Connector Awards Final Seal of Approval, Ramps up for ACA Implementation

Next steps for Connector on ACA implementationYesterday, the Health Connector Board voted to award final Seal of Approval to Qualified Health Plans (QHPs) and Qualified Dental Plans (QDPs) to be sold on the Health Connector in 2014.  In addition, the Board discussed the Health Connector’s progress in implementing the new Affordable Care Act (ACA) eligibility system as well as their outreach and education efforts.

Materials from the meeting are here, and our full report is just a click away.

Before delving into the agenda, Jean Yang shared the Executive Director’s Report, including an update on program enrollment.  As of September 1st, Commonwealth Care had 211,186 enrollees.  This is a 3,598 increase over the last two months.  Commonwealth Choice has 45,394 enrollees, which represents a 2,770 increase in August and a 3,050 increase in September, due to state open enrollment (which ran from July 1-August 15).  This is a net increase of 3,300 from this time last year.

Final Award of 2014 Seal of Approval

Objectives of the Connector Seal of Approval program

Under the ACA, many of the lowest-income people in Massachusetts who are now part of the Commonwealth Care program will transition to MassHealth.  Most of the rest will receive new federal tax credits and cost sharing assistance to purchase QHPs. Those who are below 300% of the federal poverty level (FPL) will also get additional state assistance, referred to as the “QHP wrap” in wonk circles and ConnectorCare in public.

As we describe in an earlier blog post, due to competitive carrier rates and adequate state funding, the Health Connector was able to keep base enrollee premiums the same as they are in Commonwealth Care today.

The following carriers were selected to offer ConnectorCare plans: Boston Medical Center HealthNet Plan, CeltiCare, Fallon Community Health Plan, Health New England, Neighborhood Health Plan, Network Health, and Minuteman Health.  Individuals in each region will have a choice of between 3 to 5 plans.

Qualified Health Plans
Beginning in 2014, the Health Connector will have the highest level of carrier participation, with 10 medical carriers and 5 dental carriers.  The Health Connector has retained all of the existing Commonwealth Care and Commonwealth Choice plans, and added a new entrant to the market, the new co-op, Minuteman Health.

Standardized plans make up 75% of products offered, and the Health Connector will also offer a number of new non-standardized plans.  Overall, most of the plans that were given conditional SoA in June were also recommended for final SOA.

The Division of Insurance (DOI) reviewed all proposed premium rates in accordance with ACA requirements.  Overall, the average base rate increase across the merged small/non-group market is only 1.9%, significantly lower than was anticipated in some circles.

Qualified Dental Plans
For the first time in its history, the Health Connector will also offer dental plans.  As with the QHPs, most of the plans given conditional SoA in June were also selected for final approval, with the exception of seven plans offered within the same carrier, which came in at the same premium but offered smaller networks.

The Connector Board voted to award 2014 Seal of Approval to the following medical and dental carriers:

  • Altus Dental
  • Blue Cross Blue Shield of MA
  • BMC HealthNet Plan
  • CeltiCare Health Plan
  • Delta Dental of MA
  • Fallon Community Health Plan
  • Guardian
  • Harvard Pilgrim Health Care
  • Health New England
  • MetLife
  • Minuteman Health
  • Neighborhood Health Plan
  • Network Health
  • Tufts Health Plan

National Health Care Implementation Update

Health Connector teaming with HCFA on outreach

According to Connector staff, the agency is on track for ACA open enrollment, which begins on October 1, 2013.  Preparation for October 1st includes:

  • Finalizing the 2014 Seal of Approval
  • Completing IT work for the Health Insurance Exchange-Integration Eligibility System (HIX-IES) to support individual eligibility, shopping and enrollment
  • Uploading new plans into current systems for 10/1 small group shopping
  • Ensuring operational readiness to support ACA open enrollment and member transition (e.g. new call center)
  • Intensifying outreach activities and ramping up member transition campaign
  • Completing a series of federal readiness reviews

The Health Connector hired 50 new customer service staff to handle calls related to new ACA coverage options, and opened a new walk-in center in Worcester for in-person support (in addition to the current walk-in center in Boston).  On the IT front, the Health Connector recently completed the federal operational readiness review between September 9-11 and is currently working to achieve authority to connect with the federal data services hub. This will allow the state’s eligibility system to access federal income and citizenship status information.

The Health Connector continues to manage existing programs and prepare enrollees to transition to new ACA coverage.  As such, they are embarking on an intense outreach and member transition effort, which includes:

  • Conducting an outbound calling and mailing/emailing campaign
  • Running paid, earned and social media campaigns
  • Working with navigators, Certified Application Counselors, and brokers
  • Establishing a Public Information Unit to answer ACA-related inquiries
  • Creating collateral materials, such as brief guides about the ACA for individuals and small businesses
  • Presenting across the state at employer road shows and navigator tours
  • Partnering with Health Care For All to launch a grassroots public education campaign

Outbound Call Campaign
As part of its broader outreach and communications campaign, the Health Connector plans to launch a comprehensive outbound call campaign targeting about 230,000 current and newly eligible Health Connector members transitioning to new coverage in 2014.  As such, they have proposed to revise their current contract with Dell to conduct this campaign between October 1, 2013-March 31, 2014 to add nearly $4.4 million in compensation.  This will allow Dell to hire approximately 200 staff to conduct targeted outgoing calls.

To hold Dell accountable for ensuring a smooth transition for Connector enrollees, the Connector has included a system of penalties in the contract.  For example, there will be a flat penalty for not converting the majority of eligible Commonwealth Care members by January 1, 2014.  In addition, there will be a per member penalty if Dell fails to convert beyond a minimum threshold of all populations by March 31, 2014, the end of open enrollment.

The Board voted to approve the outbound call campaign and the change order in the contract with Dell.

The next Connector Board meeting is scheduled for Thursday, October 10th at 9am at 1 Ashburton Place, 21st floor.
-Suzanne Curry

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