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Connector Prepares for Open Enrollment

Connector Prepares for Open Enrollment

September 15, 2014

Connector Outreach Campaign Summary 9-11-14

Last Thursday, the Connector Board received updates on the progress on the eligibility and enrollment system and website, approved the Connector’s Fall 2014 Open Enrollment outreach plan and voted to approve the final 2015 Seal of Approval. With 65 days until the start of open enrollment, which runs from November 15, 2014 through February 15, 2015, this is a crucial time for each of these activities.

Materials from the meeting can be found on the Connector’s website, under About – Leadership – Board Meetings. The update on the enrollment and eligibility system is here, and the outreach and education presentation is here. Our detailed report is just a click away.

Eligibility & Enrollment System Update

Connector HIX summary slide (1) 9-11-14

On Monday, the latest update to the Connector's online eligiibility and enrollment software, hCentive version 3.0, was released. This version of hCentive builds on earlier versions and includes many back-office functions, as well as Medicaid program determination:

  • Applicants can report life event changes (e.g. add a dependent, change address)
  • Customer service representatives can act “on behalf of” applicants to provide application support
  • Residency check and additional verification functionality
  • Application enhancements to support Medicaid determination

The last piece is perhaps the biggest news of the meeting – hCentive 3.0 includes Medicaid program determination for certain MassHealth programs. This functionality was not expected to be completed until next year’s open enrollment period, but is running ahead of schedule. This is an important milestone. While the separate MassHealth eligibility system was testing well, there were problems when it was hooked up with the hCentive system. hCentive 3.0 creates one integrated eligibility system for both MassHealth and Connector program.

Connector HIX summary slide (2) 9-11-14

Integrated eligibility means that people potentially eligible for MassHealth will no longer be passed down from hCentive to another system, thereby prolonging the eligibility and enrollment process. Instead, MassHealth eligibility and enrollment will be part of the hCentive system and will be done on a real-time basis.

Maydad Cohen, the special assistant to the Governor, and leaders from MassHealth and the Connector appear very confident in the hCentive system and its ability to deliver integrated eligibility for the start of open enrollment on November 15th. The key now is to vigorously test the system for both function (does the system work the way it was designed?) and performance (can the system handle a high volume of simultaneous users?).

Board member Rick Jakious asked about contingency plans should the integrated eligibility system not work Cohen and Roni Mansur, the Connector’s Deputy Executive Director and Chief Operating Officer, responded that should the MassHealth program eligibility piece not work, this will not impact the ability for the system to take people through eligibility to enrollment for QHPs, including ConnectorCare. Mansur further states that contingency plans are still being worked out. Cohen said that the integrated system will be tested over the weekend and should any issues arise, they will develop concrete contingencies to address these issues. He also promised a more detailed report at next month’s Board meeting on how the testing went and how the Connector and MassHealth are fixing any issues that come up.

Project Budget & Contract Update

Enrollment in temporary MassHealth coverage has reached approximately 285,000 enrollees. In FY2014, the state paid $139 million in claims (gross of federal reimbursement) for this program; the FY2015 cost as of the end of August is $120 million gross. According to Secretary Glen Shor, these spending figures fit within the MassHealth budget; he does not see these as added costs for the Commonwealth, as state officials anticipated covering most of this population through other subsidized programs anyway.

Las month, the Commonwealth submitted a request to federal officials at CMS for more federal matching funding to support $80 million in new IT costs and $18 million for consumer outreach and member transition activities. In addition, contract negotiations with Optum – the vendor overseeing the IT work – are not yet complete, but should be finalized by the October Board meeting.

Member Transition, Outreach & Education

Approximately 450,000 Massachusetts residents must fill out a new application during open enrollment in order to maintain coverage. In order to ease the transition of people currently enrolled in Commonwealth Care and temporary MassHealth coverage, the Commonwealth has requested from CMS approval for further extensions of these programs. Here are the proposed coverage end dates:

  • Commonwealth Care: January 31st
  • Temporary MassHealth: Staggered end dates of January 15th, January 31st and February 15th (depending on when individuals were first enrolled in the program)

Martha Bebinger provides a helpful overview on notices that will be mailed to current Commonwealth Care and temporary MassHealth enrollees about when their current coverage ends and what they need to do to enroll in new coverage. To be clear current Commonwealth Care and temporary MassHealth members can begin the application and enrollment process beginning on November 15th – they do not need to wait until they receive their termination letters to begin this process. See more on this below.

People currently enrolled in unsubsidized health insurance through the Health Connector will have a coverage end date of December 31st. These members will be required to fill out new application during open enrollment – and would need to complete the process by December 23rd in order to avoid a gap in coverage.

MassHealth and the Connector are working together to develop and implement a multi-faceted outreach and education plan to ensure consumers have the information and support they need to complete the application and enrollment process.

Key components of the outreach campaign include:

  • Direct member contact: phone calls, mailings (including notices and paper applications), emails, door-knocking
  • Enrollment assisters: engaging and training navigators and certified application counselors (CACs) to assist consumers in applying for and enrolling in coverage
  • Public education and enrollment events: working with local navigators, local media

In addition to the direct member outreach work, the Board voted to approve a work order with Weber Shandwick to carry out a media and messaging plan. The scope of work includes:

  • Public education campaign development and placement
  • Social media support
  • Strategic  messaging development

The Health Connector’s outreach plans have been submitted to CMS for approval.

Board members Nancy Turnbull and Celia Wcislo commented that the Connector and MassHealth need to send clear messages to people about what action is needed during open enrollment and that there should be a centralized place where people can check the status of their applications. Ashley Hague, Connector Deputy Executive Director, Strategy & External Affairs, responded that people can call customer service to get this information. The Connector and MassHealth are working on developing a process to track where consumers are in the process and make outbound calls to them. The Connector is working with hCentive to determine what data they need to accomplish this.

Consumer Research

Coonector Satisfaction survey results 9-11-14

This summer, the Health Connector conducted a survey of former Commonwealth Choice members as well as focus groups of both subsidized and non-subsidized Health Connector enrollees and potential enrollees.

The Commonwealth Choice survey included both those who re-enrolled in QHPs through the Health Connector and those who did not. 609 people responded – of those, about 400 re-enrolled with the Health Connector and about 200 did not.

Some key takeaways:

  • Overall satisfaction with the Connector was fairly high among both groups of respondents.
  • Respondents reported high levels of awareness about open enrollment, new subsidies, but a higher percentage of those who chose to re-enroll recall receiving an open enrollment mailing than those who did not re-enroll.
  • Of those respondents who used the website, about half had problems when visiting the website.
  • Most members who chose not to re-enroll because they were getting coverage through another source. However, of those who did not re-enroll, 7% reported being uninsured (this is something the Connector is looking into more).

The Health Connector also convened focus groups to test messaging for the 2015 open enrollment period. Key findings from the focus groups include:

  • Need for clarity about coverage and clear directions on what people need to do to stay covered
  • Expectation that there will be glitches with open enrollment for 2015
  • Uncertainty of what future coverage will look like for Commonwealth Care members

The Connector plans to use both the survey and focus group findings to help inform their upcoming outreach and education work.

2015 Seal of Approval

The Connector Board voted to award the final Seal of Approval for 2015 to 11 health insurance carriers and 5 dental carriers (note that Blue Cross will provide both medical and dental plans):

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

The final Seal of Approval incorporates the Health Connector’s and Division of Insurance’s review of premium rates, licensure, accreditation, network adequacy, service areas, and for ConnectorCare – the ability to serve low-income populations. All existing QHP carriers will continue to offer health plans through the Health Connector, with one new entrant – UnitedHealthcare. The average premium increase by non-group enrollment for all standardized QHPs is 2.9% over 2014.

The following carriers have been approved to offer ConnectorCare plans in 2015:

  • BMC HealthNet Plan
  • CeltiCare Health Plan
  • Fallon Health
  • Health New England
  • Minuteman Health
  • Neighborhood Health Plan
  • Network Health-Tufts Health Plan

One of the goals for selection of the ConnectorCare plans is for continuity as members transition between MassHealth and the Health Connector. Six of the seven ConnectorCare carriers also offer plans in MassHealth (note: CeltiCare is only a plan option in the new MassHealth CarePlus program).

Base enrollees premiums for members selecting the lowest-cost Connector plan in their region are the same as Commonwealth Care premiums today. As in the past, the Connector is also using funds to smooth the difference between the lowest-cost plan and other plans.

The next Connector Board meeting is scheduled for Thursday, October 9th, 9:00am at One Ashburton Place, 21st floor.

   -Suzanne Curry