Health Connector

Update

Massachusetts Health Care Training Forum

October 2011

Agenda

• Commonwealth Care – Current enrollment – Post-open enrollment results – Operational Updates

• Commonwealth Choice – Current enrollment – Open enrollment results – Special conditions tool

• Health Connector Outreach

2

Current Commonwealth Care Enrollment

Commonwealth Care Enrollment Aug 2010 – Sept 2011

4

154,535 155,142 154,072 154,711 158,973 160,824 158,072 155,518 157,579 158,932 159,876 159,154 158,174 159,323

Aug-10 Sep-10 Oct-10 Nov-10 Dec-10 Jan-11 Feb-11 Mar-11 Apr-11 May-11 Jun-11 Jul-11 Aug-11 Sep-11

(Preliminary)

Commonwealth Care Bridge Enrollment Aug 2010 – Sept 2011

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23,438 23,248 23,096 22,775 21,611

20,389 19,922 19,215

18,535 18,061 17,418

16,521 15,802

14,708

Aug-10 Sep-10 Oct-10 Nov-10 Dec-10 Jan-11 Feb-11 Mar-11 Apr-11 May-11 Jun-11 Jul-11 Aug-11 Sep-11

(Preliminary)

Commonwealth Care Post - Open Enrollment Results

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Commonwealth Care Enrollment By MCO (Aug 2010 vs. Aug 2011)

There have been some changes in membership distribution by MCO during FY11 and in early FY12

BMCHP

36% BMCHP34%

BMCHP30%

NWH31% NWH

28%

NWH30%

NHP22%

NHP25%

NHP25%

CeltiCare6%

CeltiCare10%

CeltiCare12%

Fallon4%

Fallon4%

Fallon4%

0%

5%

10%

15%

20%

25%

30%

35%

40%

Aug 2010 Jun-11 Aug 2011

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Early FY12 Enrollment Results

Actual enrollment results to date have been consistent with our expectations

Open Enrollment

• 11,048 members, representing nearly 7% of Commonwealth Care enrollment, switched to different health plans

– The level of transfer activity is moderately higher than in previous years

• Network Health, with its significant changes in both premium and network, experienced the most membership turnover

• NHP, which offers the most competitively-priced broad network, had the highest net growth

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Open Enrollment Details – Gain/Loss By MCO

BMCHP NWH NHP CeltiCare Fallon

PT II & III only

Premium $34-197 $0-116 $21-167 $0-116 $27-181

Premium ∆

Network Broader Narrower Broader Narrower Broader

Significant Network ∆ Unchanged Narrowed Unchanged Unchanged Unchanged

(3,789)

674

3,335

(5,021)

3,988

(1,060)

2,924

(907)

126

(271)

(# of Members)

PT II & III gain

PT I gain

PT II & III loss

PT I loss

Net Change (3,114) (1,686) 2,928 2,017 (145)

Member Web Utilization

• During Open Enrollment (June and early July), 28% of plan changes were made by web

• Web registration reached high of 28% in July 2011 – Compared to 4% in July 2010

• 25% of new enrollees in July used web to enroll – Compared to 19% in July 2010

• 24% of premium payments for July 2011 were made through EFT

– Compared to 6% in July 2010

• Use of HIP message center increased to 600 messages for both June & July

– Compared to 400 messages/month for past months

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Commonwealth Care Operational Updates

Copayment increases for Plan Type 1 members

• Beginning on October 1st, Plan Type 1 members have a copay increase for certain prescription medications

• Increase is from $3. to $3.65

• Members will have received written notification from their MCO

• Benefits and Co-pays have been updated on the Health Connector website

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Program Guide Updates

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Go to Mahealthconnector.org – Search for Program Guide

Program Guide Updates

• Purpose of the guide: Explain the Commonwealth Care program and Member responsibilities

• Updated to reflect the results of FY12 procurement

• Areas of note for Outreach staff - Incoming PT1 members - Late or missed payments

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Premium Billing Address Change

• Starting in November, Commonwealth Care payments must be sent to a new Massachusetts address

• This change means Members’ payments will be credited to their accounts faster

• We will be notifying Members by mail and email, as well as including notices on invoices for the next few months

• To avoid delays in processing, please make sure any payments you send on behalf of Members are sent to the new address

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Premium Billing Address Change

• Members who use their banks’ online bill pay services must change the Commonwealth Care address with their banks

• Members who pay by EFT on Mahealthconnector.org or use the coupon and envelope we provide don’t need to do anything different

• Help us communicate this change to members

New address: Commonwealth Care

P.O. Box 849175 Boston, MA 02284-9175

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Commonwealth Choice

Commonwealth Choice Enrollment

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32,699

31,578

33,182

35,458

25,000

30,000

35,000

40,000

Jun-11 Jul-11 Aug-11 Sep-11

CommChoice Non-Group Enrollment (Paid members)*

*Enrollment for all non-group members, including YAP.

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Commonwealth Choice Enrollment

2,244 2,228 2,200 2,272

222 180 168 165

1,651 1,567 1,683 1,725

2,577 2,554 2,534 2,480

4,228 4,121 4,217 4,205

0

2,500

5,000

CommChoice Group Enrollment (Paid members)

Bus Express - Converted Bus Express - New CP VP

Jun '11 Jul' 11 Aug '11 Sep '11

Open Enrollment for Commercial Insurance

• Open Enrollment for the purchase of commercial individual plans took place July 1, 2011 - August 15, 2011

• 3,970 new Commonwealth Choice members enrolled during that timeframe

• Individuals now interested in shopping for health insurance should use the Special Conditions Tool on Mahealthconnector.org to find out if they are able to purchase

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Special Conditions Tool (3 steps)

1

Special Conditions Tool (3 steps)

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2 3

Health Connector Outreach

"HealthWise: Strategies for your Healthcare Costs"

• The Mass Non Profit Network has partnered with the Health Connector and Health Care for All to present a series of regional meetings for its membership. – Purpose: To provide information to help attendees navigate the existing health

care system and participate in a discussion with legislators about the need for payment reform in the Commonwealth to help address rising costs.

• Friday, September 23 Berkshires – BCC Intermodal Center, Pittsfield** • Monday, October 3 MetroWest – Harvard Pilgrim Health Care Offices, Wellesley • Friday, November 4 Cape Cod – Hyannis (Location TBD) • Friday, November 18 Pioneer Valley – HCC Kittredge Center, Holyoke • Monday, November 21 Central – UMASS Medical School, Worcester • Friday, December 2 Northeast – United Way Lowell, Lowell • Monday, December 5 Greater Boston – The Boston Foundation, Boston • Friday, December 9 Southeast – Whaling Museum, New Bedford

Questions

Website: www.MAhealthconnector.org

Commonwealth Care Member Service Center

Call 877-MA-ENROLL (1-877-623-6765)

TTY 1-877-623-7773 for people with partial or total hearing loss