1. Alaska Tribal Health System Tribally-Sponsored Health Insurance Program Alaska Native Tribal Health Consortium April 2016

2. Overview 2 1.T-SHIP Program Structure 2.Marketplace Enrollment & Coverage 3.Tax Process 4.Evaluation

3. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Do you want your health insurance paid for you?

4. Program Structure 4 Nationwide, tribes and tribal health organizations are sponsoring health insurance policies for some or all of their tribal members, because: Health insurance policies will pay tribal health programs for medical services Health insurance policies will pay for patients seen at private facilities, saving tribe’s Purchased Referred Care money

5. Alaska tribal health organizations approved a system- wide demonstration project in 2013 Alaska tribal leaders sought consistency in a statewide approach to tribal health insurance sponsorship Alaska Native people are generally cared for by several Tribal health organizations at multiple locations, the insurance benefits and cost savings may be realized differently 5 Program Structure

6. 6 S.HIP established to enroll Alaska Natives and American Indians in comprehensive health insurance coverage in order to: expand access to health care services for T-SHIP enrollees and to increase the resources available to all beneficiaries of the Alaska Tribal Health System.

7. Program Structure 7 T-SHIP ParticipatingTHOs Arctic Slope Native Association Kenaitze Indian Tribe Ketchikan Indian Community Kodiak Area Native Association Metlakatla Indian Community Norton Sound Health Corporation Southcentral FoundationSouthEast Alaska Regional Health Consortium Tanana Chiefs Conference Alaska Native Tribal Health Consortium

8. Program Structure 8 Statewide Tribal steering committee oversees Program design and policies Operations, Priorities, and Evaluation Meeting quarterly in 2016 Next meeting: May 16, 2016

9. S.HIP sponsors certain IHS-eligible individuals for insurance coverage by paying the premium for a policy on the Health Insurance Marketplace. T-SHIP established agreed upon eligibility criteria Private insurance provides “essential health benefits” Federal government provides two types of assistance through the Marketplace Premium tax credits Cost-sharing reductions 9 Marketplace Coverage

10. Regional partners assess uninsured individuals for Marketplace sponsorship as well as Medicaid enrollment Regional partners/broker enroll on Healthcare.gov T-SHIP designates the plan to select Coverage is effective 2-6 weeks after enrollment No retroactive coverage 10

11. Marketplace Coverage 11 Goal for 2016 is 800 sponsored policies Coverage YearSponsored Policies (#) 2014200 2015856 2016255

12. Marketplace Coverage 12 S.HIP Statewide Office arranges with plans to streamline administration Aggregate premium payment method Referral for cost-sharing protections process Quality checks for cost-sharing paid to IHPs

13. Tax Process 13 The T-SHIP tax subsidy refund program holds individual patients harmless Reimburse individuals for refunds requested by the IRS related to a health insurance premium tax credit Help individuals find a tax advisor and pay reasonable costs for tax advice related to this health insurance

14. Results 14 S.HIP develops standards for data collection and contracts for ongoing and formal program evaluation and recommendations on Program design Costs Benefits Other impacts

15. Alaska Tribal Health System Tribally-Sponsored Health Insurance w.anthctoday.org/tship 15

16. Alaska Tribal Health System Tribally-Sponsored Health Insurance 16 Thank you Lorraine Jones, Director Tribally-Sponsored Health Insurance Program Alaska Native Tribal Health Consortium 907-729-2843 lejones@anthc.org Or sponsorship@anthc.orgsponsorship@anthc.org