u)2.4 Enrollment and Marketing Coordination and Cooperation

u)2.4 Enrollment and Marketing Coordination and Cooperation

The Exchange will take such action as it deems necessary and feasible to develop and implement programs and activities to support Contractor in its marketing and enrollment efforts, in accordance with applicable laws, rules and regulations. Such activities may include making available the following programs and resources for use by Contractor:

a) A subsidy calculator available by electronic means to facilitate a comparison of QHPs that is consistent with tools the Exchange will use for its own eligibility screenings, to ensure that preliminary eligibility screenings use the same tool;

b) Education, marketing and outreach programs that will seek to increase enrollment through the Exchange and inform consumers, including Contractor’s current enrollees, that there is a range of QHPs available in the Exchange in addition to Contractor’s QHPs;

c) A standard interface through which Contractor may electronically accept the initial binding payment (via credit card, debit card, ACH or other mutually acceptable means to effectuate coverage in the Individual Exchange);

d) A standard interface through which Contractor may electronically accept from the Exchange the initial binder payment (via ACH or EFT) to effectuate coverage and accept subsequent premium payment in Covered California for Small Business;

e) Complete documentation and reasonable testing timelines for interfaces with the Exchange’s eligibility and enrollment system;

f) Eligibility and enrollment training for Contractor’s staff and for licensed agents and brokers;

g) Joint marketing programs to support renewal, retention and enrollment in the Exchange of existing members of Contractor’s health insurance plans who are eligible for the Federal subsidies;

h) Joint marketing activities of the Exchange, Contractor and other Health Insurance Issuers designed to drive awareness and enrollment in the Exchange;

i) The Exchange will treat as Cconfidential, treatment of all Contractor marketing plans and materials consistent with Section 1.4.1;

j) The Exchange’s annual marketing plans, including Open Enrollment Period (OEP), Special Enrollment Period (SEP) retention and renewal efforts; and

k) Customer service support that will include substantially extended customer service hours during Open Enrollment Periods.

To support the collaborative marketing and enrollment effort, Contractor shall:

a) Following the Exchange making the technology available and within a reasonable time after the receipt of notice from the Exchange about the technology, and determination of its compatibility with Contractor’s system, the Contractor shall prominently display the subsidy calculator on its website;

b) Educate its agents on Contractor’s QHPs offered in the Exchange, work with the Exchange to efficiently educate its agentAgents and brokers about the Exchange’s individual and small group marketplaces and inform agentAgents that a prospective Enrollee’s health status is irrelevant to advice provided with respect to health plan selection other than informing individuals about their estimated out-of- pocket costs;

c) Provide education and awareness regarding eligibility for Federal tax credits, plan offerings and benefits available through the Exchange in connection with any applicable outreach to Contractor’s existing members, as mutually agreed;

d) Cooperate with the Exchange to develop and implement an Enrollee retention plan;

e) Submit to the Exchange a marketing plan at least thirty (30) days prior to Open Enrollment that details the anticipated budget, objectives, strategy, creative messaging and ad placement by medium promoting acquisition activities. Marketing plans for Retention and Renewal efforts should be submitted to the Exchange within thirty (30) days after Open Enrollment begins;

f) Submit to the Exchange annual actualized spend amounts for: (1) OEP within thirty (30) days after OEP closes, and (2) SEP for the calendar year, thirty (30) days after the calendar year ends, and (3) for retention and renewal, thirty (30) days after OEP begins. The Exchange shall treat as confidential consistent with Section 1.4.1; and

g) Have successfully tested interfaces with the Exchange’s eligibility and enrollment system, or be prepared to complete successful interface tests by dates established by the Exchange.

v)2.5 Enrollee Materials and Branding Documents

b) Cobranded Marketing Materials. Contractor must submit all cobranded marketing materials for review and approval to Covered California prior to release. Contractor shall allow at least ten (10) business days from the date of the request for Covered California to review any materials submitted.

c) Enrollee Materials. Upon request, Contractor shall provide the Exchange with at least one (1) copy, unless otherwise specified, of any information Contractor intends to send or make available to all the Exchange Enrollees, including, but not limited to, Evidence of Coverage and disclosure forms, enrollee newsletters, new enrollee materials, health education materials, and special announcements. The materials provided to the Exchange under this Section will not require prior-approval by the Exchange before the Contractor distributes such materials; provided, however, that Contractor shall duly evaluate any changes proposed by the Exchange with respect to such materials. Contractor shall maintain an electronic file that is open to the Exchange, or email all enrollee materials to the Exchange. Such files shall be accessible by the Exchange as required by applicable laws, rules and regulations and as otherwise mutually agreed upon by the parties.

d) Distribution of Enrollment Materials. Contractor agrees to distribute to prospective Enrollees the Open Enrollment publications developed and printed by the Exchange for Enrollees prior to the Open Enrollment Period at a time mutually agreed to by the Contractor and the Exchange. Contractor shall be responsible for the mailing cost associated with these publications.

e) Marketing Materials. In order to promote the effective marketing and enrollment of individuals inside and outside the Exchange, Contractor shall provide the Exchange with marketing material and all related collateral used by Contractor for the Exchange and non-Exchange plans on an annual basis and at such other intervals as may be reasonably requested by the Exchange. The Exchange shall treat such marketing materials as confidential information consistent with Section 1.4.1.

f) Identification Cards. Contractor shall issue identification cards to Enrollees in a form that shall be agreed to by the Exchange. Identification cards should include the product name matching the naming convention on the Exchange website and provider directory. Contractor shall submit card design to the Exchange annually at least thirty (30) days prior to Open Enrollment.

g) Mailing Addresses; Other Information. The Exchange and Contractor shall coordinate with respect to the continuous update of changes in an Enrollee’s address or other relevant information.

h) Evidence of Coverage Booklet on Contractor’s Web Ssite. During each year of this Agreement which carries over into a subsequent Contract Year, Contractor shall make the Evidence of Coverage booklet for the next benefit year available on Contractor’s web site no later than the first day of the Open Enrollment Period provided that Contractor has received any revisions in the material that is to be included in the Evidence of Coverage from the Exchange and the applicable Regulator in sufficient time to allow for posting on the first day of Open Enrollment. The Evidence of Coverage booklet for the then-current benefit year shall remain on Contractor’s web site through December 31 of the then-current benefit year.