Delaware Health Benefit Exchange (HBE) Marketplace Assister Certification

1. Delaware Health Benefit Exchange (HBE) Marketplace Assister Certification Delaware Health Care Commission Meeting: January 3, 2013

2. MPA Certification Standards During the December HCC meeting, PCG presented draft certification standards for marketplace assisters (MPAs). • MPAs will be the main outreach arm for the Exchange and provide ongoing assistance to Exchange consumers throughout the state. • The certification process will be used to ensure that individuals acting as MPAs meet certain requirements, including experience serving potential Exchange populations and meeting conflict of interest standards. The HCC supported an open comment period through December 22nd to collect stakeholder responses to the draft standards. • A summary of comments received and responses to those comments follows.

3. MPA StandardsComments/Questions & Responses There needs to be a method or process for consumers or other interested parties to raise concerns about a particular Marketplace Assister (MPA).  A recommendation of a clear path for comments and complaints be established. • A formal complaint process will be instituted under separate cover than the certification standards.  Note that the recertification and decertification processes are dependent on evaluation of consumer complaints against the MPA. What is the door to door or telemarketing function of MPAs?  • At this time, we do not expect that MPAs will conduct telemarketing or door to door solicitation.  Should this expectation change in the future, the State will ensure that such activities follow appropriate Delaware code. Who will be evaluating the results of background checks? • The State will evaluate findings from criminal background checks on a case by case basis. Language within the criminal background check description has been adjusted to clarify this process.

4. MPA StandardsComments/Questions & Responses In addition to helping individuals connect with the Health Insurance Exchange, there is great potential for MPAs to help individuals obtain needed public health and social services in the long term. • While the first year of MPA activities will focus on the Exchange and broader messaging on the importance of primary and preventive care, the State agrees that a State-operated MPA program has potential to offer broad education on a variety of public health and social service programs in the future.   Selection criteria for MPAs should be tailored to include not only the usual community organizations but also health centers, hospitals, senior centers, chamber of commerce, etc. • MPA organizations will be selected through an RFP process.  The selection criteria included within the RFP will reflect the State's intention to contract with a wide variety of organizations to serve varied populations.

5. MPA Standards and Next Steps Revised standards were distributed to Health Care Commission members in advance of today’s meeting. • The Exchange project asks the Commission to consider these standards for finalization. Next Steps: • An RFP for Marketplace Assister organizations is currently being finalized for release in January.