The following information was taken from the Request for Information (RFI) document.
Maryland Health Benefit Exchange (MHBE) is conducting an industry-wide survey as we consider partnering with vision carriers to offer vision plans to MHBE enrollees seeking vision coverage. MHBE is interested in allowing qualified Vision Carriers to offer coverage to Maryland consumers by providing links on MHC to allow consumers to easily enroll in the vision plan of their choice. MHBE is specifically interested in receiving information as outlined herein and invites vision carriers to participate in this market survey by submitting information to MHBE regarding your company and its services in the form of a written response to this Request for Information (“RFI”). This RFI process is a preliminary step through which MHBE is seeking to gather information which:
- Will be utilized to assess the feasibility of MHBE offering stand-alone vision coverage to consumers via the Maryland Health Connection platform.
- May be utilized to develop qualified vision plan certification standards for the 2023 plan year.
The goal of the MHBE is to make health coverage affordable and more accessible for the citizens of Maryland. MHBE is responsible for the Maryland Health Connection (MHC), the State’s health insurance marketplace under the Patient Protection and Affordable Care Act of 2010 (Pub. L. 111-148) as amended, including by the Health Care and Education Reconciliation Act of 2010 (Public Law No. 111-152), and all regulations promulgated pursuant thereto (the “ACA”).
MHBE currently offers medical and dental health insurance plans through MHC. As of September 30, 2021, we have 165,744 Qualified Health Plan (QHP) enrollees; 1,209,215 Medicaid enrollees, and 36,658 Stand-Alone Dental (SADP) enrollees. MHBE is now interested in making vision plans available to our enrollees as an additional benefit starting with plan year 2023. Per guidance from the Centers for Medicare and Medicaid Services, vision plans are not considered qualified health plans and as a result, cannot be offered directly through Maryland Health Connection (MHC), the insurance exchange operated by MHBE. However, federal guidance permits MHBE to partner with vision carriers to offer vision plans to MHC enrollees, and MHBE is authorized by its establishing statute to certify and make available qualified vision plans.
The MHBE is soliciting responses from health insurance carriers that offer vision plans and can support a link on MHC to a cobranded site hosted by the vision carrier to facilitate plan shopping, selection, and enrollment. MHBE is interested in organizations that will perform the following tasks when enrolling and servicing MHC enrollees in adult vision plans:
- Provide high quality service to enrollees.
- Maintain a co-branded website that serves as the landing page for enrollees and can provide a network directory as well as a simple and an easy-to-understand list of covered benefits and out-of-pocket expenses for enrollees to review.
- Provide a customer service call center that is staffed to handle questions and assist consumers.
- Invoice enrollees and collect premiums.
- Designate a representative as the Program Manager for the oversight of the Vision Program. The Program Manager would be MHBE’s primary contact for all issues related to the program.
- Track and report the number of enrollees purchasing a vision plan via MHC, and provide regular reports containing number of policies issued resulting from accessing the MHC website; number of lives added through these policies; and total premiums collected on any new or renewal policies.
