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Transitions and Progress - Connector Board meeting 1/15/15

Transitions and Progress - Connector Board meeting 1/15/15

January 15, 2015

MAhealthconnector.org has made over 353,000 program determinations for ACA health insurance.

Like the December meeting, when the Connector Board bid farewell to former Secretary of Administration and Finance Glen Shor, today’s Connector Board meeting was one of transitions. It was the first meeting shared by the new Secretary of Administration and Finance Kristen Lepore, as well as the last board meeting for Jean Yang in her capacity as Executive Director of the Health Connector. Jean shared parting words reflecting on her time as Executive Director and recognizing the hard work of her staff. Several board members also shared their thanks and reflections on Jean’s time at the Connector.

The substance of the meeting focused on progress and work ahead to ensure people transition to Affordable Care Act (ACA)-compliant coverage during this open enrollment period and approval of a contract extension for the Connector’s risk adjustment work.

Meeting materials are posted here and our full report is below.

Risk Adjustment Contract Extension

The ACA established three premium stabilization programs for the small and non-group market, effective January 1, 2014. The “3Rs” include reinsurance, risk corridors and risk adjustment. The risk adjustment program is the only one of the 3Rs that is permanent. States had the option to create their own risk adjustment programs or default to the federal program. Massachusetts is the only state running a state-based risk adjustment system, leveraging the All Payer Claims Database (APCD) established by the Center for Health Information and Analysis (CHIA) to retrieve Massachusetts-specific claims data.

The Health Connector has been running risk adjustment simulations quarterly using APCD data to enable health insurance carriers to plan ahead for rate filing and potential risk adjustment payments later on, as well as working with carriers on ensuring data quality. The Health Connector had contracted with Milliman to provide support on the risk adjustment work; at today’s meeting, the Connector Board voted to extend the contract with Milliman through December 31, 2015, with a work order for services through April 30, 2015.

Open Enrollment and System Update

Maydad Cohen began this portion of the agenda with an overview of how far the Commonwealth has come in regards to transitioning residents to ACA-compliant coverage through the new eligibility and enrollment system. The numbers include:

  • Over 350,000 eligibility determinations, including over 175,000 determinations for MassHealth and 178,000 determinations for Health Connector coverage;
  • 2.8 million unique daily visitors to the website; and
  • Creation of over 285,000 accounts.


Cohen also said they are on track to surpass the estimate of 175,000-225,000 people in the member transition population (Qualified Health Plan, Commonwealth Care, and temporary MassHealth) who would use the new system. Approximately 237,000 people have enrolled in MassHealth or Health Connector plans since November 15th. Twenty-five percent of the transition population has already enrolled in coverage for 2015. Another 118,574 people not included in the transition population have enrolled in coverage through the new system. Cohen pointed out that behind the number are real people, and shared a few stories of consumers who have greatly benefitted from enrolling in their new MassHealth or Health Connector coverage.

numbers only tell half the story. The people behind them tell the rest.

Now, the challenge lies in making sure the remainder of the transition population acts before the end of open enrollment, February 15th. About two-thirds, 265,000, of the 414,000 member transition population has coverage that expires this month and must act to stay covered.

Next week is expected to be exceptionally busy, as consumers try to meet the deadline of choosing a plan and paying their premium by January 23rd for February 1st coverage.

To prepare for next week’s rush, the Health Connector will:

  • Add 100 Optum customer service representatives (CSRs) to the 250 Health Connector (Dell) CSRs, with Maximus (the MassHealth customer service vendor) picking up overflow;
  • Expand call center and walk-in center hours: Monday (January 19th) 9AM-3PM; Tuesday-Friday (January 20th-23rd) 7AM-9PM;
  • Provide a new option for consumers to be directly transferred to CSRs who can complete phone applications and accept payments; and
  • Provide a new option for a CSR to call back consumers to reduce hold time.

The main message to consumers is: Don’t wait, act now.

Looking ahead, the Connector is working on a roadmap for 2015, which will include getting the Small Business Health Insurance Options (SHOP) program up and running, setting up system rules for closed enrollment, and entering new poverty level guidelines from CMS.

Outreach & Education Activities Through the End of Open Enrollment

Open Enrollment Outreach and Education

Along with community and provider partners (including Health Care For All, Navigators and certified application counselors), the Health Connector and MassHealth have been engaged in a multi-faceted outreach and education campaign throughout open enrollment.

Outreach and staffing strategies include:

  • Direct member mailings: More than 500,000 mailings have gone to members since the December meeting, increasing the total count to more than 1,000,000 mailings;
  • Phone calls: More than 930,000 outbound robo-calls have been deployed, with almost 600,000 calls connected;
  • Call center staffing: The Health Connector deployed 250 customer service agents and extended hours;
  • Walk-in center: Provided additional staff at the Boston walk-in center during key enrollment deadlines;
  • Enrollment events: Four enrollment events in Springfield, Boston, Worcester and Fall River served more than 1,000 Massachusetts residents;
  • Enrollment assistance & community outreach: During November and December, Navigators have submitted 4,500 individual and family applications and helped with the statewide enrollment events as well as 165 of their own local events; Health Care For All has knocked on over 300,000 doors (surpassing the goal of 200,000), supported enrollment events; and
  • Media: Both the Health Connector and HCFA undertook a media campaign including radio, TV, print and online media.

The Connector staff thanked SEIU, which has been also canvasing to fill in locations not covered by HCFA's team. Board Member Celia Wcislo thanked HCFA for its expert training of their door-to-door team. Outgoing director Jean Yang was again thanked for many of the outreach activities she championed, including the events and outbound calls. 

HCFA's role was highlighted as they continue to work in targeted areas reaching people directly.

The Health Connector has partnered with Health Care For All (HCFA) and our Navigators to provide direct consumer education and enrollment assistance.

High activity on the website, call centers, walk-in centers, as well as with Navigators and CACs in November, December and January indicate that these outreach strategies have been effective. The Health Connector, MassHealth and its partners plan to continue these activities, focusing on those in the transition population who still need to take action. With the Patriots getting close to the Super Bowl, advertising will increase on sports radio stations that will increase their audience in the coming weeks.

The next Connector Board meeting is scheduled for Thursday, February 12th at 9:00am at One Ashburton Place, 21st floor.

   - Suzanne Curry