Covered California Approves Model Contract…

The Covered California Board of Directors held a short meeting this morning.  The meeting was scheduled for the purpose of allowing the board to take action on the proposed model contract (between Covered California and Qualified Health Plans), but covered a few additional topics too.

The Model Contract is the template for the contracts that will be signed between Covered California and all of the health plans whose products will be offered in the Exchange.  This contract sets the rules for health plans and is an important place for the Board to make policy decisions that protect consumers and promote health and equity.  In the board’s last meeting, they received a great deal of feedback from stakeholders on the draft of the contract that they presented.  The draft considered by the Board today reflected some changes that were made as a result of those comments.  Some key revisions are:
* Staff reiterated Covered California’s commitment to their seven principles of Active Purchasing
* Covered California will not allow HSA plans in the Silver Tier because this will interfere with the calculation of subsidies.
* The board was disinclined to allow alternate plan designs in the individual market, sticking with the emphasis on standardized plans to help consumers make apples-to-apples comparisons.
* Contracted plans will be required to only sell standardized plans in the individual market in and out of the Exchange.

The Board approved the amended Model Contract with 4 votes in favor (Susan Kennedy left before the vote). And with that, the intense negotiating with health plans begins, with announcements of participating plans expected late May.
Additionally, the board heard an update on the Assisters Program.  Covered California Director Peter Lee explained that they 3 keys to success of the Exchange are: 1. Affordable plans, 2. successful outreach and education, and 3. simple enrollment process.  Assisters and Navigators are important to this third element, to make sure that consumers that need help signing up for coverage can get it quickly and effectively.  Staff will be presenting a comprehensive proposal related to Assisters at the next board meeting.  Topics that will likely elicit debate include continued discussion about the background check requirements for individuals who wish to become Assisters.
Lastly, staff presented proposed regulations related to Assisters which would prohibit both Assisters from accepting compensation from Agents and Agents from paying Assisters to ensure that consumers are truly getting unbiased assistance.  These regulations will be voted on in a future board meeting.
The next Covered California Board meeting will be Thursday, May 23.
Health Access California promotes quality, affordable health care for all Californians.
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