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The Center for Consumer Information & Insurance Oversight

 

Massachusetts Affordable Insurance Exchange Grants Awards List

Massachusetts has received six grant awards to build its Affordable Insurance Exchange. This includes a Planning Grant, an Early Innovator Grant, three Level One Establishment Grants and a Level Two Establishment Grant.

Summaries of Massachusetts' applications for each grant are provided below:

 

Establishment Grant Level Two Application Summary

 

Administrator: Commonwealth of Massachusetts Health Insurance Connector Authority

Award Amount: $80,225,650

Award Date: January 17, 2013

Application Due Date: November 15, 2012

Administrative Supplement Award Amount: $18,580,051 (December 18, 2013)

Level of Funding: Level Two

Summary: Massachusetts is receiving a Level Two Establishment Grant to support the transition of the Health Connector to an Affordable Care Act-compliant State-based marketplace (Exchange) in 2014. This grant will support the development and operation of a Massachusetts-specific risk adjustment program that will ensure stability in the state's merged market and will provide funding to develop and execute a robust outreach and education campaign designed to inform Massachusetts residents of the benefits available to them through the Affordable Care Act and the Health Connector.

Massachusetts received a supplement funding request to support activities underway as part of their existing grant.  Specifically, the funding will support the salary and staff for Health Connector.  MA hired additional staff to focus on ACA transition activities.  This supplement also supports operating costs, and development and implementation of customer service and business operations procurement, activities for which the initial request was under budget.   The supplement also supports 2013 open enrollment transition, as part of Massachusetts needing to effectuate a transition of small group membership from its existing Business Express small group platform to the future State small group platform on HIX-IES.  The funding will cover continued project management and change management as well as to support remaining development and build of the HIX-IES project.  

Establishment Grant Level One Application Summary

Grantee: Commonwealth Health Insurance Connector Authority
Award Amount:  $9,718,991
Award Date:  December 15, 2014
Application Due Date:  October 15, 2014

Grant Level: Level One

The (Massachusetts) Health Connector received funding to develop and improve: an Affordable Care Act-compliant SHOP for small businesses, payment processing solutions, and to improve functionality in the Massachusetts health exchange to retain current members and attract new members.  Enhancements include improving functionality for reporting, renewals and redeterminations, appeals, decision support, and establishing a portal for Navigators and Certified Application Counselors.

 

Administrator:  Commonwealth Health Insurance Connector Authority   
Amount Awarded:  $13,917,409
Award Date:  October 14, 2014
Application Due Date:  August 15, 2014
Level of Funding:  Level One

The Commonwealth Health Insurance Connector Authority (Health Connector) received funding to support state agencies establishment and executing of comprehensive outreach and enrollment efforts that transition residents to Affordable Care Act plans, and inform Massachusetts residents of the benefits available to them through the Affordable Care Act and the Health Connector. Funding from this grant will support a multi-faceted outreach and enrollment campaign that includes direct mail and phone calls, public awareness events and application events, a statewide advertising and marketing campaign, and development of a training computer based environment for internal and external stakeholders.

 

Administrator: Commonwealth of Massachusetts Health Insurance Connector Authority
Award Amount: $11,644,938; $41,679,505
Award Date: February 22, 2012; September 27, 2012
Application Due Date: December 30, 2011; August 15, 2012
Level of Funding: Level One

Summary: Massachusetts will use Level One funding to conduct analysis on coverage transitions and the operational interface between the Exchange and the Massachusetts Medicaid Program, which has been a major operational and strategic partner for the Health Connector since its inception. This will include a focus on the products and services that will best meet the needs of the individual and small group populations served in 2014. The proposed projects are intended to: enhance the consumer experience, (promote/provide) products and services for individuals and small businesses shopping for health insurance through an Exchange; help develop a plan for robust reinsurance, risk adjustment and risk corridor programs that will stabilize the market; and augment the current operational model for the relaunch of Health Connector 2.0 in 2014.

Massachusetts is receiving a second Level One award to assist the Health Connector in its efforts to successfully transition to a State-based Exchange consistent with the Affordable Care Act, while still maintaining a commitment to its existing members served under todays Exchange model. Funding from this award will support the development of a robust risk-adjustment program that will ensure stability in their merged market. A significant portion of this request will fund a multi-agency project overseen by the Health Connector, the Executive Office of Health and Human Services and the University of Massachusetts Medical School to build a single, integrated real-time eligibility system to determine eligibility for state and federally supported health insurance coverage.

 

Early Innovator Grant

 

Grantee: University of Massachusetts Medical School
Award Amount: $35,591,333

Summary: This is a multi-state consortia proposal led by the University of Massachusetts Medical School and will benefit individuals and small businesses in Connecticut, Maine, Massachusetts, Rhode Island, and Vermont. These consumers will be able to shop for, select, and purchase affordable and high-quality health plans consistent with national reform goals for 2014. The proposed project approach will be to create and build a flexible Exchange information technology framework in Massachusetts and share those products with other New England states. The proposal hopes to learn from the Massachusetts Exchange implementation and gain efficiencies so it can accelerate Exchange development for participating New England states.

Award Supplement: $8,895,029 (March 21, 2012)

Summary: Massachusetts will use the Early Innovator grant supplement to accelerate changes in its current Exchange IT infrastructure in order to assure full integration between the Health Insurance Exchange and Medicaid systems. The supplement will also fund the Exchange IT components for Massachusetts that can be leveraged by New England and other States.

 

State Planning Grant

 

Awarded September 30, 2010

Administrator: Division of Insurance

Amount Awarded: $1,000,000

  • Identify current Health Connector programs, policies, and practices in need of modification given new national requirements for Exchanges.
  • Identify a strategic and operational plan and implementation timeline.
  • Conduct research to anticipate changes in sources of insurance coverage before and after 2014, and the size and characteristics of the population served by the State Exchange.
  • Engage stakeholders in the discussion of Exchange-related issues.
  • Collaborate with MassHealth to identify and recommend changes to the existing information technology and operational infrastructure needed to comply with new requirements for Exchange eligibility determinations in 2014.
  • Review current cash flow structure and identify changes that may be necessary under national reform.
  • Review current products offered through the Connector and how they align with specifications for plan design under national reform.
  • Examine statutory and regulatory actions to identify potential needed changes, such as minimum essential coverage requirements, definitions of affordability and exemptions from the individual mandate.

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