California LifeLine Third Party Administrator Initiatives
This presentation outlines completed initiatives by a third-party administrator for California LifeLine, including enhancements to the customer portal, introduction of AEVS checks for Medi-Cal participation verification, and modifications for enrollment applications. The initiatives aim to streamline processes and improve efficiency in administering the LifeLine program.
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Presentation Transcript
California LifeLine Third Party Administrator Presentation to the Administrative Committee June 11, 2024 Presentation to the ULTS Administrative Committee
2 Contents 1. Completed Initiatives 2. Upcoming Initiatives 3. Program Reports Presentation to the ULTS Administrative Committee
3 Completed Initiatives Customer Portal, Phase 1.2 Enhancements Deployed Friday, May 17th Changed the form submission process to accept IEH worksheets (new enrollments and standalone) with "yes" responses to the 3 questions and issue automated system denials Changed the form submission process by providing blank DoB, Confirm DoB, SSN4, and Confirm SSN4 fields. A user cannot proceed past this step if the values in the primary and confirm fields do not match Add a Tribal Indicator (Enhanced Tribal Lifeline) to registered users Account Information page Implemented an enrollment pathway for applicants whose ages are between 14 and 18 when emancipation documentation is submitted. The new enrollment pathway encompasses all electronic submission channels Enhanced the public website s Provider Search functionality to display Languages Serviced by the wireline Service Providers Presentation to the ULTS Administrative Committee
4 Completed Initiatives Introduced AEVS checks to confirm applicants Medi-Cal participation during LifeLine enrollment The California Department of Health Care Services hosts the Automated Eligibility Verification System (AEVS) AEVS provides Medi-Cal participation verification Possession of Medi-Cal Benefits Identification Cards (BIC) are not a guarantee of Medi-Cal participation. BICs are a permanent form of identification. Beneficiaries retain the cards even if they are not participating in Medi-Cal during the current month. A BIC cardholder s Client Index Number (CIN) is the first 8 numeric characters followed by 1 alpha character of the BIC identification number When a CIN is entered, AEVS accesses the most current Medi-Cal participation status for the individual to whom the CIN is assigned AEVS returns a 10-character Eligibility Verification Confirmation (EVC) Number when participation is confirmed Presentation to the ULTS Administrative Committee
5 Completed Initiatives Introduced AEVS checks to confirm applicants Medi-Cal participation during LifeLine enrollment On April 19th TPA form reviewers began utilizing AEVS web-based single subscriber eligibility transaction service to confirm applicants current Medi-Cal participation The TPA modified its internal system to store applicants CINs When enrollment applications are approved based on AEVS checks, eligibility documents are created for audit purposes and joined with the approved enrollment forms When an AEVS check does not return a 10-character Eligibility Verification Confirmation (EVC) number, reviewers must deny the enrollment application Service Providers have been encouraged to revise their internal processes to prioritize collection of documentation which displays applicants BIC numbers or Client Index Numbers when applicants seek to qualify for CA LifeLine based on Medi-Cal participation Presentation to the ULTS Administrative Committee
6 Completed Initiatives Introduced AEVS checks to confirm applicants Medi-Cal participation during LifeLine enrollment For April 19 through April 30: Active Medi-Cal participation confirmed 16,852 applications [89%] Active Medi-Cal participation not confirmed 2,134 applications [11%] For May 1 through May 24: Active Medi-Cal participation confirmed 37,178 applications [88%] Active Medi-Cal participation not confirmed 5,032 applications [12%] Presentation to the ULTS Administrative Committee
7 Completed Initiatives California LifeLine Income Limits, effective June 1, 2024, through May 31, 2025 F/C (Federal and CA funding) if Income is less than or equal to C (CA-only funding) if Income is greater than Income is less than or equal to AND Household Size 1 2 3 4 5 6 7 8 For each additional person, add $20,331 $27,594 $34,857 $42,120 $49,383 $56,646 $63,909 $71,172 $20,331 $27,594 $34,857 $42,120 $49,383 $56,646 $63,909 $71,172 $23,400 $31,700 $40,000 $48,400 $56,800 $65,200 $73,600 $82,000 $7,263 $7,263 $8,400 Presentation to the ULTS Administrative Committee
8 Upcoming Initiatives The SPIA SubmitApplication and SubmitRenewal methods will be changed to add CIN as a required field when the ProgramCodeList field for the submission includes the Medical Program Code Soft Launch Date for the SPIA change is Friday, June 14, 2024 Hard Launch Date for the SPIA change is Thursday, August 15, 2024 Hard Launch means beginning Thursday, August 15, 2024, SPIA SubmitApplication and SubmitRenewal submissions which include the Medical Program Code in the ProgramCodeList field must send the applicant s CIN or the submissions will trigger errors and will not be processed Presentation to the ULTS Administrative Committee
9 Upcoming Initiatives Currently SPIA authenticates Service Provider s SPIA credentials (username and password) sent by the service providers with each transaction on the TPA s server Service Providers will submit their credentials to an authentication service hosted by Microsoft. The authentication service will provide Service Providers tokens to send with each transaction instead of sending their username and password Soft Launch Date for the SPIA authentication change is Friday, July 19, 2024 Hard Launch Date for the SPIA authentication change is Thursday, August 15, 2024 Presentation to the ULTS Administrative Committee
10 Program and Operations Reports Program Participation Active LifeLine Subscribers Active Subscribers Top 5 Service Providers - Trend Active Subscribers Top 5 Service Providers Active Subscribers Top 5 Service Providers by Tech Active Subscribers Average Age by Anniversary Month & Year Active Subscribers - Top 20 State Senate Districts Active Subscribers - Top 20 State Assembly Districts Active Subscribers Top 20 Counties Active Subscribers Top 20 ZIP Codes Active Subscribers Written Language Preferences Presentation to the ULTS Administrative Committee
11 Program and Operations Reports Subscriber Reported Demographics Household Income Subscriber Reported Demographics Gender Subscriber Reported Demographics Race Subscriber Reported Demographics Asian Ethnicity Subscriber Reported Demographics Pacific Islander Ethnicity Wireless: Response & Approval Rates All Form Types Wireline: Response & Approval Rates All Form Types Enrollment Application Volume by Received Channel - June 2023 May 2024 Renewal Form Volume by Received Channel - June 2023 May 2024 Enrollment Eligibility Methods Program Versus Income Enrollment Eligibility Methods By Qualifying Program Presentation to the ULTS Administrative Committee
12 Program and Operations Reports Top 5 Denial Reasons New Enrollment Applications - June 2023 May 2024 Top 5 Denial Reasons Renewal Forms - June 2023 May 2024 Renewal Rate - 4/1/2023 2/29/2024 Standalone IEH Volume by Received Channel - June 2023 May 2024 Monthly Inbound Call Volumes English & Spanish - June 2023 May 2024 Monthly Inbound Call Volumes Other Supported Languages - June 2023 May 2024 Presentation to the ULTS Administrative Committee
13 Program Participation Active LifeLine Subscribers Current: Total Active LifeLine Subscribers as of June 1, 2024 Wireless: 1,271,901 Wireline: 129,871 Total: 1,401,772 Total Active Subscribers as of March 1, 2024 Wireless: 1,094,738 Wireline: 136,145 Total: 1,230,883 Presentation to the ULTS Administrative Committee
Active Subscribers - Top 5 Service Providers - Trend TruConnect TracFone dba SafeLink Assurance Wireless by T-Mobile Pacific Bell by AT&T Boomerang Wireless dba enTouch Wireless 500,000 450,000 400,000 350,000 300,000 250,000 200,000 150,000 100,000 50,000 0 JUN-23 JUL-23 AUG-23 SEP-23 OCT-23 NOV-23 DEC-23 JAN-24 FEB-24 MAR-24 APR-24 MAY-24 Presentation to the ULTS Administrative Committee
Active Subscribers Top 5 Service Providers Service Provider 23-Jun 23-Jul 23-Aug 23-Sep 23-Oct 23-Nov 23-Dec 24-Jan 24-Feb 24-Mar 24-Apr 24-May TruConnect 162,422 167,967 176,088 199,369 236,540 268,999 299,873 330,010 367,475 405,990 444,171 473,155 TracFone dba SafeLink 172,383 177,226 188,469 196,204 201,026 205,449 206,480 209,565 213,581 214,586 215,228 209,222 Assurance Wireless by T- Mobile 331,097 300,508 296,862 281,410 258,217 219,266 185,971 163,702 154,726 147,417 140,299 134,536 Boomerang Wireless dba enTouch Wireless 106,101 107,571 109,054 107,304 104,935 103,020 98,243 99,157 97,435 89,849 88,086 91,509 Pacific Bell by AT&T 108,569 107,375 106,301 104,580 102,768 99,332 95,464 91,790 89,748 87,795 86,590 85,049 Presentation to the ULTS Administrative Committee
Active Subscribers - Top 5 Service Providers by Tech Wireless Wireline Service Provider Count Service Provider Count TruConnect 473,155 AT&T California 85,049 TracFone dba SafeLink 209,222 Frontier 22,502 Assurance Wireless by T-Mobile 134,536 Charter 9,287 Boomerang Wireless dba enTouch Wireless 91,509 Cox Communications 5,206 ConnectTo 2,278 Excess Telecom 89,416 Presentation to the ULTS Administrative Committee
Active Subscribers Average Age by Anniversary Month & Year Anniversary Month & Year 24-Jun 24-Jul 24-Aug 24-Sep 24-Oct 24-Nov 24-Dec 25-Jan 25-Feb 25-Mar 25-Apr 25-May Average Age 51 50 49 49 49 53 55 54 51 53 50 48 Presentation to the ULTS Administrative Committee
Active Subscribers - Top 20 State Senate Districts State Senate District 14 16 18 35 28 29 23 33 8 31 26 39 34 22 19 11 1 7 20 5 Active Subscribers 68,490 61,509 60,766 56,975 56,793 54,273 49,223 49,094 47,941 47,651 47,569 45,573 43,327 41,300 40,962 40,805 38,293 37,363 36,210 34,532 Presentation to the ULTS Administrative Committee
Active Subscribers - Top 20 State Assembly Districts California State Assembly District 57 31 35 36 39 45 65 79 60 17 54 6 27 70 80 13 10 61 18 33 Active Subscribers 44,289 41,869 39,390 36,158 36,019 35,431 32,164 30,600 30,013 29,937 28,123 27,448 27,319 26,681 25,431 24,589 24,474 24,300 24,193 23,813 Presentation to the ULTS Administrative Committee
Active Subscribers - Top 20 Counties County Los Angeles San Bernardino San Diego Riverside Orange Sacramento Fresno Kern Alameda San Francisco Santa Clara San Joaquin Contra Costa Stanislaus Imperial Tulare Ventura Merced Monterey Solano Active Subscribers 401,190 105,000 101,248 94,645 87,839 70,254 58,532 56,311 45,369 38,396 33,874 33,085 26,904 23,526 22,141 22,066 16,072 15,179 14,966 14,647 Presentation to the ULTS Administrative Committee
Active Subscribers - Top 20 ZIP Codes ZIP Code 90044 93307 92231 90003 93535 93550 92243 90011 92683 95823 92553 90805 92376 92404 92410 93304 94102 90001 93706 93702 Active Subscribers 9,370 8,561 8,086 7,350 7,266 7,061 6,679 6,603 6,346 6,220 6,135 5,983 5,915 5,865 5,819 5,374 5,369 5,295 5,263 5,231 Presentation to the ULTS Administrative Committee
Active Subscribers Written Language Preferences Language Code Subscribers English 1,340,389 Spanish 40,859 Chinese 12,728 Vietnamese 4,805 Korean 2,229 Tagalog 396 Japanese 364 Presentation to the ULTS Administrative Committee
Subscriber Reported Demographics Household Income Household Income Count 0-9999 35,189 10,000 - 19,999 16,695 20,000 - 29,999 8,091 30,000 - 39,999 3,561 40,000+ 2,959 Prefer Not To Respond 10,826 Presentation to the ULTS Administrative Committee
Subscriber Reported Demographics Gender Gender Count Female 38,940 Male 34,403 Prefer Not To Respond 3,467 Nonbinary 272 Transgender 239 Presentation to the ULTS Administrative Committee
Subscriber Reported Demographics Race Race Count Hispanic 24,163 White 21,186 Asian 10,566 Black American 8,796 Prefer Not To Respond 7,640 Other 3,358 American Indian 1,114 Pacific Islander 498 Presentation to the ULTS Administrative Committee
Subscriber Reported Demographics Asian Ethnicity Asian Ethnicity Count Chinese 3,392 Vietnamese 3,128 Other Asian 1,191 Filipino 1,057 Indian 655 Korean 465 Cambodian 298 Japanese 191 Laotian 156 Prefer Not To Respond 33 Presentation to the ULTS Administrative Committee
Subscriber Reported Demographics Pacific Islander Ethnicity Pacific Islander Ethnicity Count Other Pacific Islander 253 Native Hawaiian 93 Samoan 89 Guamanian 63 Presentation to the ULTS Administrative Committee
Wireless: Response & Approval Rates All Form Types Month Year % Qualified or Renewed # Total # Responded % Responded # Approved % Approved Jun-23 Jul-23 Aug-23 Sep-23 Oct-23 Nov-23 Dec-23 Jan-24 Feb-24 Mar-24 Apr-24 May-24 Totals 148,142 125,383 197,069 191,983 190,271 199,176 185,419 189,483 180,972 191,448 204,614 222,468 2,226,428 132,736 117,772 176,768 173,727 175,391 179,548 167,372 172,509 162,839 174,248 183,728 195,922 2,012,560 89.6% 93.9% 89.7% 90.5% 92.2% 90.1% 90.3% 91.0% 90.0% 91.0% 89.8% 88.1% 90.4% 129,705 113,070 173,793 170,206 172,317 175,449 162,824 168,425 157,920 169,613 176,935 189,184 1,959,441 97.7% 96.0% 98.3% 98.0% 98.2% 97.7% 97.3% 97.6% 97.0% 97.3% 96.3% 96.6% 97.4% 87.6% 90.2% 88.2% 88.7% 90.6% 88.1% 87.8% 88.9% 87.3% 88.6% 86.5% 85.0% 88.0% % Responded: #Responded / #Total % Approved = #Approved / #Responded % Qualified or Renewed = #Approved / #Total Presentation to the ULTS Administrative Committee
Wireline: Response & Approval Rates All Form Types Month Year # Total # Responded % Responded # Approved % Approved % Qualified or Renewed 3,979 2,462 12,135 31,940 27,855 42,329 24,938 13,805 5,924 4,699 3,777 3,872 177,715 2,152 2,043 10,884 30,707 24,299 36,897 21,093 11,424 4,222 3,244 2,626 2,545 152,136 1,963 1,873 10,674 30,219 23,762 35,732 20,487 11,119 3,935 2,947 2,366 2,353 147,430 Jun-23 Jul-23 Aug-23 Sep-23 Oct-23 Nov-23 Dec-23 Jan-24 Feb-24 Mar-24 Apr-24 May-24 Totals 54.1% 83.0% 89.7% 96.1% 87.2% 87.2% 84.6% 82.8% 71.3% 69.0% 69.5% 65.7% 85.6% 91.2% 91.7% 98.1% 98.4% 97.8% 96.8% 97.1% 97.3% 93.2% 90.8% 90.1% 92.5% 96.9% 49.3% 76.1% 88.0% 94.6% 85.3% 84.4% 82.2% 80.5% 66.4% 62.7% 62.6% 60.8% 83.0% % Responded: #Responded / #Total % Approved = #Approved / #Responded % Qualified or Renewed = #Approved / #Total Presentation to the ULTS Administrative Committee
Enrollment Application Volume by Received Channel June 2023 May 2024 1,438,851 SPIA 46,684 DAP 17,405 Mail 9,074 Customer Portal 0 200,000 400,000 600,000 800,000 1,000,000 1,200,000 1,400,000 1,600,000 # Enrollment application forms received Presentation to the ULTS Administrative Committee
Renewal Form Volume by Received Channel June 2023 May 2024 TPA System 518,426 Customer Portal 103,814 Mail 77,607 CSR-assisted 28,109 IVR 8,539 SPIA 3,179 0 100,000 200,000 300,000 400,000 500,000 600,000 # Renewal forms received Presentation to the ULTS Administrative Committee
Enrollment Eligibility Methods Program Versus Income 4.5% 95.5% Income Program Presentation to the ULTS Administrative Committee
Enrollment Eligibility Methods By Qualifying Program WIC 0.5% VSPBP 0.2% Others 0.3% SSI 0.7% Medi-Cal 28.6% CalFresh 69.7% Cal-Fresh (SNAP) Medi-Cal (Medicaid) SSI WIC VSPBP Others Presentation to the ULTS Administrative Committee
34 Top 5 Denial Reasons New Enrollment Applications June 2023 May 2024 Denial Code Type Description Second chance application form not returned by the due date 77,628 8-9 8-9 Hard Denial Documentation submitted does not meet eligibility guidelines 41,900 6-22 Correctible Denial 6-22 Initial application form not returned by the due date 27,695 6-21 6-21 Soft Denial Active Phone Number & Service Start Date not received within 30 days of status code 53 5-12 Hard Denial 26,436 5-12 No documentation submitted to confirm a household member is enrolled in a qualifying public assistance program 21,594 Correctible Denial 6-18 6-18 0 10,000 20,000 30,000 40,000 50,000 60,000 70,000 80,000 90,000 Presentation to the ULTS Administrative Committee
35 Top 5 Denial Reasons Renewal Forms June 2023 May 2024 Denial Code Type Description 213,173 22-15 Initial renewal form not returned by the due date 22-15 Soft Denial Second chance renewal form not returned by the due date 151,132 24-8 24-8 Hard Denial Second chance renewal form was returned to the TPA as non-deliverable as addressed 24-9 Hard Denial 17,159 24-9 Identity Verification form not returned by the due date 21-13 Hard Denial 7,801 21-13 Subscriber did not initial question acknowledging no other member of the subscriber s household is already receiving a LifeLine benefit 3,930 22-17 Correctible Denial 22-17 0 50,000 100,000 150,000 200,000 250,000 Presentation to the ULTS Administrative Committee
Renewal Rate: 4/1/2023 2/29/2024 Total renewal processes started: 851,752 Total Hard Denials: 171,030 Renewal Rate: 81.5% *Note: Final dispositions have been recorded for all renewal processes started for the selected period Presentation to the ULTS Administrative Committee
Standalone IEH Volume by Received Channel June 2023 May 2024 TPA System 518,426 Customer Portal 103,814 Mail 77,607 CSR-assisted 28,109 IVR 8,539 SPIA 3,179 0 100,000 200,000 300,000 400,000 500,000 600,000 # Standalone IEH forms received Presentation to the ULTS Administrative Committee
Monthly Inbound Call Volumes English & Spanish June 2023 Through May 2024 Presentation to the ULTS Administrative Committee
Monthly Inbound Call Volumes English & Spanish June 2023 May 2024 Month/Year English Spanish Jun-23 Jul-23 Aug-23 Sep-23 Oct-23 Nov-23 Dec-23 Jan-24 Feb-24 Mar-24 Apr-24 May-24 32,215 31,187 43,810 41,875 41,774 36,218 37,805 42,565 31,195 30,011 28,464 28,636 2,743 2,731 4,401 5,403 5,736 4,372 4,217 4,858 3,790 3,550 3,192 3,157 Presentation to the ULTS Administrative Committee
Monthly Inbound Call Volumes Other Supported Languages June 2023 May 2024 1600 1400 1200 1000 800 600 400 200 0 June-23 July-23 August-23 September-23 October-23 November-23 December-23 January-24 February-24 March-24 April-24 May-24 Cambodian Cantonese Hmong Japanese Korean Laotian Mandarin Tagalog Vietnamese Presentation to the ULTS Administrative Committee
Monthly Inbound Call Volumes Other Supported Languages June 2023 May 2024 Month/Year Cambodian Cantonese Hmong Japanese Korean Laotian Mandarin Tagalog Vietnamese Jun-23 6 127 1 Jul-23 4 159 0 Aug-23 5 223 1 Sep-23 3 218 0 Oct-23 12 290 2 Nov-23 8 271 0 Dec-23 9 310 0 Jan-24 10 366 1 Feb-24 5 214 0 Mar-24 4 301 0 Apr-24 3 228 0 May-24 14 181 2 29 33 48 37 46 39 36 31 35 21 21 12 123 106 151 116 156 146 166 203 143 156 113 95 13 10 7 6 8 7 6 3 8 7 6 8 197 192 235 280 368 370 375 377 318 338 265 244 24 36 34 40 40 53 26 68 44 50 51 34 153 174 182 238 311 291 313 336 225 307 195 190 Presentation to the ULTS Administrative Committee
