Operations Support for the Federal Health Insurance Marketplace

The Affordable Care Act established health insurance marketplaces, which are used by millions of consumers to enroll in health insurance coverage. AIR supports the Center for Consumer Information and Insurance Oversight’s (CCIIO) Marketplace Plan Management Group (MPMG), which is responsible for certifying qualified health plans offered on the Marketplace exchange. The contract spans more than 40 subtasks that collectively:

• Support the certification and maintenance of qualified health plans (QHP) for participation on HealthCare.gov, the Federal Health Insurance Exchange;
• Provide pharmaceutical expertise to develop annual prescription drug crosswalks;
• Provide states and issuers with technical assistance in completing the QHP certification process;
• Research and operationalize new regulatory requirements including health equity;
• Provide operational support in the form of coordination across stakeholders, meeting facilitation, lessons learned facilitation,  agenda setting, note taking, and action item tracking;
• Facilitate strategic visioning working sessions, using lean six sigma and human center design methodologies, to identify the ideal state for aligning MPMG information technology and operational business needs; and
• Implement ongoing enhanced artificial intelligence capabilities, such as large language models, to continuously streamline processes, increase accuracy, and implement efficiencies.

AIR’s support encompasses policy research and analysis, environmental scans, large-scale project management, pharmaceutical subject matter expertise, technical assistance and data analytics. AIR is proud to support MPMG in continuously identifying new ways to support CCIIO’s commitment to advancing health equity.