Connector Update on Coverage Applications, Notices and Extensions

The Health Connector and MassHealth just sent out this update on contingency plans for health coverage in light of the ongoing issues with the eligibility IT (note that we have not posted the attachments, at the request of the Health Connector):

Over the last several weeks, the Health Connector, in close collaboration with our colleagues at MassHealth, have been working to ensure that people have coverage in place on January 1. As such, we have outlined several important updates about current health coverage programs and when individuals can expect to receive notification regarding their applications.

Update on Subsidized Health Coverage Programs:

Members in the following programs will have access to benefits through the end of March.

  • Commonwealth Care
  • Medical Security Plan
  • Insurance Partnership Employees

Current Commonwealth Care or Insurance Partnership (IP) members who are not being transitioned to MassHealth, as well as members of the Medical Security Program (MSP) who are enrolled in MSP on or after December 16, will have coverage through March 31, 2014. This means that if a current member in one of these programs has not submitted an application, or has not yet received a determination on their application, they still have through March 24, 2014 to apply, select a plan and pay their first month’s premium without experiencing a gap in coverage. Over the next couple of weeks, members in these programs will receive an official letter informing them of this update about their health insurance.

Sample Letter to Enrollees Regarding Coverage Extension:

  • The attached letter [note: not attached]  to Commonwealth Care members will go out this week to 110,000 members who will now have until the end of March to enroll into a new plan.
  • The attached letter [note: not attached] to members in the Insurance Partnership program will go out this week to approximately 1,000 members who are likely eligible for subsidies through the Health Connector, informing them that the IP program ends on December 31 and that MassHealth will make premium assistance payments directly to them during the QHP open enrollment period so that they have until the end of March to enroll in a new plan.
  • Letters to members enrolled in MSP are still under review and a draft will be shared once finalized.

Commonwealth Care members who have submitted an application will receive a letter this week informing them that they will still have access to coverage through March 31, 2014, and that their application for new coverage will be processed over the coming months. MSP members (enrolled through December 16) will have access to continuation coverage. For current Commonwealth Care and MSP members whose applications are successfully processed and who complete all steps to enroll in a Health Connector Plan prior to December 23, new coverage could be effective as early as January 1. Insurance Partnership members who are likely eligible for Health Connector coverage may apply for and enroll in coverage anytime between now and March 24.

Update on Applicants for Subsidized Health Coverage Programs:

Our highest priority is to ensure that all of our populations that seek insurance coverage will have access to coverage without gaps or delay. The Health Connector and MassHealth are working to process applications for subsidized coverage as soon as possible. We are prioritizing applications from individuals who are not currently enrolled in any subsidized health program and therefore do not benefit from the extensions described above. We have created an alternative path to process new applications for subsidized coverage and effectuate enrollment in a Qualified Health Plan with premium tax credits to help pay monthly premiums.

  • Members eligible to enroll in a Health Connector plan with premium tax credits, as determined through this process, will be sent letters explaining their access to subsidies and health plan choices, and are informed to return a plan selection form or call member service to select a plan (similar to the current plan selection process for Commonwealth Care). These individuals will also receive a Frequently Asked Questions document along with this enrollment letter.
  • Members eligible for MassHealth programs, as determined through this process, are enrolled in coverage through MassHealth’s legacy eligibility system, MA-21. MassHealth-eligible members can be enrolled in any coverage type that is available in 2014, including MassHealth CarePlus.

Sample Letter to ConnectorCare Enrollees Regarding Plan Selection:

  • The attached letter [note: not attached] has been mailed to applicants seeking financial assistance indicating that the recipient is eligible for a Connector Care plan type and lists the ConnectorCare plans they can choose from as well as the methods to complete their enrollment (mail, phone, in person, fax). The letter states that a final determination notice will be sent in the mail once the application process is complete. The letter also mentions that if the recipient has questions s/he can reach out to Navigators in addition to Certified Application Counselors or Customer Service for further assistance.

If we are not able to process certain applications through this workaround (e.g., due to data limitations), we plan to provide applicants with temporary access to coverage for 1/1/2014 until we are able to process them into their final new coverage.

Update on Non-Subsidized Health Coverage Programs:

Applicants that have applied for coverage and are NOT seeking financial assistance and have selected a health plan will receive a bill this week and/or their electronic funds transfer will be withdrawn on the date specified. Payments MUST be made by December 23 to ensure coverage on January 1. If an applicant has applied for coverage and is NOT seeking financial assistance, but has NOT selected a plan they MUST go online and select a plan AND set up an electronic funds transfer to effectuate payment. Payments can also be made by mail upon receipt of an invoice, but the applicant must complete the application by selecting a plan. Individuals must pay their first month’s premium in a new plan within 5 business days of the end of that month in order to avoid a gap in coverage. For January 1 coverage, the last day to pay a bill and enroll is December 23.

Sample Invoice to Applicants:

  • The attached invoice has been mailed to  applicants who are NOT seeking financial assistance and have selected a plan [not attached]
  • In addition, the Health Connector is contacting applicants who need to update their payment due date or correct electronic payment information, or need notification that an electronic fund transfer will be made.

Young Adult Plan Members or Commonwealth Choice members who have NOT submitted an application should go online at MAhealthconnector.org to apply right away. Applying online is the fastest way to get coverage for January 1.

Individuals who are not currently in an insurance program through the Commonwealth of Massachusetts who have submitted an application will be contacted over the next several weeks with an update on their application.

Updates on Additional Communications to Health Connector Members:

  • Beginning Friday, December 6, the Health Connector mailed the attached reminder postcards [not attached] to 65,000 members including CMSP, Commonwealth Choice members with an end date of December 31, Business Express members with an end date of December 31, Voluntary Plan with an end date of December 31 and Young Adult Plan members. We have prepared talking points for you regarding this communication. As a reminder, CMSP members who do not reapply may stay enrolled in CMSP; their coverage will not end.
  • On Monday, December 9, the Health Connector mailed an informational packed on Business Express to 86 individuals with a January 31, 2014, end dates

Customer Service Center Update:

  • The Health Connector has continued to increase staff at our Customer Service Center and as of Monday we have 155 Customer Service Representatives (CSR) answering calls. Additional staff are expected to be added this month.
  • In addition to the increase in customer service representatives, the Health Connector is also offering applicants interested in filling out an application by phone with the option to request an appointment for a CSR to call them back within their choice of four blocks of time during a day that they choose.
  • MassHealth has continued to monitor its customer service call volume and staffing to ensure that we have sufficient customer service capacity and knowledge to meet the needs of members and applicants. 
  • In an effort to best assist patients and clients regarding their application, please refer to the following “cheat sheet” for customer service support:
Customer Service Number Reason for Call
MassHealthCustomer Service(Maximus) 1-800-841-2900 MassHealth Customer Service can assist callers who need to:

  • Ask about the status of an existing application
  • Report a change to an existing application
  • Report a technical problem with HIX
ConnectorCustomer Service(Dell) 1-877-623-6765 Health Connector Customer Service can assist callers who need to:

  • Apply for individual (non-group) medical and dental coverage over the phone
  • Ask about the status of an existing application
  • Report a change to an existing application
  • Ask about enrollment status
  • Report a technical problem with HIX
  • Assistance with password or login issues on HIX
EHS Help Desk(Virtual Gateway Help) 1-800-421-0938 For HIX users who are having password or login issues on HIX
MassHealth Enrollment Centers (MEC) 1-888-665-9993 Staff at the Enrollment Centers can assist anyone with:

  • Questions about eligibility for subsidized coverage
  • Ask about the status of an existing application

Report a change to an existing application

No Wrong Door # 1-855-624-4584
  • Self-service phone system that routes a caller to either MassHealth Customer Service or Health Connector Customer Service. This system is for the individual who is not sure how to start the process of applying for coverage.

 


Virtual Gateway Update:

As you may know, the Health Assistance (MassHealth, et. al.) portion of the Virtual Gateway Common Intake application was previously scheduled to be unavailable starting in mid-December.  We are pleased to inform you that we have decided to extend access to it, for use when assisting applicants needing immediate, pre-1/1/2014, health coverage, through the end of December, 2013.

Outbound Calling Campaign Update:

  • The Health Connector’s Outbound Call Campaign is planning to deploy automated calls to applicants who have selected plans to remind them to make a payment later this week or early next week. Payments can be made by mail via check or money order, online at the time of plan selection or in-person. No payments will be taken over the phone.

The Health Connector and MassHealth are dedicated to ensuring everyone who needs insurance on Jan. 1 has it. We know it has been a confusing and frustrating time, but we will do everything it can to help.

Thank you,

The Health Connector and MassHealth

About HCFA

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