By Katie Kerwin McCrimmon
Colorado’s health exchange managers are preparing for possible IT and sign-up snafus that could gum up the next open enrollment this fall as they grapple with more employee turnover.
Connect for Health Colorado’s Chief Financial Officer, Cammie Blais, is now leaving weeks after her former boss, CEO Patty Fontneau, departed in August. Alan Schmitz has joined the exchange as chief counsel, while Interim CEO Gary Drews has taken charge. In the meantime, the board has hired a search firm to help hunt for a permanent CEO.
On top of many personnel changes, one health insurance carrier — SeeChange Health — will no longer be selling health insurance in Colorado or California, meaning that about 4,000 Colorado customers will have to find new coverage. And as many as 1,500 people could lose their health coverage by the end of this month if they fail to provide proof of citizenship or other essential documentation.
So far, Connect for Health has sold private health insurance to about 145,000 people. It has a modest goal of selling about 216,000 plans by the end of 2015. Managers also hope that at least 65 percent of current customers renew their plans in 2015.
In all, when open enrollment starts again on Nov. 15, customers will be able to choose from 175 individual plans. Altogether, there will be a total of 322 plans including options for small business, dental and medical plans.
On the IT front, Adele Work, a project management consultant for the exchange, warned board members during Monday’s meeting about some possible risks that could affect open enrollment.
Exchange managers have been working with counterparts at Colorado’s Department of Health Care Policy and Financing (HCPF), who manage Medicaid, to build a shared IT portal. Problems with Colorado’s sign-up system emerged last fall when people trying to buy insurance first had to navigate a long, clunky application to determine if they would qualify for Medicaid. Since then, Colorado has vowed to build a simple, seamless “Kentucky-style” system that would allow customers to quickly determine if they could qualify for Medicaid or if they should shop for private insurance instead.
Work said testing is behind and that software problems could affect how the system works.
She compared the problems to a dam blocking free flow of water.
“It’s not going as rapidly as we had hoped,” Work said. “We’re working well with HCPF. We just need to break through the dam by the end of this week.
Work also said testing with a federal system for renewals and re-verifications is going poorly.
“The risk is increasing because the testing is not going very well,” Work said.
Operations managers are assessing how well their network of health coverage guides is doing and whether all of them should receive additional funding to help with this year’s open enrollment.
It’s unclear exactly how many of the 145,000 people health coverage guides helped sign up. It may be as few as 7,000 or as many as 14,000.
“It’s about three times as expensive to use the health coverage guides as opposed to the call center (employees),” said Chief Operating Officer Lindy Hinman. “Health insurance is difficult to sell. It’s a complex product. That is a really big policy discussion that needs to happen.”
Hinman said brokers have signed up about 25 percent of customers while health coverage guides have signed up 3.6 percent and employees at the call center are credited with 56 percent of sign-ups.
The concept of Travelocity-style instant sign-ups also has not materialized. From start to finish, most people take about three weeks to enroll.
When coverage guides heard that they were being evaluated during the meeting, some cried foul, saying a system to provide their metrics to Connect for Health doesn’t even work properly.
IT experts promised to fix the system while board members pressured Connect for Health staffers to figure out if they can afford in-person assistance programs.
“It has to be financially efficient and if it’s not, we can’t afford it,” said board member Eric Grossman.
Board member Gretchen Hammer disagreed with Grossman.
“I think it’s important that we have a balanced approach,” she said, noting that in-person help is vital to some people.
She acknowledged that there’s a “no-money, no-mission” problem, but said it’s simplistic to look only at how many people health coverage guides have signed up.
As managers prepare for the next open enrollment, COO Hinman said the biggest problem could be too many people needing help at the same time — both for renewals and for new coverage.
“As we get into this crunch time, we’re concerned about the unknowns out there,” Hinman said.
Editor’s note: Based on a chart that Connect for Health staffers prepared for the board, an earlier version of this story said that Colorado’s exchange was not keeping as many as 40 percent of customers. Connect for Health managers say they have not lost 40 percent of customers. Instead they say they had estimated that 40 percent might not renew plans for 2015. They say they hope that 65 percent of customers who bought insurance for 2014 will renew their plans for 2015.