eValue8 Submission. During each Contract Year, Contractor shall submit to the Exchange certain information that is a required disclosure under the eValue8 Health Plan Request for Information, as modified by the Exchange in the California Health Benefit Exchange 2012-2013 Initial Qualified Health Plan Solicitation to Health Issuers and Invitation to Respond, as amended December 28, 2012, and may be updated from time to time by the Exchange:
eValue8 Submission. During each Contract Year, Contractor shall submit to the Exchange certain information that is a required disclosure under the eValue8 reporting system. Such information will be used by the Exchange to evaluate Contractor’s performance under the terms of the Quality, Network Management and Delivery System Standards and/or in connection with the evaluation regarding any extension of the Agreement and/or the recertification process. The timing, nature and extent of such disclosures will be (i) established by the Exchange based on its evaluation of various quality-related factors, including, disclosure requirements included in the Solicitation and (ii) set forth in technical specifications included in the Administrative Manual. Contractor’s response shall include information relating to all of Contractor’s then-current California-based business and Contractor shall disclose any information that reflects national or regional information that is provided by Contractor due to Contractor’s inability to report on all California business. Contractor shall also provide a break down by products offered in the SHOP and the Individual Exchange in the event that Contractor offers products in both the Individual Exchange and SHOP.
eValue8 Submission. During each Contract Year, Contractor shall submit to the Exchange certain information that is a required disclosure under the eValue8 reporting system. Such information will be used by the Exchange to evaluate Contractor’s performance under the terms of the Quality, Network Management and Delivery System Standards and/or in connection with the evaluation regarding any extension of the Agreement and/or the recertification process. The timing, nature and extent of such disclosures will be (i) established by the Exchange based on its evaluation of various quality-related factors, including, disclosure requirements included in the Solicitation.. Contractor’s response shall include information relating to all of Contractor’s then-current California-based business and Contractor shall disclose any information that reflects national or regional information that is provided by Contractor due to Contractor’s inability to report on all California business. Contractor shall also provide a break down by products offered in the SHOP and the Individual Exchange in the event that Contractor offers products in both the Individual Exchange and SHOP.
eValue8 Submission. During each Contract Year, starting in 2015, Contractor shall submit to the Exchange certain information that is a required disclosure under the Covered California eValue8 Health Plan Request for Information, as modified by the Exchange and may be updated from time to time by the Exchange. The Covered California eValue8 Request for Information questions are listed in Appendix 3 to Attachment 7. Contractor is absolved of the responsibility to complete the original eValue8 as outlined in Attachment 14, Group 3, Item 3.5 of the 2014 Qualified Health Plan Contract. For calendar year 2014, the Covered California eValue8 may be optionally submitted to satisfy Quality/Network Management reporting requirements 4.1 through 4.15 as listed in Appendix 2 to Attachment 7. Such information will be used by the Exchange to evaluate Contractor’s performance under the terms of the Quality, Network Management and Delivery System Standards and/or in connection with the evaluation regarding any extension of the Agreement and/or the recertification process. The timing, nature and extent of such disclosures will be established by the Exchange based on its evaluation of various quality-related factors. Contractor’s response shall include information relating to all of Contractor’s then-current California-based business and Contractor shall disclose any information that reflects California-based information that is provided by Contractor due to Contractor’s inability to report on all Exchange-specific business. Contractor shall also report data separately for HMO/POS, PPO and EPO product lines.
