A state board will focus on four companies as potential candidates for a contract to provide the technology for an Arkansas-based health insurance exchange for individual consumers, a committee decided Wednesday.
Deloitte Consulting, a subsidiary of New York-based Deloitte Touche Tohmatsu; Dublin-based Accenture; Montreal-based CGI Group; and Falls Church, Va.-based CSC were each the lead contractor in charge of establishing at least one of the seven state-based health insurance exchanges that the Arkansas Health Insurance Marketplace board considers to be successful.
Deloitte built the health exchanges for four of those states: Washington, Kentucky, Rhode Island and Connecticut.
CGI built the exchange for Colorado and was also the lead contractor for the federal enrollment website, healthcare.gov, which suffered from widespread technological glitches during the first months after it opened for sign-ups in October 2013.
Accenture built California's exchange and replaced CGI as the lead contractor for healthcare.gov in February 2014.
CSC built the exchange for New York.
The four companies will be the only ones allowed to respond to a request by the Arkansas board for information on the cost of establishing an exchange for individual consumers in Arkansas using the computer code from one of the seven states with successful exchanges, the marketplace board's information technology committee decided Wednesday.
The marketplace's staff had recommended that any interested vendor be allowed to respond to the solicitation.
But Sherill Wise, the committee and board chairman, said it's likely that only the company in charge of establishing an exchange in one of the seven states would be qualified to set up another exchange using the same code.
"I'd like to limit this to those that we're confident have the expertise and have done this," Wise said.
To begin enrollment in October 2016, she said, a contract will likely need to be awarded by the end of the year.
"We're running out of time," she said.
Established under the 2010 federal Patient Protection and Affordable Care Act, health insurance exchanges allow consumers to shop for coverage and apply for subsidies to help pay for it.
Sixteen states and the District of Columbia established their own exchanges for individual consumers. Arkansas and 33 other states have federally operated exchanges.
A law passed by the Arkansas Legislature in 2013 created the marketplace board and directed it to set up exchanges that would replace those set up for the state by the federal government.
The marketplace board is using money from a $99.9 million federal grant to set up the exchanges.
Enrollment in an exchange for small-business employees, which is being built by Reston, Va.-based hCentive under a $7.2 million contract, is expected to start Nov. 1 for coverage that will begin in December.
Coverage for plans issued on the individual exchange would start in 2017.
Proponents of establishing state-based exchanges say they could be tailored to suit Arkansas' needs. That includes potentially providing an enrollment portal for the program that will replace the private-option Medicaid program after the federal waiver authorizing the program expires at the end of 2016.
The program uses Medicaid funds to buy insurance on the federally run exchange for more than 200,000 Arkansans.
The marketplace board had initially planned to solicit bids in May for a contract to build the technology for the individual market insurance exchange.
Last month, however, the board decided to scrap that plan in favor of using the computer code from another state's exchange.
Compared with starting from scratch, using another state's technology would be quicker and cheaper, with the code supplied to Arkansas at no cost, the marketplace's director, Cheryl Smith Gardner, has said.
The copied code could also include software for verifying eligibility for tax credits, allowing the marketplace to avoid using the state Department of Human Services enrollment and eligibility system.
The department's system, which has been under construction since April 2013, has flaws that have caused delays in processing Medicaid applications and conducting annual eligibility checks of those already enrolled.
The marketplace board is waiting for the results of an assessment of the Human Services Department system by Gartner Inc. of Stamford, Conn., before deciding whether to use that system or one supplied by the company it hires to set up the exchange.
Gardner said the marketplace staff "went back and forth a lot" about whether to recommend that any company be allowed to respond to the request for qualifications.
She said it's possible that a company that was a subcontractor on one of the successful exchange projects would be qualified to transfer the code to Arkansas.
"It's not that it's impossible, it's that there's definitely a higher risk" in hiring a company that wasn't the main contractor in one of the seven states, Gardner said.
In addition to building the exchange for healthcare.gov and Colorado, CGI built the exchange for Vermont and was in charge of revamping the health exchange in Massachusetts to be compliant with the Affordable Care Act.
Software flaws left consumers unable to use the revamped site, leading Massachusetts to sever ties with CGI in 2014 and hire hCentive.
Similar problems prompted Vermont to fire CGI as its exchange contractor last year, replacing it with Optum, a unit of Minnetonka, Minn.-based UnitedHealth Group.
Deloitte Consulting was hired to overhaul Minnesota's glitch-plagued exchange last year and was in charge of using software code from Connecticut to revamp Maryland's exchange.
Gardner, who worked for Deloitte before being hired by the marketplace board last year, said in an email that she will not be part of the team that will evaluate responses from the four companies "out of an abundance of caution (and to avoid even the appearance of any conflict.)"
She noted that she has worked for the marketplace for about 15 months, compared with less than a year for Deloitte.
"While I don't feel there would be a conflict of interest I certainly appreciate any concern there may be in that respect," she said.
Metro on 08/13/2015