The Health Connector: What We Have Accomplished, Where We Are Going, and What You Need To Know For 2014

Transcription

1 The Health Connector: What We Have Accomplished, Where We Are Going, and What You Need To Know For 2014

2 Massachusetts Health Reform: Health Connector 1.0 Created in 2006 by Massachusetts health reform law (Chapter 58 of the Acts of 2006) Quasi-public agency with eleven-member Board, chaired by Secretary of Administration & Finance Four ex-officio: A&F/GIC/DOI/MassHealth Four Gov. appointees: small business/actuary/health economist/broker Three AG appointees: consumer/labor/taft-hartley Staff of about 50 FTE s: mix of private health care industry and public sector experience Annual operating budget of ~$35M State, private and federal matching/grant financing 2

3 Role of Health Connector 1.0 The Role of Health Connector 1.0 Health insurance exchange facilitating access to private health insurance coverage Commonwealth Care state/federal subsidized coverage for lowincome adults Commonwealth Choice unsubsidized coverage serving individuals and small businesses Policymaking and appeals related to the Massachusetts adult health coverage mandate ( individual mandate ) Outreach and public education about the value of health insurance, where to find it, and the consequences of not having it 3

4 Health Connector 1.0 : Accomplishments to Date Breaking Down Barriers to Coverage Nearly 240K covered through Health Connector (1/13) Force for Cost Savings and Competition Annual avg. premium trend <2% in Commonwealth Care New market entrants in Commonwealth Care and Choice Fair, Effective Steward of Individual Mandate Only 1.1% of tax filers assessed a penalty (2010) Approve majority of penalty appeals Driving Innovation in Health Insurance Coverage Pioneered an employee choice coverage model Wellness Track for small employers Laboratory for narrower networks Platform for Garnering Support for Reform More than 60% of MA residents support MA HCR 4

5 Why It Matters If I didn t have health insurance, I would never have made an appointment with my doctor because of the cost. The cancer would have spread and I would not be alive today. Jaclyn Michalos Norwood 5

6 Why It Matters (cont d) When our existing health plan provider announced a 23 percent increase in our health insurance rates, we wanted to explore our options. Business Express made it very easy for us to perform a side-by-side comparison of each of the health plans offered. Benefits are standardized on the website so you can really compare apples to apples to make the best choice. It saved us time, allowing us to get back to our business of building custom rackmount and touch screen computers for our customers. But perhaps the best part of all is that our company and our employees saved a combined $9,300 compared to what we would have spent if we simply continued on with a very similar plan from another insurer. Matt McGinity, CEO, SuperLogics 6

7 Why It Matters (cont d) The Health Connector has continuously worked to address the needs of the small business community through their work with brokers. There are many options with leading carriers that allow brokers to shop, compare and select the best plan for their small business client based on premiums and outof-pocket co-pays that make it affordable without comprising coverage. I look forward to continuing my work with them. Broker John Vigliotti John J. Vigliotti Insurance & Consulting, Inc. 7

8 Health Connector 2.0 Not just comply with national health care reform but do more for consumers and small businesses Make it easier than ever to compare, choose and enroll in innovative health insurance products Offer cutting-edge wellness programs Promote affordability and competition and reinforce payment and delivery system reform 8

9 Health Connector 2.0 : Under Construction 9

10 Health Connector 2.0 : Under Construction Improved end-to-end customer experience Real-time eligibility determination even for subsidized coverage Updated website with new decision support tools More options for customers Federal tax credits for certain individuals and small employers Expanded access to state wellness rebates Upgraded carrier and product portfolio, including stand-alone dental coverage and an improved employee choice model Meshing state and federal health reform Individual mandate/minimum Creditable Coverage Employer responsibility Building bridges with market participants Broker and carrier engagement Sub-connector channel 10

11 Questions? 11