Date: 05/13/2015
Final
Previous Open Enrollments & Improvements for 3rd Open Enrollment
HEALTH CARE EXCHANGE
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10:27 AM -- Discussion of the Challenges of the Previous Open Enrollments and Plans to Improve the Third Open Enrollment
Gary Drews, outgoing interim CEO, Connect for Health Colorado, Marcia Benshoof, Chief Strategy and Sales Officer, Connect for Health Colorado, and Adela Flores Brennan, Member, Connect for Health Colorado Board of Directors, came to the table. Mr. Drews spoke briefly about the challenges the exchange faced during the previous two open enrollment periods and the plans to improve the third open enrollment. He spoke about the transition period between himself and Mr. Patterson. He provided the committee with a handout (Attachment C), and referred to the handout as he spoke about the sustainability of the exchange and the planning and budget process. He pointed to page 6 of the handout and discussed the significant variables used in planning the next budget. He told the committee that almost half of the customers who purchase insurance through the exchange do not receive financial assistance, but rather use the exchange for the ease and transparency of selecting plans. He expressed the need for the exchange to address the needs of both the customer population who applies for subsidies and the customer population who does not apply for financial assistance. He explained that the exchange is focused on increasing customer access, affordability, and choice. He also told the committee that the tax credit subsidy declined by almost 20 percent for almost all recipients. Committee discussion followed.
Marcia Benshoof, Chief Strategy and Sales Officer, Connect for Health Colorado, responded to questions about the role of brokers within the exchange. She told the committee that the insurance carriers continue to pay broker commissions, not the exchange. She stated that brokers can use the exchange or they can sell insurance outside of the exchange, but brokers' customers must go through the exchange in order to qualify for a premium subsidy. Committee discussion followed about the requirement that a brokers must use the exchange if their customer would like to qualify for a premium subsidy.
10:51 AM
Mr. Drews responded to questions about carrier market share of policies sold through the exchange held by the Colorado HealthOP and Kaiser. Ms. Benshoof told the committee that Colorado has plenty of licensed carriers in the general insurance marketplace, but there are dominate carriers which include Colorado HealthOP and Kaiser. She explained that the DOI is responsible for reviewing insurance rates and network adequacy. Ms. Benshoof further explained that the exchange provides all carriers doing business on the exchange with marketing strategy assistance and educates customers to choose a provider that fits with their health needs.
Further committee discussion centered on whether individuals between the ages of 18 and 32 purchase insurance. Ms. Benshoof told the committee that the exchange has focused on educating this population about the benefits of health insurance and that currently more individuals in this age group have purchased insurance than originally expected.
10:59 AM
Committee members discussed whether the exchange asks customers if they were previously insured and the benefits associated with asking this question. Ms. Benshoof responded that the question is on the application, but that it is not mandatory that the customer respond to the question. Additional questions from the committee focused on health care inflation and the cost of health care. Mr. Drews responded to questions about how the exchanges handles consumer complaints by telling the committee that there are dedicated staff who worked with these customers to resolve concerns.
11:23 AM
In response to questions about the sustainability of Colorado HealthOP, Mr. Drews stated that the question would be more appropriately directed to the Division of Insurance.
11:28 AM
Ms. Flores Brennan explained to the committee that exchange customers have access to brokers, health coverage guides, and service center staff who can help them make decisions about insurance coverage. She discussed the role of exchange staff in assisting customers who qualify for Medicaid and the potential for reimbursement from CMS for the time spent with these customers. She also discussed the number of small businesses that utilize the exchange and referred to page 26 of the handout (Attachment C).
11:40 AM
Mr. Drews referred to page 21 of the handout (Attachment C) in response to questions about individuals who qualify for Medicaid. He explained that exchange employees do not have access to Medicaid eligibility information for customers and that there is discussion about allowing exchange employee to have access to the Colorado Benefits Management System.
11:54 AM
The committee took a brief recess.
12:13 PM
The committee reconvened.
12:13 PM
Senator Roberts announce that the agenda item, Review of Policy and Procedures for Board and Staff Regarding Conflicts of Interest and Departing Employees, will be moved to the June 5, 2015, committee meeting. She also discussed whether having insurance carriers on the the board creates a conflict of interest. She suggested that the Commissioner of Insurance be added to the agenda for the June 5, 2015, meeting to discuss her experience as a member of the board, and that the board members provide information about the criteria for certifying brokers to sell insurance through the exchange.