Connecticut: New features/services for 2017 Open Enrollment

I'm watching the livestream of the AccessHealthCT board meeting. Among other stuff, they're announcing three major changes/improvements for OE4:

First, it sounds like ConnectCare (the largest carrier on the CT exchange) is jumping on the "standardized plan" bandwagon, by offering what they call "Passage" exchange plans:

  • HMO-style, $5 co-pay for Primary Care Physician (PCP) visits (pre-deductible)
  • The Silver "Passage" plan would have a flat $50specialist co-pay
  • High-quality PC network included
  • Simple/easy to understand standardized plans
  • also offering "Passage" plans to small group / Medicare enrollees

--Standardized plans help but not enough; still lots of confusion about process, what's included/not included, etc; launching 4 retail "ConnectiCare Centers" to help people shop, enroll, member services, billing/payment issues, health/wellness assessments, education/outreach events

--CliniSanitas: Multicultural health delivery for hispanic/etc. members (3 centers; 100% bilingual services)

RATE REVIEW:

  • 13 carriers down to 12 carriers; 18 filings down to 16 filings due to HealthyCT going out of business
  • Utilization of services increased; severity of utilization increased; prescription drug costs increased
  • Some of it is just correction of claim level assumptions ("experience adjustment")
  • A delayed effect...a lot of the people who enrolled for the first time in 2014 didn't understand how/when to use their new insurance, so it took a year or so for them to actually start utilizing it; as a result, 2014 actually wasn't too bad, but 2015-2016 are ugly; they expect it to stabilize in 2018
  • Sunsetting of the reinsurance program = around 5-6 percentage points of rate increases for indy market
  • Risk Adjustment volatility is a huge unknown
  • Total Anthem Sm. Group covered lives: 42,000 total (on + off exchange)
  • Individual Market: 2015: -1.6%; 2016: 3.5%; 2017: 24.8%;  3 year average 8.8% average increase

(oof...sorry, I ended up missing the rest of the livestream, sorry...hopefully the exchange will post some sort of press release with the highlights)