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Connector Recaps Open Enrollment, Approves Affordability Schedule, and Plans for Seal of Approval

Connector Recaps Open Enrollment, Approves Affordability Schedule, and Plans for Seal of Approval

March 14, 2016

Call Center Satisfaction Survey

Last Thursday, the Health Connector Board convened to discuss a variety of topics, including a recap of the Open Enrollment period, the 2017 Affordability Schedule, the Risk Adjustment Data Validation (RADV) contract and plans for the 2017 Seal of Approval. Materials from the meeting are here.

The meeting began with the Executive Director’s report on the consumer experience during the 2016 Open Enrollment period, which ended on January 31st. During Open Enrollment, the Health Connector assisted over 18,000 people across the state in their walk-in centers, with 93% overall customer satisfaction rate, and reduced average call-handling times, overall improving customer service.

As of March 1st, 208,374 members were enrolled in coverage through the Health Connector, including 156,679 in ConnectorCare and 51,695 in unsubsidized and Advanced Premium Tax Credit (APTC) coverage. 55,312 consumers are enrolled in dental plans through the Health Connector. Overall, the Health Connector was pleased with the progress during the 2016 Open Enrollment period, and is planning for additional improvements for the 2017 Open Enrollment period.

Risk Adjustment Data Validation

The Affordable Care Act (ACA) requires that a state that operates its own risk adjustment program perform Risk Adjustment Data Validation (RADV) to ensure the integrity of the risk adjustment program. The Connector Board approved a new work order with the Connector’s existing consulting company (FTI), to do a risk adjustment audit for 2015.

2017 Affordability Schedule

The Connector Board also voted to approve the 2017 Affordability Schedule, which determines what premiums are considered affordable for the purpose of enforcing the state individual mandate. The Health Connector received comments on the proposed schedule from one entity – our very own ACT!! Coalition. The ACT!! Coalition supports the proposed 2017 schedule, and encourages the Health Connector to continue to explore how to impact rising out-of-pocket costs.


2017 QHP Product Shelf

2017 Seal of Approval

Health Connector staff also provided an overview of the 2017 Seal of Approval (SoA) process.  The Health Connector hopes to make the consumer shopping experience more user-friendly by streamlining plan offerings and further supporting “apples-to-apples” comparison shopping. The Connector proposes to reduce the number of Qualified Health Plan (QHP) plan offerings and for the first time institute a cap on the number of allowable Qualified Dental Plans (QDPs). 

Connector considering "Value Based Insurance Design" for 2018

The Health Connector proposed eliminating the second standardized Gold plan design, standardizing the Bronze tier, and standardizing additional benefit categories. In addition, the Health Connector is “looking to leverage this year’s SOA to start influencing the way products in our marketplace address the health needs of our members, such as opioid use disorder therapy and chronic disease management through value-based insurance design.” For 2017, the Health Connector also proposes a requirement to embed pediatric vision coverage and encourages health plans to embed pediatric dental coverage.

The Connector Board had an interesting discussion about the impact of the state’s Minimum Creditable Coverage (MCC) requirements on plan offerings and the most appropriate standardized plan option for the Gold and Bronze tiers.

The Health Connector plans to release the QHP and QDP RFR on Monday, March 14th, award Conditional 2017 SoA at the July board meeting, and award final 2017 SoA at the September board meeting, to ensure completion prior to the start of the next open enrollment period on November 1, 2016.

The next Connector Board meeting is scheduled for Wednesday, April 20th from 1:00-3:00pm.

                     -Sara O’Brien & Suzanne Curry