Families USA Workshop November 11, 2010 Selecting Good Plans for Health Insurance Exchanges

Agenda Typical Process for Plan Certification Benefits of Selective Contracting Model outline of the procurement process 2

Typical Process for Plan Certification Develop criteria, process, and standards of participation Publish a solicitation document Develop objective scoring criteria Evaluate and score respondents Certify QHPs based on evaluation and score 3

Benefits of Selective Contracting Allows for greater level of partnership and collaboration with market Structured properly can create healthy competition and enhanced consumer choice Can be catalyst for market innovation Demands a transparent, objective process which benefits all market participants 4

Model Outline of Procurement Process Upfront goal setting & analytics Develop the procurement process: – Transparent to market – Create some degree of flexibility – Establish timeframe and stay within stated deadlines Communicate with market the goals of procurement 5

Model Outline of Procurement Process (cont) Allow for period of negotiation after receipt of responses – Allows state to smooth-out potential disruptions resulting from responses – Provides opportunity to leverage or reward innovation by responders 6

Model Outline of Procurement Process (cont) Allow for the ability to Blue Sky and expect more from market – Goal is to push the envelop – Do not pre-judge how market will respond – Often-times will be pleasantly surprised with strength of response and willingness for carriers to partner & collaborate 7