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The Center for Consumer Information & Insurance Oversight

 

Rhode Island Health Insurance Marketplace Grants Awards List

Rhode Island has received multiple grant awards to build its Health Insurance Marketplace. This includes a Planning Grant, an Early Innovator Grant, four Level One Establishment Grants and a Level Two Establishment Grant.

Summaries of Rhode Island's applications for each grant are provided below:

 

Establishment Grant Level Two Application Summary

 

Administrator: Rhode Island Department of Business Regulation
Award Amount: $58,515,871
Award Date: November 29, 2011
Application Due Date: September 30, 2011
Administrative Supplement Award Amount: $7,950,989 (January 17, 2013)


Level of Funding: Level Two

Summary: Rhode Island will use Level Two funding to continue work already underway through its Level One grant, which includes: operations, information technology (IT) infrastructure design and development; establishment of an integrated consumer support structure; reporting and evaluation; establishment of governance structures and staffing. Under the Level Two grant, Rhode Island will begin building its capacity in the following critical areas: health plan certification and qualification; financial sustainability; and oversight and financial integrity.

The State plans to implement these project areas as a single, integrated initiative, led jointly by Medicaid and Exchange leadership. The State will continue to work closely with the New England States Collaborative Insurance Exchange Systems collaborative and leverage IT systems knowledge and design where appropriate and feasible. Its total federal request is intended to fund the seven major projects listed below, plus implementation of technology components, which will be reviewed and refined through IT reviews conducted by CCIIO. Funding will be provided through December 31, 2014.

Award Supplement: $7,950,989 (January 17, 2013)

Summary: Rhode Island's supplement to the state's Level Two grant awarded in November 2011 will support: mature estimates of expenses for Exchange Customer Service (call center) costs for training and testing; expanded stakeholder outreach to brokers and small businesses; the creation of a robust in person assister program for small businesses and their employees; funding for governance and staffing; funding for health plan certification and qualification; and managing the implementation of the Commercial Claims Database to support risk adjustment and reinsurance.

 

Establishment Grant Level One Application Summary

 

Administrator: Rhode Island Department of Business Regulation
Award Amount: $5,240,668, $9,822,646; $15,298,487; $6,176,368
Award Date: May 23, 2011; April 8, 2013; October 23, 2013; January 22, 2014
Application Due Date: March 30, 2011; February 15, 2013; August 15, 2013; November 15, 2013
Administrative Supplement Award Amount: $1,300,000 (January 17, 2013)


Level of Funding: Level One

Summary: Rhode Island will use resources from the Affordable Care Act to strengthen health information technology systems, develop an integrated consumer support program to provide support to individuals and small businesses, and strengthen its business operations.

Rhode Island's second Level One Establishment Grant will support 1) the development of a robust In-Person Assister Program, 2) product and delivery system development, 3) a strategy for premium invoice consolidation, 4) independent verification and validation services for system development, and 5) post-Marketplace-implementation quality improvements.

Rhode Island will use the Level One grant supplement to increase the scale of their Exchange's planned data and evaluation components, to ensure that the Exchange is able to measure and report on the full range of its work, especially in the areas of improvements for small businesses, health outcomes, and payment and delivery system reforms.

The Rhode Island Health Benefits Exchange, recently named “HealthSource RI,” will use its third Level One grant to build and expand upon existing work underway through previous Establishment agreements.  Specifically, the Level One award will fund Rhode Island’s:

  • Contact Center through the end of calendar year 2014
  • Technology for non-Navigator assisters (also known as In Person Assistors) to assist in onsite enrollment of Rhode Islanders
  • Technical enhancements to Integrated Eligibility System to ensure that the user experience is easy and seamless
  • Mail center equipment for HealthSource RI. Website and mobile platform development that include new features for the website to facilitate easy access and enhanced decision support for all Rhode Islanders
  • Predictive Modeling to allow HealthSource RI to continue to develop its strategic policy and planning, refine its organizational priorities, and further develop strategic partnerships and relationships
  • Tools development to track progress on enrollment, quality, access, cost, and effectiveness.

The Rhode Island Marketplace will use its fourth Level One funds to build critical new Small Business Health Options Program (SHOP) capacities. These include a SHOP application Information Technology (IT) interface that will: allow brokers assess the effects of different employer insurance offerings on employees; and enable small business owners and employees to review, compare and select insurance plans. Funding will also support outreach and engagement activities to ensure employer awareness of the tax credit value and availability as well as other potential tax savings.  

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. 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.

 

State Planning Grant

 

Awarded September 30, 2010

Administrator: Office of the Health Insurance Commissioner

Amount Awarded: $1,000,000

  • Create an Interagency Task Force to assure activities supported by grant are appropriately coordinated.
  • Compare cost and benefit of State run Exchange versus federally run Exchange
  • Create an operations plan which provides staffing plan.
  • Coordinate eligibility and enrollment with Medicaid.
  • Develop a product design and contracting plan.
  • Create a data and evaluation plan.
  • Put in place information system requirements support.

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