S y st e m T riball y Sponsor e d He a lth Insur a nce Program A la s ka N ati v e T ribal H ealth Consortiu m A pril 2 0 16 Overview 2 ID: 656210
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Slide1
Alaska
Tribal Health SystemTribally-Sponsored Health Insurance Program
A
la
s
ka
N
ati
v
e
T
ribal
H
ealth
Consortiu
m
A
pril
2
0
16Slide2
Overview
2T-SHIP Program StructureMarketplace Enrollment &
C
o
vera
g
e
T
ax
Proc
e
ss
E
v
aluationSlide3
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Do
you
want
your
health
insurance
paid
for
you?Slide4
Pro
gram Structure4Nationwide, tribes and
tribal
he
a
l
t
h 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 servicesHealth insurance policies will pay for patients seen at private facilities, saving tribe’s Purchased Re
ferred
Care moneySlide5
Alas
ka tribal health organizations approved a system- wi
d
e
demo
n
strat
ion project in 2013Alaska tr
ibal leaders sought consistency in a statewide approach to tribal health insurance sponsorshipAlaska Native people are generally cared for by several Tribal health organizations at multiple locations, the insurance benefits and cost savings may be realized dif
ferently
5
Pro
g
ram
Struct
u
reSlide6
Pro
gram Structure6HIP established to enroll
Alas
k
a
N
a
tives and American Indians in comprehensive heal
th insurance coverage in order to:expand access to health care services for T-SHIP enrollees andto increase the resources available to all beneficiaries ofthe Alaska Tribal Health System.Slide7
Pro
gram Structure7T-SHIP Participating THOs
Arctic
S
l
o
pe
NativeAssociation
Kenaitze Indian TribeKetchikan Indian CommunityKodiak Area Native AssociationMetlakatla Indian CommunityNorton Sound Health CorporationSouthcentral FoundationSouthE
ast
A
l
aska
R
e
g
i
o
n
al
H
e
alth
C
o
nsortium
T
an
a
na
C
h
i
e
fs C
o
nference
A
l
aska
N
a
tive
T
ribal
Hea
l
th C
o
nsortiumSlide8
Pro
gram Structure8Statewide Tribal steering committee ov
e
rsees
Program des
i
gn
and policiesOperations,
Priorities, andEvaluationMeeting quarterly in 2016Next meeting: May 16, 2016Slide9
H
IP sponsors certain IHS-eligible individuals for insurance coverage by paying the premium for a poli
cy on
the
H
e
alth Insurance Marketplace.T-SHIP establ
ished agreed upon eligibility criteriaPrivate insurance provides “essential health benefits”Federal government provides two types of assistancethrough the MarketplacePremium tax creditsCost-sharing reductions9Marketplace CoverageSlide10
Market
place CoverageRegional partners assess uninsured individuals for
Marketpl
a
ce spo
n
sorship
as well as Medicaid enrollmentRegional
partners/broker enroll on Healthcare.govT-SHIP designates the plan to selectCoverage is effective 2-6 weeks after enrollmentNo retroactive coverage10Slide11
Market
place Coverage11Goal for 2016 is 800 sponsored policies
Co
v
erage
Y
ear
Sponso
redPolicies (#)201420020158562016255Slide12
Market
place Coverage12HIP Statewide Office
arranges
w
ith
plans
to streamline administrationAggregate premium payment method
Referral for cost-sharing protections processQuality checks for cost-sharing paid to IHPsSlide13
T
ax Process13The T-SHIP tax subsidy refund program holds individual
patients h
a
rm
l
ess
R
eimburse individuals for refunds requ
ested by the IRS related to a health insurance premium tax creditHelp individuals find a tax advisor and pay reasonable costs for tax advice related to this health insuranceSlide14
Re
sults14HIP develops standards for data collection and contracts for ongoing and
formal pro
g
ram ev
a
luat
ion and recommendations onProgram design
CostsBenefitsOther impactsSlide15
Alaska
Tribal Health SystemTribally-Sponsored Health Insurance
w
w
w
.
a
nthctoda
y.org/tship15Slide16
Alas
ka Tribal Health SystemTribally-Spon
s
ored
Hea
l
th
Insurance16Than
k youLorraine Jones, DirectorTribally-Sponsored Health Insurance ProgramAlaska Native Tribal Health Consortium907-729-2843lejones@anthc.orgOr sponsorship@anthc.org