Connector Awards Conditional Seals of Approval

The Connector Board met on Thursday to review and award conditional Seal of Approval (SoA) for plans to be offered on the Connector in 2014, present the Connector’s Outreach and Enrollment strategy for the Open Enrollment period, and vote on extending the Connector’s contract with its advertising vendor Weber Shandwick. Materials from the meeting are available here. Just click on for our full report.

The meeting kicked off with Jean Yang giving her Executive Director’s Report and the latest enrollment numbers: Commonwealth Care enrollment slightly up at 206,393, and Commonwealth Choice slightly down at 41,234.

The Seal of Approval (SoA) Process

Overall, the Connector Board was pleased with the industry’s response to the request for SoA proposals. Ten issuers, including one new market entrant, the Minuteman cooperative plan (which is currently in the process of obtaining licensure), will offer QHPs (Qualified Health Plans). Five carriers will offer QDPs (Qualified Dental Plans); all five are new entrants as this is the first time that dental plans will be available on the Connector.

In order to obtain a SoA as a QHP, carriers were required to offer 7 standardized plans covering the 4 actuarial levels (2 platinum, 3 gold, 1 silver, and 1 bronze), a catastrophic plan, and a wrap-eligible plan at the silver actuarial level. Issuers could also propose non-standardized plans. Dental plan carriers were required to offer 3 standardized plans (pediatric, high, and low) and had the option of proposing additional non-standardized plans.

The review process was led by a Procurement Management Team (PMT), who worked alongside DOI and independent analysts to assure plan integrity and compliance with requirements. In order to receive the PMT’s recommendation as a non-standardized plan, an offering had to both meet the QHP or QDP standard and add value to the market by including options that were otherwise limited or not present.

The Board voted to grant a conditional SoA to those plans that were recommended by the PMT team. The vote of a final SoA will take place on September 12th, in anticipation of the October 1st open enrollment period.

PMT Recommendations for QHPs and QDPs

In total, there are 86 standardized QHP offerings, along with 20 non-standardized options, and 9 catastrophic health plans. The 86 standardized plans are comprised of the following:

  • Each of the 10 carriers was required to offer 7 required standardized plans, thus accounting for 70 of these choices.
  • Fallon proposed offering each of its 7 required plans on 2 additional networks, giving 14 further plans.
  • CeltiCare offered an additional standardized plan that included vision benefits at both the bronze and the silver level, thus making available 2 more plans.

The Health Connector’s proposed 2014 offerings were compared to what is currently on the market. The Massachusetts market is concentrated at the gold and platinum levels, and nothing offered on the Connector today will come under the ACA bronze level. Our current bronze level plans will be either gold or silver under the ACA’s requirements.

Non-Standardized Plans: PMT members discussed details about the recommended non-standardized plans, identifying the ways in which each plan added value to the exchange offerings, for instance by enabling lower cost sharing or providing a coinsurance option.

Catastrophic Plans: While all issuers were asked to submit a catastrophic plan, 3 have requested to withdraw their proposal. Given that the 9 plans from the 7 remaining issuers provide access in all parts of the state, the PMT members recommend allowing these 3 carriers—BMC HealthNet Plan, CeltiCare, and Network Health—to withdraw their catastrophic plans.

Discussion arose on the issue of pricing adjustments in catastrophic plans. The Connector Board announced that it will research whether pricing in Catastrophic Plans can be adjusted to the characteristics of the risk pool. If that is the case, the Board will seek to determine whether the state would have authority to override this provision.

Qualified Dental Plans: 21 standardized dental plans and 10 non-standardized plans were given initial SoA. Dialogue was sparked around the topic of group pediatric plans; board members wondered how many employers would offer such a plan when it would not actually cover the employee, but just the employee’s children. This seems to be an open question, so we will have to wait and see how this plays out.

SoA Vote: This portion of the meeting concluded with a unanimous vote awarding conditional SoA to the recommended QHPs and QDPs. However, prior to the vote, board members voiced concerns about the number of plans that would be offered, and whether this would be unmanageable for the average consumer. One response was that, while 86 is certainly a large number, most consumers will not face quite that many choices. For instance, filtering by zip code would eliminate plans outside of the consumer’s geographic region. Additionally, the number of plans offered could decrease if certain plans fail to obtain final approval; approval is premised on both quality and value, and the Connector cannot make value determinations until they see the premium rates, (which are due by July 1st). Nonetheless, Board members acknowledged that consumer experiences on the Connector must be monitored as we transition to Connector 2.0. Many consumers do not understand differences between plans and can easily be frustrated by what may seem like an overwhelming number of options.

Outreach and Enrollment Strategy and Contract Extension

As the start of the federal open enrollment period draws closer, attention is focused on coordinating an effective outreach and awareness campaign. Board members stressed that the ACA will be good for Massachusetts, and that this angle should be incorporated into messaging endeavors.

Initiatives: The Connector has proposed a variety of initiatives to provide a coordinated and expansive outreach effort. The messages will initially be rather general, but will become more specific and aggressive as the campaign continues.  The campaign has the following components:

  • Outbound Calling Campaign: The Connector will coordinate automated calls and provide live operators able to offer assistance.
  • Direct Mail and Email.
  • Enrollment Assisters: the Connector will provide training to brokers, Navigators, and Certified Application counselors.
  • Road Shows: Planning is underway for town hall style events, designed to target various groups, especially employers, who can be helpful in disseminating information. Additionally, community fair events will be held for community members, with a focus on engaging those segments of the population that currently have higher rates of uninsurance.
  • Public Education: 2-3 staff members will be made available to manage inquiries and proactively identify issues and themes that can shape the continued outreach strategy. Additionally, brochures and other handouts will be developed for distribution, both electronically and at public events.
  • Media Campaign: The media campaign will have a “real people, real stories” focus. Outreach efforts will also make extensive use of social media.

Crucial to the outreach campaign is coordination: assuring that messaging, whether from the Connector, insurance carriers, or the Health Care For All HelpLine is consistent and accurate.

The final action item for the outreach strategy was to propose a one-year renewal of the contract with Weber Shandwick, the vendor that has been supporting the Connector’s advertising and outreach since 2007. The proposal passed by unanimous vote.

The next connector meeting is scheduled for Thursday July 11th from 9-noon on the 21st floor of 1 Ashburton Place.
-Claudia Kraft

About HCFA

The Ultimate Massachusetts Health Care Insider Information
This entry was posted in MA Health Reform. Bookmark the permalink.

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s