Oregon Health Insurance Marketplace Grants Awards List

Oregon has received five grant awards to build its Health Insurance Marketplace. This includes a Planning Grant, an Early Innovator Grant, two Level One Establishment Grants and a Level Two Establishment Grant.

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

 

Establishment Grant Level Two Application Summary

 

Administrator: Oregon Health Insurance Exchange Corp

Award Amount: $226,442,074

Award Date: January 17, 2013

Application Due Date: November 15, 2012

Level of Funding: Level Two

Summary: Oregon is receiving a Level Two Establishment grant to allow the Oregon marketplace (Exchange), Cover Oregon, to become fully operational as a State-based marketplace. The funding requested will cover costs associated with testing, training and implementation of the IT user interface through the October 2013 open enrollment date, as well as subsequent post enrollment updating and maintenance. Oregon's goal is to continually refine the user-centered user interface, so that it is responsive to customer needs. The marketplace plans to operate its own service call center. Level Two funding will allow the service center to be fully staffed for operations and trained on the Affordable Care Act, Medicaid and commercial insurance options for the individual market and SHOP. Service center staff will offer customer service in the major languages spoken in the state and contract for additional translation services. A competitive solicitation will be issued to create a broad range of marketing materials using print, radio and television mediums. Communications materials will be translated into three or four languages, with a goal being to use more visual images and fewer words. The marketplace will be fully staffed by quarter two of 2014.

 

Establishment Grant Level One Application Summary

 

Administrator: Oregon Health Insurance Exchange Corp
Award Amount: $8,969,600; $6,682,701
Award Date: August 12, 2011; May 16, 2012
Application Due Date: June 30, 2011; March 30, 2012
Administrative Supplement Award Amount: $2,195,000 (September 27, 2012)

Level of Funding: Level One

Summary: The Health Insurance Exchange builds on Oregon's past and current health reform efforts. Oregon has been studying an Exchange model for several years and is an Early Innovator IT grantee. This Establishment grant will support the state's continued progress toward Exchange implementation. Funding will support the final design and initial implementation of the Exchange's business and operations plan. To bring the business and operations plan to life, Oregon will use funding to: hire an Executive Director and key staff; build a financial management plan and structures; finalize waste , fraud, and abuse plans; appoint a Board of Directors to provide oversight and management; finalize interagency agreements with relevant agencies; develop transition plans for state programs and their enrollees; consult with stakeholders; determine whether additional risk mediation activities are required; finalize protocols and payment rules for producers and Navigators; develop marketing and communications strategies; begin evaluation activities; and create a detailed business plan in preparation for the February 2012 Legislative Session.

Oregon established an Exchange during the 2011 legislative session and appointed a nine-member Board responsible for the Exchange. Oregon's second Level One Establishment grant will allow the Exchange to meet several new milestones and prepare for full federal certification in 2013. Specifically, the additional funds will supplement the Business Operations Core Area by allowing for the hire of additional staff, engage in a competitive solicitation to select a local vendor to design the individual and SHOP IT user interface, and pay for other administrative costs.

Administrative Supplement Award Amount: $2,195,000 (September 27, 2012)

Summary: Oregon will use these supplemental funds to fund an under budgeted initial request specifically related to Stakeholder Consultation and Business Operations. In this request, Oregon is requesting additional funding for Board Committee and CAC meeting costs through spring of 2013. The state is also requesting funding to reimburse members for workgroup meetings and for Technical Advisory Stakeholder Group meetings. Oregon is also requesting funding to finalize service center operational planning, development and implementation as well as additional necessary staffing in the form of contractors.

 

Early Innovator Grant

 

Grantee: Oregon Health Authority
Award Amount: $48,096,307
Administrative Supplement Award Amount: $11,820,905 (January 17, 2013)

Oregon is using commercially available, off-the-shelf software to create the Exchange. The Exchange Early Information Technology Innovation Grant will help Oregon create a modular, reusable IT solution that will provide the Exchange's customers with seamless access to information, financial assistance and easy health insurance enrollment, with no gaps in coverage or assistance cliffs for anyone up to 400% of the federal poverty level. The OHA estimates that 516,000 Medicaid clients and 277,000 commercial insurance consumers will use the Health Insurance Exchange to shop for and enroll in health coverage.

Award Supplement: $11,820,905 (January 17, 2013)

Summary: The Oregon Health Authority requested an administrative supplement to its Innovative Exchange Information Technology Systems Cooperative Agreement awarded in February, 2011.  The State requested funding for: accelerated work to meet framework functionality and configuration and the increased costs of hosting and licenses; specialized tool configuration, customization and training to configure and support the State's public sector systems and the requirements for the health insurance Exchange, and to assure the system is supported in an efficient and sustainable way for the long term; known interface/integration standardization costs that will support user experience with portal use and seamless interfaces with legacy and internal systems; and additional software requirements tied to financial management guidelines and configuration.

 

State Planning Grant

 

Awarded September 30, 2010

Administrator: Office for Oregon Health Policy & Research

Amount Awarded: $1,000,000

• Study the feasibility of a public corporation Exchange model, including:
• Using a public comment web-portal and soliciting feedback.
• Guidance from technical assistance work group and consumer advisory group.
• Partnering with nearby States for joint purchasing.
• Create a final operational and technical infrastructure plan.
  

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