Meeting Materials for

November 17, 2016 Meeting Minutes

Presentation - Executive Director's Report

Resolution 2017-04

Presentation - Covered California Policy Items

• Individual Eligibility and Enrollment Regulations Emergency Readoption

  • Individual Eligibility and Enrollment Regulation Resolution (2017-05)

• Plan Based Enrollment Permanent Regulations Amendment

• SHOP Eligibility and Enrollment Emergency Regulations Readoption

• Draft QHP Certification Application for Plan Year 2018 Individual Marketplace (clean)

• Draft QHP Certification Application for Plan Year 2018 Individual Marketplace (redline)

  • Attachments B C1 C2 D2 D3 – Individual QHP

  • Attachment D1 Member Communication Calendar – Individual QHP

  • Attachment E QIS Run Charts – Individual QHP (Amended)

• Draft QDP Certification Application for Plan Year 2018 Individual Marketplace (clean)

• Draft QDP Certification Application for Plan Year 2018 Individual Marketplace (redline)

  • Attachments C1 C2 D2 D3 – Individual QDP

  • Attachment D1 Member Communication Calendar – Individual QDP

• Draft QHP Certification Application for Plan Year 2018 Covered California for Small Business (clean)

• Draft QHP Certification Application for Plan Year 2018 Covered California for Small Business (redline)

  • Attachments B C1 C2 D2 D3 G – CCSB QHP

  • Attachment D1 Member Communication Calendar – CCSB QHP

  • Attachment E QIS Run Charts – CCSB QHP

• Draft QDP Certification Application for Plan Year 2018 Covered California for Small Business (clean)

• Draft QDP Certification Application for Plan Year 2018 Covered California for Small Business (redline)

  • Attachments C1 C2 D2 D3

  • Attachment D1 Member Communication Calendar – CCSB QDP

• Appendix A Definition of Good Standing

• Appendix B Issuer Participation Fee Billing Discrepancy Resolution

• Appendix C PMPM_Member_Level_Detail_Response SAMPLE

• Appendix D Covered California Reconciliation Process Guide v2

• Appendix E Covered California Agent of Record (AOR) Policy

• Appendix G Covered California Brand Style Guide

• Appendix H 2017 QHP Issuer Contract Attachment 7

• Appendix I Provider Data Submission Guide 2018

• Appendix J Issuer Payment Discrepancy Resolution

• Appendix K NOD 23 Report Glossary

• Appendix L 834 Companion Guide v16.9.40

• Appendix M 834 Companion Guide Design v2.2

• Appendix N CCSB Agent of Record Policy

• Appendix O GAO 15-593SP

• Appendix P CCSB Group XML Schema v2.1a

• Appendix Q CCSB EDI 820 Companion Guide v2.0

• Appendix R Attachment 7_Meaurement Specifications

• Proposed Standard Benefit Design

• Proposed Covered California 2018 Patient Centered Benefit Plan Designs 10.0

• Proposed Covered California 2018 Patient Centered Benefit Plan Designs 9.5

• Proposed Plan Designs Side-by-Side Comparison

• Proposed Endnotes for 2018 PCBPD 2017

• Proposed 2018 Dental Benefit Plan Designs

• Proposed 2018 Dental Copy Schedule

Comments to the Board (with Table of Contents and Links) -Updated 1/26/17

Reports and Research (with Table of Contents and Links)

• Covered California Report to the Governor and the Legislature, Fiscal Year 2015–2016

• An Integrated Quantitative and Qualitative Study on Post-Election Attitudes Toward Enrolling in and Renewing Health Insurance Coverage Topline Report

• Consumer and Market Implications of Affordable Care Act Repeal without a Viable Replacement

• Review and Analysis of Potential Policy Changes to the Affordable Care Act

• Evaluating the Potential Consequences of Terminating Direct Federal Cost-Sharing Reduction (CSR) Funding

  • Appendix

• Lessons Learned From Five Years of Patient-Centered Reform

Press and Media Clips (with Table of Contents and Links)