Health Insurance Marketplace

Building a strong marketplace requires effectively bringing together stakeholders and participants.”

Michael Karris, Client Executive, Healthcare and Human Services Practice
Michael Karris

Health Insurance Marketplace

The requirements and timelines for the health insurance marketplace are ambitious. CSG provides the program, policy, technology, and management expertise that is essential to successfully implement your marketplace solution.

CSG'S Expertise in Action

 
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The Iowa Marketplace: A State Partnership Model

 
Des Moines
Des Moines

As the State of Iowa moves forward with their health insurance marketplace, they have chosen a Plan Management State Partnership model. They are also implementing a Premium Assistance Waiver for their Medicaid expansion population - one of two states pioneering this innovative approach. The State selected CSG to help with these complex efforts.

PMO by CSG SM

CSG is working with the Iowa Medicaid Enterprise and the Iowa Insurance Division to manage the implementation of their Plan Management State Partnership. We have established a Project Management Office (PMO); conducted background research; facilitated planning, requirements, and design sessions; and prepared for federal Establishment Reviews and the State’s blueprint application. CSG also provides RFP development and procurement support and Independent Verification and Validation (IV&V) services.

Iowa is pursuing a vision to improve access to health insurance for all Iowans. CSG is there to help achieve that goal.

The Rhode Island Unified Health Infrastructure Project

 
Providence
Providence

Rhode Island’s Unified Health Infrastructure Project (UHIP) is a multi-phased effort, developing an integrated technology platform across healthcare and human services programs. UHIP is a collaboration of five Rhode Island government agencies with a vision for a single technology solution that simplifies enrollment for individuals and families eligible for Medicaid/CHIP, SNAP, TANF, and commercial-based healthcare plans. The project includes implementation of an ACA-compliant health benefits exchange solution.

IV&V by CSG SM

Rhode Island selected CSG to provide comprehensive Independent Verification and Validation (IV&V) services for the design, implementation, and operation of the UHIP technology platform. The CSG team conducts proactive project health and risk assessments encompassing the full system development life cycle. Our assessments identify project risks and opportunities to implement best practices. We develop risk mitigation strategies, alternative approaches, and recommendations for improving project performance.

CSG is also leading the State’s user acceptance testing to validate that the system complies with federally-mandated requirements. In addition, we provide independent security assessments and system audits.

Rhode Island is pursuing a vision to improve access to healthcare and human services programs. CSG is there to help achieve that goal.

Integrated Eligibility Modernization in Massachusetts

Boston
Boston

The Commonwealth of Massachusetts’ Health Insurance Exchange and Integrated Eligibility System (HIX/IES) is co-managed by the Massachusetts Executive Office of Health and Human Services and the Commonwealth Health Insurance Connector Authority. The HIX/IES provides a one-stop marketplace that makes it easier than ever for individuals and families to enroll in affordable health coverage that meets their needs.

IV&V by CSG SM

CSG was selected to provide IV&V oversight, including ongoing risk management, completion of MEELC IV&V Progress Reports and checklists, and validation testing and attestation for federal compliance. We completed an initial risk and impact assessment and provide continuous reporting related to the project portfolio, structure, management, and approach, as well as all procurements related to the system. To assure project success, CSG applies our expertise to advise stakeholders on all aspects of the project including planning, procurement development, program management, vendor integration, and service level agreements. Our team also performs requirements traceability throughout the entire project life cycle and monitors implementation quality.

EOHHS and the Connector are dedicated to providing integrated services that improve the health and well-being of Commonwealth individuals and families. Together, the Commonwealth and CSG are working to ensure the HIX/IES system efficiently serves the residents of the Commonwealth.