Common use of Reuse, Sharing and Collaboration Clause in Contracts

Reuse, Sharing and Collaboration. The business functions of certifying, renewing and managing the Qualified Health Plans (QHPs) available in the Arkansas Marketplace are elements of Plan Management and will be the state’s responsibility in the SPM. State regulators and insurers need an efficient, effective and compliant means to submit and review health plans for certification and inclusion in the Marketplace. Currently, AID uses the National Association of Insurance Commissioners (NAIC) System for Electronic Rate and Form Filling (SERFF), developed in 1998, to support handling of insurance policy rate and form filings from Arkansas’s issuers. As previously noted, AHCD is utilizing SERFF as a single point of interaction for Arkansas issuers to submit plans for certification and renewal and for Arkansas state regulators to certify, renew and manage QHPs participating in the FFM. SERFF’s role and approach leverages existing systems, assist states in certifying QHPs and facilitates integration. Using existing information technology will mitigate costs and lessen the burden to issuers of adapting to a new system. AHCD Accounts Manager Xxxxx Xxxxxxxxx attended all NAIC/SERFF forums and any SERFF related forums at State Grantee Meetings. He assisted with SERFF adjustments to meet plan management needs. The plans reviewed will eventually land up in the federal Health Insurance Oversight System (HIOS). XXXX identified five goals and objectives held by stakeholders in the SERFF Plan Management project:  G01- Enhance SERFF to allow state departments of insurance to meet their Plan Management functions  G02- Streamline the process for insurers submitting plans for inclusion on the Marketplace  G03- Support integration between applications involved in Marketplace operations  G04- Provide flexibility to the states regarding Plan Management  G05- Minimize duplicative entry. Xxxxxx Xxxxxxxx also helped coordinate state-NAIC requirements development and planning for the Arkansas- SERFF Plan Management Functions to facilitate the Department using SERFF in the selection process for QHPs. This work included close collaboration between the AHCD Plan Management Specialist and the Compliance Division Compliance Officer. We were pleased with SERFF functioning for the first year review and recommendation cycle. AID’s Consumer Services Division (CSD) is designed to assist insurance consumers with complaints resolution and inquiries regarding insurance companies or agents. CSD investigates all complaints, working with the insurance company and the consumer to determine the appropriate course of action. Prior to 2011, all CSD staff members were generalists, addressing all life, health, and property/casualty calls. In 2010, CSD was awarded a CCIIO Consumer Assistance Program (CAP) grant to help consumers with issues related to provisions of the Affordable Care Act. The AHCD and CSD staffs are committed to working collaboratively to expand CAP efforts in preparation for 2014 SPM implementation. CSD and AHCD are working to catalogue consumer inquiries and complaints in an effort to standardize responses, identify trends and work to continuously improve consumer services associated with the SPM. In response to Act 1439 we will be using the existing AID licensing process for all Marketplace navigator and non- navigator personnel including licensed agents and brokers. AHCD is working with the AID License Division to establish processes whereby AHCD will review for successful completion of training, testing, and background checks. The License Division will process license applications and fees. A public hearing was held July 31, 2013 to address public comments regarding Rule 104 which sets the Marketplace license fee at $35.

Reuse, Sharing and Collaboration. The business functions of certifying, renewing and managing the Qualified Health Plans (QHPs) available in the Arkansas Marketplace Exchange are elements of Plan Management and will be the state’s responsibility in the SPMFFE Partnership. State regulators and insurers need an efficient, effective and compliant means to submit and review health plans for certification and inclusion in the MarketplaceExchange. Currently, AID uses the National Association of Insurance Commissioners (NAIC) System for Electronic Rate and Form Filling (SERFF), developed in 1998, to support handling of insurance policy rate and form filings from Arkansas’s issuers. As previously notedreported, AHCD HBEPD is utilizing planning to utilize SERFF as to provide a single point of interaction for Arkansas issuers to submit plans for certification and renewal and for Arkansas state regulators to certify, renew and manage QHPs participating in the FFMFFE. SERFF’s role and approach leverages existing systems, assist states in certifying QHPs and facilitates integration. Using existing information technology will mitigate costs and lessen the burden to issuers of adapting to a new system. AHCD Accounts Manager HBEPD staff member Xxxxx Xxxxxxxxx has attended all NAIC/SERFF forums and any SERFF related forums at State Grantee Meetings. He assisted with reports progress in SERFF adjustments to meet plan management needsneeds to HBEPD and other effected AID staff. The plans reviewed will eventually land up in  Forum #1 brought together more than 30 states and CCIIO/CMS to discuss the federal development of Health Insurance Oversight System (HIOS)Exchanges and potential use of SERFF in Plan Management. XXXX NAIC provided a demonstration of SERFF functionality as it worked currently and preliminary mock-ups showing how SERFF might be modified to support Plan Management.  Forum #2 was to continue and expand on the discussion on Health Insurance Exchanges and the role of SERFF in Plan Management.  Forum #3 involved the SERFF Plan Management project team and provided updates on project timelines, progress on analysis and design, and plans for implementation and training. NAIC staff provided an overview of key areas of Plan Management: 1) QHP Certification; 2) Issuer Account Management; 3) QHP Oversight; and 4) QHP Renewal/Certification/Decertification.  Forum #4 was where NAIC staff provided updates toward leveraging SERFF for Plan Management functions related to the health insurance exchanges. Presentations were: 1) Updates to the project timeline and scope; 2) Enhancements planned for a summer 2012 release; 3) An update on efforts to achieve uniform data sets for Plan Management; 4) The critical path for SERFF in Phase 1, and information related to Phase 2 functionality; and 5) A panel discussion with CCIIO, the states and issuers. NAIC/SERFF have identified five 5 goals and objectives held by stakeholders in the SERFF Plan Management project:  G01- Enhance SERFF to allow so that state departments of insurance can use it to meet their Plan Management functions plan management functions;  G02- Streamline the process for insurers submitting plans for inclusion on the Marketplace Exchange;  G03- Support integration between applications involved in Marketplace operations Exchange operations;  G04- Provide flexibility to the states regarding in how SERFF is used for Plan Management Management; and  G05- Minimize duplicative entry. Xxxxxx Xxxxxxxx also helped coordinate state-HBEPD has had an opportunity to study the business model flowchart of the certification process in a FFE model. It presents a high level overview of the process flows of a QHP as it initiates from Insurer into SERFF to HIOS and finally up on the federal exchange portal. NAIC is working closely with CCIIO to define special needs and requirements development for FFE and planning for the Arkansas- SERFF Plan Management Functions to facilitate the Department Partnership Exchanges using SERFF in the selection process for QHPsQHP Certification. This work included close collaboration between the AHCD Plan Management Specialist SERFF will allow states to individualize data collection and the Compliance Division Compliance Officer. We were pleased with SERFF functioning for the first year review and recommendation cycleprocesses. AID’s Consumer Services Division (CSD) is designed to assist insurance consumers with complaints resolution and inquiries regarding insurance companies or companies, agents, and adjusters. CSD investigates all complaints, working with the insurance company and the consumer to determine the appropriate course of action. Prior to 2011, all CSD staff members were generalists, addressing all life, health, and property/casualty calls. In 2010, CSD was awarded a CCIIO Consumer Assistance Program (CAP) grant Grant to help consumers with issues related to provisions of the Affordable Care Act. Services under this program include: assisting consumers with filing of complaints and any needed appeals processes; collecting, tracking, and assessing consumer problems and inquiries; educating consumers on their rights and responsibilities with respect to group health plans and health insurance coverage; and assisting consumers with enrollment in group health plans or health insurance coverage by providing information, referral, and assistance. The AHCD CSD added a CAP manager and new investigator to devote 100% effort to health issues. Another investigator was reassigned to this effort, transitioning from a generalist to a 100% health specialist. CSD staffs has provided outreach and education, using staff and print and electronic media advertising. When Federal funds were exhausted in June 2012, AID CSD continued consumer assistance activities addressing health insurance concerns. CSD has applied for another CCIIO Consumer Assistance Program Grant in July 2012 that, if awarded, will assist CSD in meeting anticipated service increases related to FFE Partnership implementation. The status of this funding is “pending”. The HBEPD and CSD-CAP staff are committed to working collaboratively to expand CAP efforts in preparation for 2014 SPM Health Benefits Exchange implementation. CSD Coordinated efforts will focus on outreach education, complaints resolution, and AHCD data collection/analysis to inform Exchange planning/implementation and health insurance system improvements at all levels—consumers, carriers, producers, and providers. Program Integrity As part of our planning assessments we included review of existing monitoring tools for consideration when the Exchange system is designed. As the FFE Partnership Model is finalized and we begin to establish the Exchange organization, we are working putting in place the oversight, auditing and fraud, waste, and abuse prevention tools needed to catalogue consumer inquiries assure proper stewardship of public funds. We are constantly monitoring that resources are used efficiently and complaints appropriately from the outset and ongoing. AID has in place an accounting and financial department that is strictly governed by existing state policy. Arkansas audit procedures are performed yearly and are implemented to insure that no one person or position has sole authority to receive, process, and make payments. These policies are in force to provide an effective and efficient system of checks and balances. Additionally, Level One Grant funding has allowed us to hire a Grants/Contracts Specialist dedicated to the financial management of the federal grants accorded under ACA. Xxxx Xxxxx was hired to fill this position in May, 2012. He is currently leading the effort to standardize responses, identify trends develop HBEPD specific policies and work procedures to continuously improve consumer services associated with the SPM. In response supplement and provide adequate checks and balances to Act 1439 we will be using the our existing AID licensing process for accounting office. The Grants/Contracts Specialist is tracking and reporting all Marketplace navigator expenses, receivables, and non- navigator personnel including licensed agents and brokers. AHCD is working expenditures in collaboration with the AID License Division to establish processes whereby AHCD will review accounting office. Individual DHHS grants are tracked by specific grant identification and account numbers so that expenses, payments and draw-downs are separately and appropriately accounted for successful completion of training, testingand reported. Affordable Care Act Requirements Rate Review - The AID currently has prior approval authority over individual health insurance rates for all issuers. In recent years the Commissioner has negotiated with issuers for all rate increases, and background checksrecently negotiated a lower rate affecting approximately 90,000 policyholders. He reduced the increase in rates by approximately 4% for the year 2010. The License AID was recipient of Initial Rate Review and Cycle II grant funding from CCIIO which helped Arkansas move toward an effective rate review program for all health insurance markets. Specifically, AID issued two bulletins (6- 2011 and 7-2011) to increase requirements for individual rate filings and to obtain prior approval authority in the small group market. Effective September 1, 2011, all rate increases over the 10% threshold are subject to the new filing requirements in these Bulletins. Arkansas has been designated by CCIIO as having an “Effective Rate Review Program”. Rate review will help keep down the premium costs for Arkansas small businesses and families. The RRD will have an independent expert review proposed health plan rate increases submitted by insurance issuers. Arkansans will be able to access the issuer’s justifications submitted as part of the rate review process online on the RRD’s website. This site will also link to the Arkansas HBE website as well as the federal website (www. Xxxxxxxxxx.xxx). Citizens will be able to provide public comment on all rate filings. The AID Rate Review Division (RRD) will continue all current activities and tasks related to the Affordable Care Act (ACA), including but not limited to rate filings for major medical policies. The AID Life and Health Division will work closely with RRD and will utilize all programs, job aids and other rate review tools developed by RRD. The Life and Health Division will support RRD in all required HHS and Health Information Organizations (HIOS) filings and reporting requirements related to planning for Rate Review. Consumer and plan outreach and other similar activities related to Rate Review will remain within the RRD scope of services. In June, 2012 the RRD hosted a National Rate Review conference in Little Rock where the HBEPD director presented a session on State Level Collaboration Between Rate Review and Exchange Implementation. Between twenty-five and thirty states and territories attended this conference in person and a number more attended by live, interactive video. Minimum Loss Ratio (MLR) - As MLR filings are made with AID, the RRD will process license applications all MLR filings utilizing its recently developed MLR tracking program to effectively monitor these filings. RRD will verify the issuers’ calculations of rebates, or lack thereof, and feesensure that all rebates are made in the required time frame and in the proper amount. A public hearing was held July 31MLR tracking is essential for accurate review of all rate filings. In August 2012 Arkansas consumers were awarded $7.8 million in rebates. No further action is required. Reinsurance, 2013 Risk Corridor and Risk Adjustments - The RRD plans to address public comments be the AID liaison for planning and implementation of these adverse selection mitigation strategies. The Reinsurance program could be State or Federally operated under the Partnership option. Risk Adjustment and Risk Corridor Programs will be run by the Federal Government. Current thought is that Arkansas will defer operations of the Temporary Reinsurance program to the federal government. Other ACA requirements:  AID issued Rule 102 which required all carriers in the individual market to offer a child only policy. AID also began review of all policies to insure that any pre-existing condition provisions do not apply to anyone under age 19.  AID will not approve any policy that does not comply with the ACA requirement that coverage be extended to children to age 26 on their parents’ policy.  AID adopted Rule 76 entitled “Arkansas External Review Regulation” which puts in place the NAIC model rule, thereby complying with the federal regulation regarding Rule 104 which sets the Marketplace license fee at $35external review.

Reuse, Sharing and Collaboration. The business functions of certifying, renewing and managing the Qualified Health Plans (QHPs) available in the Arkansas Marketplace Exchange are elements of Plan Management and will be the state’s responsibility in the SPMFFE Partnership. State regulators and insurers need an efficient, effective and compliant means to submit and review health plans for certification and inclusion in the MarketplaceExchange. Currently, AID uses the National Association of Insurance Commissioners (NAIC) System for Electronic Rate and Form Filling (SERFF), developed in 1998, to support handling of insurance policy rate and form filings from Arkansas’s issuers. As previously notedreported, AHCD HBEPD is utilizing planning to utilize SERFF as to provide a single point of interaction for Arkansas issuers to submit plans for certification and renewal and for Arkansas state regulators to certify, renew and manage QHPs participating in the FFMFFE. SERFF’s role and approach leverages existing systems, assist states in certifying QHPs and facilitates integration. Using existing information technology will mitigate costs and lessen the burden to issuers of adapting to a new system. AHCD Accounts Manager HBEPD staff member Xxxxx Xxxxxxxxx has attended all NAIC/SERFF forums and any SERFF related forums at State Grantee Meetings. He assisted with reports progress in SERFF adjustments to meet plan management needsneeds to HBEPD and other effected AID staff. The plans reviewed will eventually land up in • Forum #1 brought together more than 30 states and CCIIO/CMS to discuss the federal development of Health Insurance Oversight System (HIOS)Exchanges and potential use of SERFF in Plan Management. XXXX NAIC provided a demonstration of SERFF functionality as it worked currently and preliminary mock-ups showing how SERFF might be modified to support Plan Management. • Forum #2 was to continue and expand on the discussion on Health Insurance Exchanges and the role of SERFF in Plan Management. • Forum #3 involved the SERFF Plan Management project team and provided updates on project timelines, progress on analysis and design, and plans for implementation and training. NAIC staff provided an overview of key areas of Plan Management: 1) QHP Certification; 2) Issuer Account Management; 3) QHP Oversight; and 4) QHP Renewal/Certification/Decertification. • Forum #4 was where NAIC staff provided updates toward leveraging SERFF for Plan Management functions related to the health insurance exchanges. Presentations were: 1) Updates to the project timeline and scope; 2) Enhancements planned for a summer 2012 release; 3) An update on efforts to achieve uniform data sets for Plan Management; 4) The critical path for SERFF in Phase 1, and information related to Phase 2 functionality; and 5) A panel discussion with CCIIO, the states and issuers. NAIC/SERFF have identified five 5 goals and objectives held by stakeholders in the SERFF Plan Management project:  • G01- Enhance SERFF to allow so that state departments of insurance can use it to meet their Plan Management functions  plan management functions; • G02- Streamline the process for insurers submitting plans for inclusion on the Marketplace  Exchange; • G03- Support integration between applications involved in Marketplace operations  Exchange operations; • G04- Provide flexibility to the states regarding in how SERFF is used for Plan Management  Management; and • G05- Minimize duplicative entry. Xxxxxx Xxxxxxxx also helped coordinate state-HBEPD has had an opportunity to study the business model flowchart of the certification process in a FFE model. It presents a high level overview of the process flows of a QHP as it initiates from Insurer into SERFF to HIOS and finally up on the federal exchange portal. NAIC is working closely with CCIIO to define special needs and requirements development for FFE and planning for the Arkansas- SERFF Plan Management Functions to facilitate the Department Partnership Exchanges using SERFF in the selection process for QHPsQHP Certification. This work included close collaboration between the AHCD Plan Management Specialist SERFF will allow states to individualize data collection and the Compliance Division Compliance Officer. We were pleased with SERFF functioning for the first year review and recommendation cycleprocesses. AID’s Consumer Services Division (CSD) is designed to assist insurance consumers with complaints resolution and inquiries regarding insurance companies or companies, agents, and adjusters. CSD investigates all complaints, working with the insurance company and the consumer to determine the appropriate course of action. Prior to 2011, all CSD staff members were generalists, addressing all life, health, and property/casualty calls. In 2010, CSD was awarded a CCIIO Consumer Assistance Program (CAP) grant Grant to help consumers with issues related to provisions of the Affordable Care Act. Services under this program include: assisting consumers with filing of complaints and any needed appeals processes; collecting, tracking, and assessing consumer problems and inquiries; educating consumers on their rights and responsibilities with respect to group health plans and health insurance coverage; and assisting consumers with enrollment in group health plans or health insurance coverage by providing information, referral, and assistance. The AHCD CSD added a CAP manager and new investigator to devote 100% effort to health issues. Another investigator was reassigned to this effort, transitioning from a generalist to a 100% health specialist. CSD staffs has provided outreach and education, using staff and print and electronic media advertising. When Federal funds were exhausted in June 2012, AID CSD continued consumer assistance activities addressing health insurance concerns. CSD has applied for another CCIIO Consumer Assistance Program Grant in July 2012 that, if awarded, will assist CSD in meeting anticipated service increases related to FFE Partnership implementation. The status of this funding is “pending”. The HBEPD and CSD-CAP staff are committed to working collaboratively to expand CAP efforts in preparation for 2014 SPM Health Benefits Exchange implementation. CSD Coordinated efforts will focus on outreach education, complaints resolution, and AHCD data collection/analysis to inform Exchange planning/implementation and health insurance system improvements at all levels—consumers, carriers, producers, and providers. Program Integrity As part of our planning assessments we included review of existing monitoring tools for consideration when the Exchange system is designed. As the FFE Partnership Model is finalized and we begin to establish the Exchange organization, we are working putting in place the oversight, auditing and fraud, waste, and abuse prevention tools needed to catalogue consumer inquiries assure proper stewardship of public funds. We are constantly monitoring that resources are used efficiently and complaints appropriately from the outset and ongoing. AID has in place an accounting and financial department that is strictly governed by existing state policy. Arkansas audit procedures are performed yearly and are implemented to insure that no one person or position has sole authority to receive, process, and make payments. These policies are in force to provide an effective and efficient system of checks and balances. Additionally, Level One Grant funding has allowed us to hire a Grants/Contracts Specialist dedicated to the financial management of the federal grants accorded under ACA. Xxxx Xxxxx was hired to fill this position in May, 2012. He is currently leading the effort to standardize responses, identify trends develop HBEPD specific policies and work procedures to continuously improve consumer services associated with the SPM. In response supplement and provide adequate checks and balances to Act 1439 we will be using the our existing AID licensing process for accounting office. The Grants/Contracts Specialist is tracking and reporting all Marketplace navigator expenses, receivables, and non- navigator personnel including licensed agents and brokers. AHCD is working expenditures in collaboration with the AID License Division to establish processes whereby AHCD will review accounting office. Individual DHHS grants are tracked by specific grant identification and account numbers so that expenses, payments and draw-downs are separately and appropriately accounted for successful completion of training, testingand reported. Affordable Care Act Requirements Rate Review - The AID currently has prior approval authority over individual health insurance rates for all issuers. In recent years the Commissioner has negotiated with issuers for all rate increases, and background checksrecently negotiated a lower rate affecting approximately 90,000 policyholders. He reduced the increase in rates by approximately 4% for the year 2010. The License AID was recipient of Initial Rate Review and Cycle II grant funding from CCIIO which helped Arkansas move toward an effective rate review program for all health insurance markets. Specifically, AID issued two bulletins (6- 2011 and 7-2011) to increase requirements for individual rate filings and to obtain prior approval authority in the small group market. Effective September 1, 2011, all rate increases over the 10% threshold are subject to the new filing requirements in these Bulletins. Arkansas has been designated by CCIIO as having an “Effective Rate Review Program”. Rate review will help keep down the premium costs for Arkansas small businesses and families. The RRD will have an independent expert review proposed health plan rate increases submitted by insurance issuers. Arkansans will be able to access the issuer’s justifications submitted as part of the rate review process online on the RRD’s website. This site will also link to the Arkansas HBE website as well as the federal website (www. Xxxxxxxxxx.xxx). Citizens will be able to provide public comment on all rate filings. The AID Rate Review Division (RRD) will continue all current activities and tasks related to the Affordable Care Act (ACA), including but not limited to rate filings for major medical policies. The AID Life and Health Division will work closely with RRD and will utilize all programs, job aids and other rate review tools developed by RRD. The Life and Health Division will support RRD in all required HHS and Health Information Organizations (HIOS) filings and reporting requirements related to planning for Rate Review. Consumer and plan outreach and other similar activities related to Rate Review will remain within the RRD scope of services. In June, 2012 the RRD hosted a National Rate Review conference in Little Rock where the HBEPD director presented a session on State Level Collaboration Between Rate Review and Exchange Implementation. Between twenty-five and thirty states and territories attended this conference in person and a number more attended by live, interactive video. Minimum Loss Ratio (MLR) - As MLR filings are made with AID, the RRD will process license applications all MLR filings utilizing its recently developed MLR tracking program to effectively monitor these filings. RRD will verify the issuers’ calculations of rebates, or lack thereof, and feesensure that all rebates are made in the required time frame and in the proper amount. A public hearing was held July 31MLR tracking is essential for accurate review of all rate filings. In August 2012 Arkansas consumers were awarded $7.8 million in rebates. No further action is required. Reinsurance, 2013 Risk Corridor and Risk Adjustments - The RRD plans to address public comments be the AID liaison for planning and implementation of these adverse selection mitigation strategies. The Reinsurance program could be State or Federally operated under the Partnership option. Risk Adjustment and Risk Corridor Programs will be run by the Federal Government. Current thought is that Arkansas will defer operations of the Temporary Reinsurance program to the federal government. Other ACA requirements: • AID issued Rule 102 which required all carriers in the individual market to offer a child only policy. AID also began review of all policies to insure that any pre-existing condition provisions do not apply to anyone under age 19. • AID will not approve any policy that does not comply with the ACA requirement that coverage be extended to children to age 26 on their parents’ policy. • AID adopted Rule 76 entitled “Arkansas External Review Regulation” which puts in place the NAIC model rule, thereby complying with the federal regulation regarding Rule 104 which sets the Marketplace license fee at $35external review.

Reuse, Sharing and Collaboration. The business functions of certifying, renewing and managing the Qualified Health Plans (QHPs) available in the Arkansas Marketplace Exchange are elements of Plan Management and will be the state’s responsibility in the SPMState Partnership Exchange. State regulators and insurers need an efficient, effective and compliant means to submit and review health plans for certification and inclusion in the MarketplaceExchange. Currently, AID uses the National Association of Insurance Commissioners (NAIC) System for Electronic Rate and Form Filling (SERFF), developed in 1998, to support handling of insurance policy rate and form filings from Arkansas’s issuers. As previously noted, AHCD noted HBEPD is utilizing planning to utilize SERFF as to provide a single point of interaction for Arkansas issuers to submit plans for certification and renewal and for Arkansas state regulators to certify, renew and manage QHPs participating in the FFMFFE. SERFF’s role and approach leverages existing systems, assist states in certifying QHPs and facilitates integration. Using existing information technology will mitigate costs and lessen the burden to issuers of adapting to a new system. AHCD Accounts Manager HBEPD staff member Xxxxx Xxxxxxxxx has attended all NAIC/SERFF forums and any SERFF related forums at State Grantee Meetings. He assisted with reports progress in SERFF adjustments to meet plan management needsneeds to HBEPD and other effected AID staff. The plans reviewed will eventually land up in • Forum #1 brought together more than 30 states and CCIIO/CMS to discuss the federal development of Health Insurance Oversight System (HIOS)Exchanges and potential use of SERFF in Plan Management. XXXX NAIC provided a demonstration of SERFF functionality as it worked currently and preliminary mock-ups showing how SERFF might be modified to support Plan Management. • Forum #2 was to continue and expand on the discussion on Health Insurance Exchanges and the role of SERFF in Plan Management. • Forum #3 involved the SERFF Plan Management project team and provided updates on project timelines, progress on analysis and design, and plans for implementation and training. NAIC staff provided an overview of key areas of Plan Management: 1) QHP Certification; 2) Issuer Account Management; 3) QHP Oversight; and 4) QHP Renewal/Certification/Decertification. • Forum #4 was where NAIC staff provided updates toward leveraging SERFF for Plan Management functions related to the health insurance exchanges. Presentations were: 1) Updates to the project timeline and scope; 2) Enhancements planned for a summer 2012 release; 3) An update on efforts to achieve uniform data sets for Plan Management; 4) The critical path for SERFF in Phase 1, and information related to Phase 2 functionality; and 5) A panel discussion with CCIIO, the states and issuers. NAIC/SERFF have identified five 5 goals and objectives held by stakeholders in the SERFF Plan Management project:  • G01- Enhance SERFF to allow so that state departments of insurance can use it to meet their Plan Management functions  plan management functions; • G02- Streamline the process for insurers submitting plans for inclusion on the Marketplace  Exchange; • G03- Support integration between applications involved in Marketplace operations  Exchange operations; • G04- Provide flexibility to the states regarding in how SERFF is used for Plan Management  Management; and • G05- Minimize duplicative entry. HBEPD has had an opportunity to study the business model flowchart of the certification process in a FFE model. It presents a high level overview of the process flows of a QHP as it initiates from Insurer into SERFF to HIOS and finally up on the federal exchange portal. NAIC is working closely with CCIIO to define special needs and requirements for FFE and Partnership Exchanges using SERFF for QHP Certification. SERFF will allow states to individualize data collection and processes. Xxxxxx Xxxxxxxx also helped has begun to coordinate state-NAIC requirements development and planning for the Arkansas- Arkansas-SERFF Plan Management Functions to facilitate the Department using SERFF in the selection process for QHPsFunctions. This work included includes close collaboration between the AHCD HBEPD Plan Management Specialist and the Compliance Division Life and Health Compliance Officer. We were pleased with SERFF functioning for the first year review and recommendation cycle. AID’s Consumer Services Division (CSD) is designed to assist insurance consumers with complaints resolution and inquiries regarding insurance companies or companies, agents, and adjusters. CSD investigates all complaints, working with the insurance company and the consumer to determine the appropriate course of action. Prior to 2011, all CSD staff members were generalists, addressing all life, health, and property/casualty calls. In 2010, CSD was awarded a CCIIO Consumer Assistance Program (CAP) grant to help consumers with issues related to provisions of the Affordable Care Act. Services under this program include: assisting consumers with filing of complaints and any needed appeals processes; collecting, tracking, and assessing consumer problems and inquiries; educating consumers on their rights and responsibilities with respect to group health plans and health insurance coverage; and assisting consumers with enrollment in group health plans or health insurance coverage by providing information, referral, and assistance. The AHCD CSD added a CAP manager and new investigator to devote 100% effort to health issues. Another investigator was reassigned to this effort, transitioning from a generalist to a 100% health specialist. CSD has provided outreach and education, using staff and print and electronic media advertising. When Federal funds were exhausted in June 2012, AID CSD continued consumer assistance activities addressing health insurance concerns. CSD applied for another CCIIO Consumer Assistance Program grant in July 2012 to assist CSD in meeting anticipated service increases related to State Partnership Exchange implementation. CSD was notified in August that the grant was funded and received their legislative appropriation for these funds on December 21, 2012, the same day that HBEPD’s Level One B funding was approved. The HBEPD and CSD-CAP staffs are committed to working collaboratively to expand CAP efforts in preparation for 2014 SPM State Partnership Exchange implementation. CSD CSD-CAP and AHCD HBEPD are working to catalogue consumer inquiries and complaints in an effort to standardize responses, identify trends and work to continuously improve consumer services associated with the SPM. In response to Act 1439 we will be using the existing AID licensing process for all Marketplace navigator and non- navigator personnel including licensed agents and brokers. AHCD is working with the AID License Division to establish processes whereby AHCD will review for successful completion of training, testing, and background checks. The License Division will process license applications and fees. A public hearing was held July 31, 2013 to address public comments regarding Rule 104 which sets the Marketplace license fee at $35State Partnership Exchange.