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Sub-Connector Recommendation

Sub-Connector Recommendation. Commonwealth Health Insurance Connector Authority Board Meeting February 8, 2007. Agenda. Background and Objectives RFR Process Vendor Recommendation Contracting. Project Background and Objectives.

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Sub-Connector Recommendation

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  1. Sub-Connector Recommendation Commonwealth Health Insurance Connector Authority Board Meeting February 8, 2007

  2. Agenda • Background and Objectives • RFR Process • Vendor Recommendation • Contracting

  3. Project Background and Objectives • The Connector is entering its next critical phase in healthcare reform, enabling individuals above 300% of FPL to enroll in affordable health plans starting May 1, 2007 for coverage effective July 1, 2007 • The first critical milestone in meeting this date is the selection of a Sub-Connector

  4. Project Background and Objectives • The Connector, through the Sub-Connector must provide key administrative services for the Commonwealth Choice Program including: • Customer service center; • Eligibility and enrollment support; • Premium billing, collections and remittance services; • Section 125 Program support; • Notifications and reconciliation; and • Broker relationships / management.

  5. Project Background and Objectives • Key objectives include developing a plan that will ensure that the Connector meets its legislatively mandated enrollment and coverage dates by: • Building strong working relationships with the website vendor (CSC), marketing and advertising vendor (Weber Shandwick) and Connector Seal of Approval Health Plans; • Understanding the marketplace and administrative processes required to serve Commonwealth residents and small businesses; and • Servicing Connector customers in a manner consistent with the Connector’s brand, vision for automation and streamlined business processes, and top-notch customer service

  6. Sub-Connector RFR Process

  7. Scoring Criteria • Bidder meets all Mandatory Requirements • Bidder effectively responds to all technical aspects of RFR questionnaire (90 points): • History servicing businesses and individuals (5 points) • Administrative capacity and systems capabilities (20 points) • Employer, Individual, and Broker Outreach and Communication Activities (10 points) • Staffing for administrative and outreach activities (10 points) • Financial resources and controls (10 points) • Workplan (15 points) • Performance standards (20 points)

  8. Scoring Criteria • Bidder presents affordable cost proposal (60 points) • Bidder demonstrates ability to work together, respond to Connector questions and exhibits operations knowledge during site visit (50 points)

  9. Recommended Partner: SBSB • Highest Quantitative Score – 142 vs. 125 • Efficient Total Price – Straight PSPM fee • Existing technical and administrative capacity and infrastructure enabling us to meet May 1, 2007 • Strong capabilities for seamless, integrated and complete workflows • Depth and breadth of broker network, including partnership with Northeast Business Trust (NBT) • Active in local health care with payer, government and other relationships across the state • Good knowledge of HCR details and issues facing the Connector

  10. SBSB Qualifications

  11. Contract Details and Next Steps • SBSB has agreed to Commonwealth Terms and Conditions and all other requirements of the contract • Sub-Connector kick-off upon approval • Integration with other key projects (Connector Web Portal, Marketing & Advertising, Health Plan selection) • All business and technical requirements finalized by end of February • Ready to enroll on May 1, 2007

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