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System Releases

▪ Summer Release: Focus on auto-renewals for fall open enrollment

▪ Fall Release: Focus on fall open enrollment and user enhancements

▪ User Enhancements prioritized based on what we’ve heard from stakeholders and what we’ve seen in usability testing

▪ Will be discussing approach with Committees

▪ January release: Medicaid shopping

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