Mass. health insurance clearinghouse to operate better
Photo | Antonio Caban, SHNS
Health Connector Exec. Dir. Gutierrez briefs media during a meeting prior to the pandemic.
On the verge of the start of the open enrollment period, Health Connector Executive Director Louis Gutierrez said the state's health insurance clearinghouse will operate better than it has in past years, though he doesn't expect the process to be entirely free of bugs.
"We know that with more than 200,000 renewing members and new enrollees using the system this year there will be some problems or questions that people will need help with. But we are confident that the phones will be answered more quickly than in the past and that problem cases will be fixed more quickly than in the past," Gutierrez said Friday morning. "In short, we will do better than in the past."
Open enrollment, the period during which individuals can buy insurance plans through the online, state-based health insurance exchange, will run from Sunday through Jan. 31, 2016.
This open enrollment period will be the first full period under Gov. Charlie Baker, a onetime health insurance executive who had previously criticized the Connector's performance.
“Obviously the Health Connector has been a total crackup for the last couple of years, and the Commonwealth has spent literally hundreds of millions of dollars and hundreds of thousands of people have had their lives disrupted as a result of that," Baker said Friday.
When asked how he expects the Connector to handle this year's open enrollment process, Baker leaned over and rapped his knuckles on his wooden desk before answering.
"I feel they are extremely well prepared for this," the governor said of the Connector. "That doesn't mean there won't be a bump or two once they go live, but I am expecting that, for the vast majority of people for whom the last couple of years have been a nightmare, that this process this year should go pretty smoothly."
After a disastrous 2013 rollout of the Connector website that was intended to be compliant with the Affordable Care Act, the state built a new website for last year's open enrollment. A year ago, the enrollment period saw "unprecedented call volume," leading the Connector to work with its customer service vendor to develop detailed operations forecasts to better forecast its needs for this year's enrollment period.
The Connector has made improvements to its computer system that Gutierrez said will solve many of the problems customers experienced last year, including electronic payment system upgrades that will ensure payments will not be lost or attached to the wrong policy.
Gutierrez, who started his job this year but whose background includes stints as the state's chief information officer, said that the work done to prepare the Connector's IT system ahead of open enrollment "far exceeds" the amount of work done to prepare for enrollment last year.
"I've been around systems enough to know that it's always the unknown that you stay up at night worrying about," he said. "But I feel very solid about the testing we've done on the system."
In addition to hiring and training new call center employees to assist shoppers during open enrollment -- there will be more than 300 on standby -- the Connector's three call centers will be open for more hours and on more days than during previous open enrollment periods.
The call centers, which are located in Boston, Oklahoma City and Bowling Green, Kentucky, will be open from 8 a.m. to 9 p.m. Mondays through Fridays, and 9 a.m. to 5 p.m. on Saturdays and Sundays. Call takers will be able to assist shoppers in English, Spanish, French, Portuguese, Creole and Cape Verdean, the Connector said.
Also this year, the Connector will staff additional walk-in centers in Springfield, Fall River, Brockton and Lowell to supplement those already established in Boston and Worcester. Shoppers will also be able to get help from 14 community groups selected to act as "Navigators" and provide enrollment and renewal support throughout open enrollment.
After about eight months of seven-day work weeks to prepare for open enrollment, Gutierrez said, the Connector is as ready as ever to handle the influx of insurance shoppers, with one million monthly web hits expected and 100,000 monthly phone calls predicted during the three-month period beginning Sunday.
"I am a very conservative person. I don't like to be optimistic without the facts," he said. "I'm not thinking we'll be without incidents that must to be dealt with on an urgent and rapid basis, but I feel very solid about the system that we're entering this open enrollment with."
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