State Materials | Jan 31, 2012

Blueprint for Exchange Business Operations: Maryland Health Benefit Exchange

Wakely Consulting Group

This document, produced by Wakely Consulting, is intended to provide a high level overview of the business functions that must be established, the type of work that must be undertaken, and a relative timeline and chronological order for establishing the Maryland Health Benefit Exchange. This document is organized around 17 core work areas and coordinated around six primary business areas processes necessary for exchange implementation: Exchange Set Up, Core Systems, Communication & Outreach, QHP Plan Management, Risk Adjustment and Reinsurance, and Regulatory Compliance & Reporting. While the document does not represent the entire list of tasks and responsibilities that the Exchange will need to complete prior to 2014, it provides structure provides sufficient detail to allow key stakeholders and Exchange staff with a blueprint of the major business operation functions critical to successful implementation.