Offer More Than Choices
Covered California has to be more than justa health insurance marketplace. There are already some excellent broker operated, web-based portals, like eHealthinsurance.com and HealthcareShopper.com, that present plans and rates to individuals and small businesses. The private sector is more than able to adapt to the new Affordable Care Act (ACA) rules and develop dynamic choice portals. If the private market can deliver choices, the Exchange has to deliver more than choices.
Insure “No Wrong Door” Functionality
The Covered California health insurance marketplace must become a proactive force of change in the market. It can be a model that educates individuals and small business and efficiently delivers them to carrier partners. It must organize these two disorganized market segments - individual health insurance and small business health insurance - by offering a better way for sellers to sell and buyers to buy. It must also lead qualified individuals to existing public programs like Medi-Cal. In short, Covered California must deliver on the concept of “no wrong door” envisioned in the ACA.
Provide a First-Class User Experience
A coalition of 11 states, the federal government, eight charitable foundations, and a leading Silicon Valley design firm have collaborated to meet this challenge. Their solution, Enroll UX 2014, provides a road map for every state and the federal government to create a state-of-the-art, online process for application, eligibility determination, enrollment, and health plan selection. It can be customized by states to be the public face of the insurance exchanges required by the federal health reform law.
Provide Value for Partners
Finally, Covered California must provide real value for its partners. That means it must make life easier, not more complicated for insurers, agents, employers, individuals and providers. It must remove some of the inefficiencies involved in serving these market segments by providing centralized education, quality ratings, online enrollment, participant eligibility maintenance, automated billing and collection, carrier EDI, electronic disbursements and reconciliation.