| Connecticut Charter Oak Health Plan |
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The State of
The srHS team was tasked with providing
strategic advice and actuarial support throughout the legislative and
procurement processes. We strived to design
an affordable benefit package that is partially subsidized by the State while
hitting a target monthly premium of $300.
Solution
srHS
worked directly with DSS staff to bring the Charter Oak program to life. We
were involved with the initial program design and subsequent redesign, and
developed the actuarially sound MCO rate ranges. Also, as part of the joint procurement with
the HUSKY Medicaid programs, we designed the RFP, supported DSS by
answering questions from bidders and supplying additional information, and negotiating
the final rates paid to the MCOs.
It was important to have a
rich enough benefit package that it would be attractive to potential buyers,
yet still remain affordable enough to allow them to purchase the coverage
regardless of their income level. srHS helped
DSS decide what benefits were essential, the appropriate cost sharing, and at
what levels the sliding scale premiums should be set at.
As there was no Charter
Oak historical experience data to work with and build appropriate capitation rates, srHS started with a Medicaid base and
adjusted for differences in benefits, demographics, and trended the data
forward to the relevant time period. One of the most critical assumptions was
determining the risk of those that would ultimately enroll in the program. To
do that, srHS created a selection
model that used the elasticity of demand to project enrollment based on premium cost to
the enrollee, covered benefits, and cost sharing. All of these adjustments resulted in
actuarially sound capitation rate ranges for the Charter Oak program.
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