Hartford Business Journal

www.HartfordBusiness.com October 3, 2016 • Hartford Business Journal 5 Test looms for CT's insurance exchange By Matt Pilon mpilon@HartfordBusiness.com T he fourth annual enrollment period for the state's health insurance exchange could prove to be its most challenging. Headed into the Nov. 1 enrollment kickoff, Access Health CT faces numerous headwinds that could hinder its efforts to maintain or grow its base of 99,000 non-Medicaid customers. Access Health has lost half of its par- ticipating insurers and seen double-digit increases in 2017 premiums. Meantime, brokers — a key sales channel over the past three years that accounted for approxi- mately 40 percent of exchange customers — have been all but eliminated from the process after Anthem and ConnectiCare axed commissions. The broker vacuum will place a much larg- er burden on Access Health's newly hired call- center vendor, Faneuil Inc., which will hire 20 brokers to work in-house and offer advice on plan selection for those who ask for it. That's a big change from recent years, when hundreds of independent brokers around the state sold the plans and received monthly commissions from insurers. In an interview, Access Health CEO James Wadleigh acknowledged the chal- lenges and the pressure they place on the exchange. Despite that, he said the exchange aims to boost enrollment to somewhere between 115,000 and 125,000. The focus will be on getting back some 16,000 former customers who lost coverage after they stopped paying premiums or didn't provide required paperwork. There are also still about 8,000 people who lost Medicaid eligibility in August, due to state budget cuts, who haven't enrolled in an exchange plan. And Wadleigh hopes new, stricter docu- mentation requirements for off-season spe- cial enrollments (which are permitted in certain situations such as loss of other cover- age, marriage and relocation) could also help regular enrollment in the coming months. Caught flat-footed Wadleigh said the series of events that have set a potentially messy table for 2017 felt like they happened in the blink of an eye. "It was like 'holy cow, what just hap- pened?' " he said. "I think when HealthyCT went under receivership [in early July], a bunch of dominoes fell that we couldn't react to." HealthyCT owned 10 percent of the exchange's market share before state insur- ance regulators shut down the nonprofit health plan over concerns about its long-term financial health. UnitedHealthcare also with- drew from the exchange. Wadleigh said HealthyCT planned to keep broker commissions in 2017, which gave him confidence that other insurers would do the same. But that didn't happen and Connec- tiCare and Anthem didn't include commis- sions in their premiums, which still went up by double digits from last year. Depending on how open enrollment goes, Wadleigh said he isn't ruling out a discussion of mandated commissions for 2018 plans. But for now, Access Health will have to make do. "Next year we could do something, assum- ing we have a relationship [with brokers] at that point in time," he said. "We've got to limp through this open enrollment as best we can." Broker Jesse D. McDonald, owner of Milford-based Modern Insurance and a member of the exchange's broker advisory committee since early 2015, said many bro- kers are upset, but he understands Wadle- igh's contention that it may have been too late to salvage 2017 commissions. "Clearly it was a contingency they weren't ready for," McDonald said. "All of this has happened in such a compressed time period I think everyone has had to scramble for how best to handle it." To try to make up for the loss of commis- sions for his 250 exchange customers, McDon- ald plans to delve into other insurance lines. The 20 brokers to be hired by Faneuil will be the only Access Health representa- tives legally authorized to offer advice on plan selection to customers. It will be up to Faneuil, which has operated several other exchanges, to take on much of the added customer volume. Carriers have also beefed up their in-house broker teams. Faneuil CEO Anna Van Buren said her com- pany, which is investing $3.3 million to reno- vate, furnish and staff a 38,000-square-foot space in downtown Bristol, is up to the task. "We are not really feeling pressure to perform, we are feeling absolute commit- ment to perform for the consumers and for Access Health," Van Buren said. n PDS has been meeting the needs of the construction industry since 1965. 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