Tag Archives: Exchange

Obamacare: Inside health care exchange websites’ issues

In less than a week, the first Americans will have health insurance under the Affordable Care Act, commonly known as Obamacare. Many of the early problems wi…
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Array Health to Offer Private Health Insurance Exchange Solution Through AHIP Connect Program

Seattle, Wash. (PRWEB) April 10, 2014

Array Health, a provider of private insurance exchange technology, today announced its approval to participate in the AHIP Connect program.

AHIP Connect is an industry solution provider sourcing and independent evaluation program that helps AHIP’s health plan members choose companies to implement operational business solutions that reduce costs; increase efficiency, safety, and quality; and enhance the consumer experience.

As an AHIP Connect approved solutions provider, Array Health seeks to engage payers interested in launching branded private exchange solutions. Health plans can leverage the Array Spectrum™ private health insurance exchange platform to support end-to-end consumer engagement for marketing, selling, enrolling, managing, renewing and administering health and ancillary benefits for their large and small group, individual and retirement business segments.

Array Health delivers a world-class experience for consumers shopping for and enrolling in benefit programs. As employer and consumer needs continue to change, Array Health’s technology is designed to simplify and humanize the process of buying benefits. The Array SmartFit™ technology takes the consumer’s responses to simple behavioral statements indicating their preferences around financial risk, desired access to providers, prescription needs and more; it then uses proprietary algorithms to suggest plans that best map to each individual’s values based on the responses provided. In addition to simplifying the decision-making process, health plan details are presented in natural language, not insurance terms, further facilitating the shopping experience.

“Private health insurance exchanges represent a substantial opportunity in the new marketplace,” said Jonathan Rickert, CEO of Array Health. “As health plans are learning how to sell to consumers in this retail-focused world, our participation in AHIP Connect can help payers build and offer a superior and differentiated shopping and enrollment experience to attract new business and enhance existing relationships.”

“The market for health insurance continues to diversify, and payers are developing promising new products to reduce costs and improve outcomes,” said Charles Stellar, Executive Vice President of Professional Services at AHIP. “We look forward to exposing our health plan members to Array Health’s team of technology, retail and insurance industry experts as they consider new exchange options.”

About America’s Health Insurance Plans

America’s Health Insurance Plans (AHIP) is the national trade association representing the health insurance industry. AHIP’s members provide health and supplemental benefits to more than 200 million Americans through employer-sponsored coverage, the individual insurance market, and public programs such as Medicare and Medicaid. AHIP advocates for public policies that expand access to affordable health care coverage to all Americans through a competitive marketplace that fosters choice, quality and innovation.

About Array Health

Array Health is a leading provider of private insurance exchange technology. Its cloud-based software platform enables health plans of any size to power their own branded online exchanges—a strategic channel that helps them compete and thrive in the post health-reform world. With its state-of-the-art member marketplace and support for defined contributions, insurers win and retain business by giving employers a way to control costs and members a better way to buy benefits. Array Health is a privately held company based in Seattle. To learn more, visit http://www.arrayhealth.com.







Health Exchange CT Scrambles to Address Errors, Federal Changes

Health Exchange CTAs has been well-publicized in the media, the debut of the health insurance exchanges as mandated by the Affordable Care Act has been rocky to say the least. In response to the many problems experienced by Americans attempting to sign up for health insurance through the exchanges, the unexpected cancellation of millions of noncompliant policies and the numerous reporting errors received by health insurance companies, the federal government made several changes to deadlines and the law itself.

These changes and delays caused state exchanges, including Health Exchange CT, to scramble to address these problems and meet the new federal guidelines. Fortunately, Connecticut has consistently been recognized as a leader in the implementation of the ACA and has been able to handle the unexpected delays and changes with relative ease.

Health Exchange CT Catastrophic Coverage Availability Expanded

When millions of Americans began receiving letters from their insurance companies in November telling them their current policies would be cancelled due to noncompliance, the federal government knew it had to find a solution to get these residents covered without making them pay premiums that could be much higher than their 2013 premiums. First, the government allowed states and insurance companies to grant one-year extensions for these policies, thereby giving consumers an extra year before they would be dropped.

Most states and insurance companies, however, elected not to extend their noncompliant policies because they didn’t have rates in place, nor were they prepared to administer these plans for an additional year. As a result, the federal government, through the Center for Medicare and Medicaid Services (CMS), announced that individuals whose policies were cancelled for noncompliance reasons would now be eligible to purchase catastrophic plans. Previously, these plans were only available to young adults between the ages of 18 and 29.

Health Exchange CT honored the change by the CMS and opened enrollment into catastrophic plans to anyone who had his or her plan cancelled by insurance companies due to noncompliance with the ACA. The catastrophic plans offered through the CT health insurance exchange will offer comparable coverage to many of the cancelled plans, which often had high deductibles.

Residents who want to enroll in catastrophic coverage will have to apply for a “hardship” exemption through Health Exchange CT and provide proof of a cancelled plan. If an exemption is granted, residents will then have 60 days to change their current coverage to a catastrophic plan. This exemption must be granted by the end of the open enrollment period on March 31.

Inaccurate Information on Shopping Screens

Although Health Exchange CT’s website ran much more smoothly than the federal government’s exchange website, it was not without its share of problems. In some cases, people who attempted to enroll in coverage through the website in October may have been shown inaccurate plan information when they compared policies.

The exchange became aware of these inaccuracies on September 26 and proceeded to place a warning on these pages, advising consumers to look at the plan summaries, all of which included the correct information. In addition, the exchange called every person who enrolled in a plan in October to advise them of the errors on the shopping screens. Written communication also told these individuals they could choose another plan if the inaccuracies were sufficient enough to warrant such a change.

Moreover, the health exchange did not submit any information received in October to health insurance companies to give consumers time to make any changes. Only after consumers were notified of the inaccuracies did Health Exchange CT pass the data from October enrollments to the insurers.

The shopping pages were corrected by October 30, so anyone who purchased a plan in November was not affected. Health Exchange CT has been proactive in correcting any problem with the website or enrollment process that has been identified by users or technicians. Currently, there are more than 13,000 visitors to the site every day, with more than 1,400 of those visitors completing the enrollment process.

All website improvements are documented on the exchange’s calendar and are addressed regularly at public forums including exchange board meetings. Although problems with such a complex website roll-out were expected, Health Exchange CT has been successful at promptly responding to technical issues and getting them fixed within a reasonable time-frame.

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New York State Health Exchange Exceeds Federal Results

new york state health exchangeAs of December 16, the New York State Health Exchange, the official Affordable Care Act online marketplace, saw 363,258 completed applications from New York residents. In addition, 134,622 New Yorkers had enrolled for health insurance coverage to be effective on January 1, 2014. That number represented a 34 percent increase over the 100,881 who had enrolled through December 9.

New York residents, as with all Americans, have until March 31 to sign up for a qualified health plan to be in compliance with the individual mandate as required by the ACA. The first date an ACA plan can be effective is January 1, 2014. To meet that effective date, New Yorkers had to enroll in and pay the first month’s premium for a plan by midnight on December 23.

New York State Health Exchange Performs Better than Federal Exchange

Unlike the problematic federal health insurance exchange, HealthCare.gov, the New York State Health Exchange is on pace to meet or exceed the state’s enrollment goals. However, there are still some consumers who have had difficulty signing up through New York’s website. Some users have said they are frequently confronted with system outages and have spent several hours on the telephone trying to reach someone for help.

Not only that, but some consumers have still not received confirmation of coverage, even if they were one of the first to enroll. Once they finished the enrollment process, they often reported a sense of relief and accomplishment, since the path toward coverage was anything but easy. The navigators hired to help residents make their way through the system have also been relieved to reach the end and receive that “congratulations” screen that signals they have made it through the process.

Enrollment Data Not Released

Even though the New York State Health Exchange is clearly outperforming the federal website, there are still some unknowns in terms of what types of residents have enrolled in the plans. The state Health Department has not provided the public with any breakdowns of the data, so it is uncertain whether or not the enrollment numbers include more young and healthy residents or more sick and elderly residents.

Younger and healthier residents are necessary for the financial success of the ACA. Their premiums are needed to balance out the expected higher medical costs of the older and sicker enrollees who may have not had insurance for many years, if ever. The state Health Department has said it does not have that data yet and describes the enrollment situation as “fluid.”

New Yorkers’ Rates Lower on Average

In contrast with many markets throughout the country, New York is seeing much lower premiums. In fact, people who purchase their policies through the New York State Health Exchange are finding rates are as much as 53 percent lower than what they were paying in 2013 for similar coverage. In addition, many residents are able to reduce their costs even more in the form of federal tax credits designed to help low- and middle-income families pay for their insurance coverage.

For instance, one New Yorker who had coverage through Healthy NY, a program designed for hard-to-insure individuals that will expire on December 31, for $ 269 per month, was able to find a Silver level plan through the state exchange for $ 195 per month. Moreover, she was able to add a dental plan for just $ 15 per month.

Another resident , used to pay $ 518 per month for a plan through BlueCross BlueShield. Once he was able to make it through the complicated enrollment process, he found a plan through Health Republic that will cost just $ 366 per month. The $ 150-per-month savings will be a welcome windfall for the self-employed individual.

Call Center Busy

Since its debut on October 1, the New York State Health Exchange customer service center has responded to almost 300,000 calls. The volume is ratcheting up in advance of the enrollment deadline for a January 1 effective date. Although consumers reported long wait times initially, the exchange has added extra employees to help handle the extra volume.

More than 5,000 certified assistors or “navigators” are available throughout the state to help New Yorkers apply in person. Navigators at one in-person help center have answered close to 1,300 calls and have scheduled over 250 appointments. They are completely booked until well into January.

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Health Care Exchange Cost Is More Important Than Provider Network

Health Care Exchange Cost Is More Important Than Provider NetworkHealth Care Exchange Cost Takes Priority

Based on the results of a recent consumer survey, more people who are eligible for federal premiums subsidies are worried about how much they are going to pay for health insurance than they are about whether or not a certain provider will included in the health exchange provider network. For this reason, health insurance companies are choosing to narrow their provider networks so they can keep their premiums as low as possible and reduce health care exchange cost.

37 percent of all respondents who are eligible to receive subsidies said that they consider health exchange cost most important when choosing health insurance. That percentage was higher than the 31 percentage of respondents who said benefits were the most important factor when choosing health insurance. The results of this survey led insurers to restrict their provider networks for the plans that will be sold on health insurance exchanges.

Benefits Most Important for People Not Eligible for Subsidies

Interestingly, for people who earn too much money to be eligible for federal subsidies do not look at the health care exchange cost as the primary factor when choosing health insurance. Neither do they believe that the provider network is most important. 37 percent of consumers who will not be receiving federal premium subsidies through the health insurance exchanges believe that benefits are the biggest determining factor for choosing health insurance.

This may be why only six percent of survey respondents will be shopping for health insurance on their state exchanges in 2014. All health insurance plans must cover the 10 essential health benefits to be considered qualified health plans under the Affordable Care Act, but if they aren’t receiving subsidies, they may be able to get a better deal outside of the exchange. They may also be able to find plans with richer benefits off exchange as well.

More Benefits at a Better Price

Regardless of whether or not people purchase health insurance through the exchanges, they will be getting more for their money. This is because all plans are required to cover those essential health benefits. So, even if they pay a little more, they are getting a whole lot more benefits. This is also true for people who will be shopping on the health insurance exchanges. While they may have to travel a little further to see a doctor that is participating in the health exchange provider network, they will still be getting more than they were on a pre-ACA policy.

The key to reaping the health care exchange cost savings is to finding a provider that is in network before receiving services. Even if a consumer has to drive for several miles, the savings are worth it, particularly for those who are receiving federal subsidies to help them pay for their premiums.

Some Physician Groups Wary of Low Reimbursements

One of the reasons the health exchange provider networks are restricted is because some physician groups are nervous about the low reimbursement rates from insurance companies operating through the exchanges. 59 percent of the respondents to a second survey of physician groups said the low reimbursement rates would pose a financial risk to their practice. As a result many physicians are taking a wait-and-see approach to the exchanges. While they might not be participating in 2014, it is possible more doctors will participate in subsequent years as they see how the system works.

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