Fillable Printable Basic RACI Chart Template
Fillable Printable Basic RACI Chart Template
Basic RACI Chart Template
DRAFT Responsible, Accountable, Consulted, Informed (RACI) Chart
Ref #
Activity / FunctionExchange BusinessDHS Business
1
Analysis and requirements documentation
of Eligibility Policy for Insurance
Affordability Programs (IAP) for initial
launch of Exchange:
- Medicaid
- CHIP
- Advanced Payment Tax Credit (APTC)
- Cost-sharing reduction (CSR)
- Basic Health Program (as applicable)
Accountable for final approval of
documented eligibility policy requirements
for:
- APTC
- CSR
Responsible for all IAP programs
Accountable for final approval of
documented eligibility policy requirements
for:
- Medicaid
- CHIP
- BHP
2
Analysis and requirements documentation
of Eligibility Policy for Individual Mandate
Exemption for initial launch of Exchange
Accountable for final approval of
requirements
Responsible
3
Analysis and requirements documentation
of policy for eligiblity to enroll in QHP
through the Exchange for initial launch of
Exchange
Accountable for final approval of
requirements
Responsible
4
Analysis and requirements documentation
of Exchange Notices policy
requirements:templates (dynamic/static)
content, etc.
Responsible and Accountable for overall
notice design and content for all IAP, SHOP
notices and general communication
Responsible
Additional specific accountability for
ensuring Medicaid/CHIP notice design and
content satisfy Medicaid requirements
5
Analysis and requirements documentation
of Medicaid and CHIP Appeals business
requirements for initial launch of Exchange
Consulted
Responsible and Accountable for non-legal
business policy requirements
Informed
Individual(s) or groups that are informed of
a final decision or action that has been
taken.
Consulted
Individual(s) or groups that must be
consulted prior to a final decision or action.
Will provide subject matter expertise to be
used in making the final decision and/or
action
Accountable/Verifier
The Individual(s) who is ultimately
responsible and has the final authority on
the decision or action. Has veto authority
Responsible
Individual(s) who actually complete the
task or action. Responsibility can be shared
and delegated to others
10-27-12DRAFT VERSION - FOR DISCUSSION PURPOSES
DRAFT Responsible, Accountable, Consulted, Informed (RACI) Chart
Ref #
Activity / FunctionExchange BusinessDHS Business
6
Analysis and requirements documentation
of APTC, CSR, Individual Mandate
Exemption, and eligibility to enroll in QHP
through Exchange appeals business
requirements for initial launch of Exchange
Responsible and AccountableResponsible
7
Full Exchange Functional Requirements and
Design. Ensure business architecture
supports needs of all functions within the
Exchange (e.g. Screen Designs, Work flows,
Business user error messages, Help Text,
Navigational Flows, etc.)
Responsible and AccountableResponsible and Accountable
8
User Acceptance Testing
Responsible and Accountable - in
partnership with IT
Responsible and Accountable - in
partnership with IT
9
Usability Testing
Responsible and Accountable - in
partnership with IT
Responsible and Accountable - in
partnership with IT
10
Navigators program and Agents, Brokers
requirements, design and build
Responsible and AccountableConsulted
11
Creation of Business Conversion Plan for
existing Medicaid and CHIP individuals
eligible under MAGI Medicaid policy. This
effort is focused on the business decisions
regarding Medicaid and CHIP conversion
and does not address IT specific plans. This
plan may need to be adjusted based on IT
parameters.
ResponsibleResponsible and Accountable
12
Training County Users of Exchange on
Medicaid/CHIP policy changes being
administered via the Exchange
ConsultedResponsible and Accountable
13
Training Navitators, Agents and Brokers,
and in-person assisters on their defined
roles within the Exchange
Responsible and AccountableResponsible
10-27-12DRAFT VERSION - FOR DISCUSSION PURPOSES
DRAFT Responsible, Accountable, Consulted, Informed (RACI) Chart
Ref #
Activity / FunctionExchange BusinessDHS Business
14
Analysis and requirements documenation
of Eligibility Policy for Small Business Health
Options Program (SHOP).
Responsible and AccountableInformed
10-27-12DRAFT VERSION - FOR DISCUSSION PURPOSES
