Connector Board Debriefs ACA Open Enrollment Progress, Reviews ConnectorCare, Student Health Insurance Regulations

Yesterday, the Connector Board met for the first time since the launch of open enrollment on October 1st, a significant milestone for Massachusetts and the nation as the coverage provisions of the Affordable Care Act (ACA) become reality.

Meanwhile, enrollment in current Health Connector program has continued to grow, with the highest enrollment seen to date: 210,219 Commonwealth Care members and 43,526 Commonwealth Choice members.

The Board discussed the open enrollment which began last week, new regulations for “ConnectorCare,” which will replace Commonwealth Care for many current members, and student health insurance regulations.

Materials from the meeting should be available on the Connector website (try the About link at the top, then Leadership/Board Meetings on the side menu). You know what to do to read our full report.

2014 Open Enrollment Check-In
The Health Connector launched their new website on October 1st at 8:27 am to allow individuals and families to shop for coverage effective beginning in January.  A lot of intense time and effort went into getting this new system up and running.   As with any large and complex IT implementation, the Health Connector is focusing attention on troubleshooting and resolving glitches and now sees the website in its “stabilization” phase.

From October 1st to now, there has been significant activity on the Connector site:

  • Accounts created: 10,028
  • Applications started: 7,258
  • Applications submitted: 1,704

The Customer Service Center received 9,492 calls since October 1st, with an average speed of answer of 9.28 seconds.  The Connector hopes to maintain these quick call answer times throughout the open enrollment period.  Last, the Health Connector also has staffed up its walk-in centers in Boston and Worcester.

The Health Connector also plans to do significant outreach – via mailings and an outbound calling campaign – to make sure current Commonwealth Care and Commonwealth Choice members, as well as those transitioning from other programs to the Health Connector, have the information they need to transition to new coverage.  They have also come up with helpful materials for navigators and certified application counselors to use as they help people sign up for new coverage.  And, they will unveil new TV, radio, digital and print ads in the coming weeks.

Draft ConnectorCare Regulations
On December 31, 2013, the Commonwealth Care program will end.  Under the ACA, most of the Commonwealth Care enrollees below 133% FPL will transition to MassHealth.  Most of the rest will receive new federal tax credits and cost sharing assistance to purchase Qualified Health Plans (QHPs). Those who are below 300% of the federal poverty level will also get additional state assistance – which will be referred to as the ConnectorCare program.  The goal is to keep coverage active and premiums stable for this population.

The proposed ConnectorCare regulations borrow heavily from the Commonwealth Care regulations, with some important changes to both comply with the ACA and to use any state flexibility to ensure that the ConnectorCare program operates similar to the current Commonwealth Care program.

  • Eligibility: Individual is eligible for federal advanced premium tax credits (APTC’s) with a tax household income at or below 300% FPL.  One improvement is that unlike with Commonwealth Care, under the ACA people with access to employer-sponsored insurance (ESI) that is not affordable may be able to access ConnectorCare, as will those who have access to a student health insurance plan.  ConnectorCare will maintain Plan Types seen in Commonwealth Care today – premiums and cost-sharing vary by plan type.
  • Premium hardship waivers: Like Commonwealth Care enrollees, ConnectorCare enrollees who have difficulty making their premium payments may be eligible for a hardship waiver under certain circumstances.  Unlike Commonwealth Care, the Connector will no longer be able to offer  payment plans to members.
  • State-specific enrollment triggering events: In Commonwealth Care today, there is rolling enrollment – that is, you can apply and enroll in a plan at any time.  Under the ACA , there is a specific open enrollment periods when people can purchase coverage or switch plans.  Only those who have a “triggering event” can purchase coverage outside this time.  The Health Connector is using state flexibility under the law to maintain broad enrollment opportunities now available in Commonwealth Care by proposing state-specific triggering events in addition to the federal ones:
    • Determination of eligibility for ConnectorCare;
    • Change in ConnectorCare Plan Type;
    • Approval of a hardship waiver; or
    • End of a hardship waiver.

The Connector Board voted to release the proposed ConnectorCare regulations for public comment.  The Connector will hold a public hearing on Thursday, November 21st.

Draft Student Health Insurance Program Regulations
Under last year’s Chapter 224, authority over the student health insurance program (SHIP) was transferred from the Division of Health Care Finance and Policy (now the Center for Health Information and Analysis) to the Health Connector.

The ACA changes what health insurance options may be available to higher education students.  For example, with the expansion of MassHealth coverage to 133% of the poverty level, students who now lose MassHealth coverage upon turning age 19 will be able to keep that coverage.  In addition, students may be eligible for tax credits and cost-sharing subsidies through the Health Connector even if they have an offer of health insurance from their school, whereas today students are ineligible for Commonwealth Care.

Before releasing draft regulations, the Health Connector sought public feedback to inform their thinking.  See Health Care For All’s comments here (pdf).  Taking this feedback into consideration, the Health Connector proposes several changes to the SHIP regulations; a few highlights are listed below.

  • Applying ACA insurance market reforms and consumer protections to all SHIPs, both fully-insured and self-insured – including offering Essential Health Benefits, removing yearly and annual lifetime benefit limits, and removing cost-sharing for preventive services
  • Refining plan design requirements to mirror ACA requirements and allow more plan design flexibility for schools
  • Permitting students to purchase a SHIP for part of the year
  • Allowing students to enroll in SHIP 60 days after losing previous coverage (up from 30 days)
  • Requiring schools to allow students to waive SHIP if they are enrolled in MassHealth or subsidized coverage through the Health Connector
  • Streamlining reporting requirements from twice-yearly to once a year

The Connector Board voted to release the proposed SHIP regulations for public comment.  The Connector will hold a public hearing on Tuesday, November 19th at 9:30am in Asbhurton Café (registration begins at 9:00am).

The next Connector Board meeting is scheduled for Thursday, November 14th at 9:00am at One Ashburton Place, 21st floor.
   -Suzanne Curry

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One Response to Connector Board Debriefs ACA Open Enrollment Progress, Reviews ConnectorCare, Student Health Insurance Regulations

  1. Pingback: Connector Board Report: Website Woes Is Just The Beginning |

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