2016 Open Enrollment and Outreach Update Board of Directors Meeting, January 14, 2016
Welcome message from author
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
2016 Open Enrollment and Outreach Update
Board of Directors Meeting, January 14, 2016
Update: Open Enrollment and
Outreach 2016
There are approximately 189,000 members enrolled in Qualified Health Plan (QHP) coverage
for 2016 (both January 1 and February 1 coverage start dates), with nearly 28,000 new
members enrolled in Health Connector coverage
Preliminary data suggest that our targeted outreach efforts are prompting the uninsured to sign up
for coverage, particularly in the top 10 communities with the highest numbers of uninsured
The customer experience, in general, continues to be smooth for our renewing and new
members, with service centers capably handling increased volume around the December
23rd deadline
We continue to encourage new enrollment through a series of e-mail reminders before Open
Enrollment ends on January 31st and we are preparing our call and walk-in centers for an
expected increase in customer service activity as the deadline for Open Enrollment nears
2
We are more than two-thirds of the way through a stable first renewals
Open Enrollment period.
August September October November December January
9/16-10/5
First round of prod-like testing
12/7-12/11 Invoices
mailed for 1/1 renewals
(~135k)
12/23 Jan.
enrollment
deadline
Open Enrollment Timeline
11/20 – 11/25
Auto enrollment for
passive renewals
Renewals technical
release (6.5)
8/19-9/4
Preliminary notices
generated & mailed
(~120k)
10/7- 10/16 2016
Final Eligibility
1/31 March
enrollment deadline
(in OE)
1/23 Feb. enrollment
deadline
11/21-11/24
Carrier 834 files sent for
renewal population
8/24-9/16
“What to Expect”
for members
(~135k)
11/2
Mailing to Bronze members (~7k)
11/9-11/30
Eligible & unenrolled Open Enrollment reminder (~149k)
11/2-11/6
Message to shop (unsub) (~28k)
11/9-11/20
“Where to get help” (subsidized) (~120k)
1/13-1/22
OE is ending
reminder (plan in
cart) (volume TBD)
10/5-11/2
DOR mailing to self-
reported uninsured
(~115k)
11/1-12/21
Paid Messaging Phase 1
1/1-1/22
Paid Messaging Phase 2
11/1-1/31
Call Center hours extended for Open Enrollment
11/2 Walk-in Centers launch (six sites)
11/1 Provider search go-live
1/1
Coverage effective for 2016
10/14-10/28
Renewal notices
generated & mailed
(~135k)
10/19-11/7
Second round of prod-like testing
10/19 Technical release (7.0) shopping improvements
10/26 7.0 post production release
Open Enrollment 2016
Renewals
Member Web Improvements
Operational Readiness
Outreach & Communications 3
12/2-12/16
Shopping information
(unsub) (~28k)
1/4
New member
survey (~16k)
1/7
Message to 2015-
2016 Bronze
members (~5k)
1/19
Press Release
reminder that OE
is ending
Enrollment and Outreach
Update
Approximately 28,000 new
members are enrolled in
2016 QHPs
These “new” members are
those that were not enrolled
in MassHealth for 2015, and
either obtained a program
determination in 2015 but
never enrolled or have never
been with us before (in this
new system)
Renewing and New Members
5
With just over two weeks remaining in Open Enrollment,
approximately 189,000 individuals are enrolled in 2016 health
coverage.
For renewing members, these figures represent a 92% retention rate, comparable to the
retention rate during the Commonwealth Choice program in 2012 and 2013 of ~90%
129,435
7,227
38,418
175,080
118,707
6,440
35,686
160,833
20,596
1,248
5,857
27,701
210
37
50
297
-
20,000
40,000
60,000
80,000
100,000
120,000
140,000
160,000
180,000
200,000
2015 2016 2015 2016 2015 2016 2015 2016
ConnectorCare APTC-Only Unsubsidized Total
Health Connector Membership
2015 Membership (~175k) 2016 Renewals (~160k) 2016 New (~27.7k) 2015 MassHealth PD (~300)
2016 Renewing Member Metallic Tier*
2015 Metallic Tier Catastrophic Bronze Silver Gold Platinum ConnectorCare
Catastrophic 78% 13% 4% 1% 0% 5%
Bronze 0% 84% 9% 2% 0% 5%
Silver 0% 1% 93% 2% 0% 4%
Gold 0% 1% 10% 86% 1% 2%
Platinum 0% 0% 3% 12% 82% 2%
ConnectorCare 0% 0% 2% 0% 0% 98%
Renewing Members
6
As noted, we are seeing a 92% retention rate of those eligible to renew for this
year’s Open Enrollment, with the vast majority of members remaining in the
same metallic tier.
*Data as of January 8, 2016
Likewise, we have seen very little movement between carriers
Any movement is likely due to members buying down for the lowest cost ConnectorCare plan in
their region or members seeking a particular provider network
There is still time left to switch health plans or metallic tiers, and we recently sent a special
mailing to 2015 Bronze members reminding them to closely review their benefits and that
they can still switch before the end of Open Enrollment
New Enrollment by Metallic Tier
and Carrier
7
To date, we have seen nearly 28,000 new members enroll in Health Connector
coverage, with the vast majority (non-ConnectorCare) enrolling in Silver and
Gold plans, and the majority of ConnectorCare members selecting Tufts
Direct.
*Data as of January
8, 2016.
1%
7%
64%
22%
6%
New Unsubsidized and APTC-only
Membership by Metallic Tier
Catastrophic
Bronze
Silver
Gold
Platinum
11%
19%
34%
22%
14%
New ConnectorCare Membership by
Plan Type
ConnCare 1
ConnCare 2a
ConnCare 2b
ConnCare 3a
ConnCare 3b
5%
10% 0%
3%
13%
3% 6%
19% 4%
36%
1%
New Unsubsidized and APTC-only
Membership by Carrier
Blue Cross Blue Shield of MA
BMC HealthNet
CeltiCare
Fallon Community Health Plan
Harvard Pilgrim Health Care
Health New England
Minuteman Health
Neighborhood Health Plan
Tufts Health Premier
Tufts Health Direct
United Healthcare
16% 1%
2%
3%
1%
24%
53%
New ConnectorCare Membership by
Carrier BMC HealthNet
CeltiCare
Fallon Community Health
PlanHealth New England
Minuteman Health
Neighborhood Health Plan
Tufts Health Direct
The concentration of new QHP membership closely aligns
with the communities with the highest numbers of uninsured
individuals.
Source: The Geography of Uninsurance
in Massachusetts, 2009-2013, Blue
Cross Blue Shield Foundation of
Massachusetts
Number Uninsured 0 5,522
Source: Health Connector enrollment
data as of January 8, 2016
8
Number of New Health Connector
Enrollments
0 500
Outreach and New Membership
Nearly 28% of new QHP enrollments are from our top 10 communities or places
where Navigators are our main platform of outreach
Approximately 7% of new QHP enrollments come from areas where our outreach
was led by Navigator organizations, such as Cape Cod, North Berkshire County and
Framingham
9
Our messaging during Open Enrollment has targeted our 10 priority
communities and is focused on encouraging uninsured residents to
enroll in coverage.
New Enrollee data as of January 8.
Top 10 Priority Communities
Dorchester Lynn
Brockton New Bedford
Fall River Quincy
Lawrence Springfield
Lowell Worcester
Characteristics of New Membership
The demographics of our new members (included below) align with the outreach and
education platforms and strategies we pursued to reach them
Of our new members who indicated a preferred language preference, the most common languages
following English were Spanish (7%), Chinese (2%) and Portuguese (1%)*, and our primary ethnic
media platforms have been Spanish-language television, Spanish and Portuguese radio; and
African-American, Spanish, Portuguese, Chinese and Cambodian newspapers
10
The characteristics of our new membership reflect the variety of
outlets featuring our messaging this Open Enrollment period.
New 2016
Members by Gender
Male 46%
Female 54%
New 2016 Members by
FPL
≤ 100% 8%
>100 - ≤150% 14%
>150 - ≤200% 25%
>200 - ≤250% 16%
>250 - ≤300% 11%
>300- ≤400% 7%
> 400% 5%
Not applying for
Financial
Assistance or
Not Found
13%
New 2016 Members by Race
WHITE 72%
African American 9%
OTHER 6%
CHINESE 5%
ASIAN INDIAN 2%
Other Asian 2%
VIETNAMESE 2%
KOREAN 1%
FILIPINO 0%
JAPANESE 0%
American Indian or
Alaskan Native 0%
Other Pacific Islander 0%
Guamanian or Chamorro 0%
Native Hawaiian 0%
SAMOAN 0%
4% 10%
30%
19%
20%
17%
0%
< 18
18-25
25-34
35-44
45-54
55-64
65+
4% 10%
30%
19%
20%
17%
0%
< 18
18-25
25-34
35-44
45-54
55-64
65+
46%
54%
Male
Female
8%
14%
25%
16%
11%
7%
5%
13%
≤ 100%
100 - ≤150%
150 - ≤200%
200 - ≤250%
250 - ≤300%
300- ≤400%
> 400%
Not applying for FinancialAssistance or Not Found
72%
9%
6%
5%
2% 2% 2% 1%
WHITE
AFRICAN AMERICAN
OTHER
CHINESE
ASIAN INDIAN
OTHER ASIAN
VIETNAMESE
KOREAN
New Member Survey Results
11
49%
10%
9%
8%
2%
22%
Length of Time Uninsured
1-3 mos.
4-6 mos.
7-12 mos.
Over 1 year
First time
Don’t know
64% 6%
18%
5% 7%
Why did you shop?
Insured in last 6 mos.
Lost other insurance
Moved to MA
Other insurance
unaffordable
Couldn’t enroll during
closed enrollment
Other
39%
35%
12%
6% 8%
Why did you shop?
Uninsured for over 6 mos. Wanted access to care
for self and family
Realized could get an
affordable plan
Didn't want to pay the
penalty
Ease of applying and
enrolling because got
helpOther
44%
4%
21%
3%
5%
11%
1% 2%
9%
Why did you shop?
Unknown duration
Lost other insurance
Recently moved to MA
Other insurance
unaffordableCouldn't enroll during
closed enrollment
Wanted access for self and
familyRealized could get an
affordable plan
Didn’t want to pay penalty
Ease of applying and
enrolling because got help
Other
Of all new members, 88% reported being previously insured while
12% reported never having had insurance before.
49%
10%
9%
8%
2%
22%
Length of Time Uninsured
1-3 mos.
4-6 mos.
7-12 mos.
Over 1 year
First time
Don’t know
Customer Experience Update
Service Center Performance:
Open Enrollment
0
20,000
40,000
60,000
80,000
100,000
120,000
140,000
160,000
180,000
200,000
Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Nov-15 Dec-15 Jan-16
Ca
lls
Calls Offered
Jan 2015 – Dec 2015 = Actual Jan 2016 = Forecasted
87,407 75,774
OP
EN
EN
RO
LLM
EN
T
Forecast
1,153
1,669
1,281
149 81 28 12 32 27 20 8 29
0
200
400
600
800
1,000
1,200
1,400
1,600
1,800
2,000
Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15
Se
co
nd
s
Average Speed to Answer (ASA), in Seconds
32.2%
40.3%
35.6%
5.6%
0.0% 0.0% 0.0% 0.0% 0.3% 0.7% 0.2% 0.6%
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15
Abandonment Rate
13
Service Centers:
Open Enrollment Nov-Dec 2015
TOP CALL DRIVERS
Application /
Eligibility
31%
Enrollment
25%
Billing /
Payments
21%
Account
Change
8%
Other 4%
General
Questions
11%
0
1,000
2,000
3,000
4,000
5,000
6,000
11/2 12/2
Calls Handled
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
11
/2
11
/9
11
/1
6
11
/2
3
11
/3
0
12
/7
12
/1
4
12
/2
1
12
/2
8
% Answered Calls
within 150 secs
0%
1%
2%
3%
4%
5%
6%
7%
8%
9%
10%
11
/2
11
/9
11
/1
6
11
/2
3
11
/3
0
12
/7
12
/1
4
12
/2
1
12
/2
8
% Abandoned
0
50
100
150
200
250
300
350
11
/2
11
/9
11
/1
6
11
/2
3
11
/3
0
12
/7
12
/1
4
12
/2
1
12
/2
8
Speed of Answer
14
Customer, Partner and Media Feedback
“(She) took the time to help me find a plan that included my mental
health provider. I have been paying out of pocket for this service and she
found coverage that included my provider. Customer service at its best!”
– December 21, 2015 walk-in
“The partnership with us has been a seamless integration into our
operations. Overall, this has been a really great fit and is exactly what
the Greater Fall River community needs.” – Julie Almond, CEO,
HealthFirst Family Care Center, Inc.
“With the deadline to sign up for health insurance for 2016 coming soon,
the Massachusetts Health Connector and HealthFirst Family Care Center
are urging people without coverage to sign up by the Dec. 23 deadline at
HealthFirst’s walk-in center.” – Fall River Herald News, December 3,
3,329
1,926
709 842
636
1,755
0
500
1,000
1,500
2,000
2,500
3,000
3,500
Boston Brockton Fall River Lowell Springfield Worcester
Walk-Ins by Location
Walk-In Center Performance
0% 0% 1% 6%
93%
0%
20%
40%
60%
80%
100%
Overall Satisfaction – Dec 2015
Very Dissatisfied Dissatisfied
Neither Satisfied nor dissatisfied Satisfied
* On a scale of 1 to 5, with 1 being very dissatisfied and 5 being very satisfied, how satisfied are you with the overall service provided to you by the Health Connector today?
* Until Jan 02 * Until Jan 02
Total Walk-Ins: 9,197
Billing &
Payment
34%
General
Questions
4%
Notices
9%
Enrollment
14%
Document
Processing &
Verification
9%
Applications
21%
Account
Changes
9%
Reasons for Walk-In
15
355 423
538
381 310
350 266 249 229
160 176 209
90
136 162 91
37
Jan Feb March April May June July Aug Sep Oct Nov Dec Jan 2016 MTD
Urgent Services Ombudsman
1 4 5
23
53 54
6
18
33
22
0
20
40
60
August September October November December Jan 2016 MTD
Urgent Services and Ombudsman Inventory
Urgent Services Ombudsman
Urgent Services and Ombudsman
Urgent services cases resolved, Jan 2015 – Jan MTD = 4,052
Current Total Inventory : 219
Number of Urgent Services & Ombudsman Cases received by Month
Consistent drop in new cases
Ombudsman started on 9/28/15.
Fine-tuning of the process is helping
to reduce cases that can be helped
through self-service and normal
customer service channels
16
Call Center Satisfaction Survey:
December Results
* How satisfied are you with the overall service provided to you by the Health Connector today?
1 How satisfied are you with how our customer service representative resolved your issue today?
2 How friendly and courteous our customer service representative was today.
3 How satisfied are you with the knowledge of the customer service representative you spoke with today?
Overall satisfaction decreased slightly by 3%
Decreased satisfaction levels can be attributed to website usability and access, Customer
Service Representative (CSR) knowledge or follow-through and billing issues
20% 17% 16% 23%
32% 40% 39%
51% 42% 39%
64% 60% 22% 21%
18%
22%
22%
21% 23%
18% 31%
31%
13% 14%
13%
7% 11%
15%
14%
15% 7%
11% 8% 12% 7% 9%
11%
10% 15%
13% 11%
7% 10%
11% 7% 9% 6% 5% 34%
44% 40%
27% 22% 18% 20%
8% 12% 10% 10% 12%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Overall Satisfaction* by Month
72% 73% 73%
10% 10% 10%
4% 4% 4% 3% 3% 3%
10% 10% 10%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
CSR Satisfaction1 CSR Friendliness2 CSR Knowledge3
Customer Satisfaction Score –
December 2015
17
2016 Open Enrollment: Year-Over-
Year Comparison (first 60 days)
247
162
0
50
100
150
200
250
2014 2015
Calls Offered (Thousands)
903
771
0
200
400
600
800
1,000
2014 2015
Average Handle Time (AHT) (Seconds)
34% Fewer Calls Received Year-over-
Year
61
1 0
10
20
30
40
50
60
70
2014 2015
Abandoned Calls (Thousands)
653
19
0
100
200
300
400
500
600
700
2014 2015
ASA (Seconds)
18
Abandonment Rate Reduced Year-over-Year
2014: 25% II 2015: 0.4%
AHT 132 Seconds Reduced Year-over-
Year
ASA 634 Seconds Reduced Year-over-
Year
Customer Feedback:
We are listening…
[The representative] had knowledge of all questions that I asked and she was able to answer them in a
professional manner…
Hi, I just want to say that the customer service representative that helped me was very kind. She let me know
why she was putting me on hold, how long she was putting me on hold [for] and it was very accurate. She did
come back to me and filled in the knowledge that I needed. She called [my carrier] and fixed the issue.
Brenda was extremely helpful and courteous. [She explained] the whole process to me and I really
appreciate it.
My call was answered in a very timely fashion and the representative was polite and answered my questions
immediately.
…The service representative today was very good…but I have been calling since the beginning of
November…my issue has not been resolved. I keep being told you will get a call back in a couple of days and
[that my problem] is resolved but it doesn’t get resolved.
I am having a very, very difficult time getting through on the Health Connector and getting a solution to my
problem. My problem is simply that I cannot log into the website. This is my fifth or sixth call and its just
mindboggling that this is so difficult just to reset my password. 19
Open Enrollment 2016
Final Weeks of Open Enrollment
New members have until January 31st to choose, pay
for and enroll in a QHP for 2016 coverage
21
We are sending an “Open Enrollment is ending” and payment reminder e-mail,
letting individuals know that they have until January 23 to pay for coverage
effective February 1, and until January 31 to enroll in 2016 coverage
We are preparing a press release for statewide distribution, reminding the public of
the final deadline to get coverage during Open Enrollment
And we will be supporting remaining Navigator enrollment events, including this
Saturday’s Health Care For All event in Framingham
Choose a plan and pay
Enrollment Bill by:
To be enrolled in a new
plan starting:
January 23 February 1
January 31 (select by date,
pay by February 23) March 1
Related Documents
