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Home Fairfield

In Connecticut, shopping for insurance with options

Patrick Gallagher by Patrick Gallagher
May 25, 2013
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A New York City nonprofit that runs a private health insurance exchange for about 3,500 organizations and their nearly 30,000 employees has been selected to manage Connecticut”™s small business health insurance marketplace.

HealthPass and its technology partner bswift Inc., of Chicago, will manage Connecticut”™s Small Business Health Options Program (SHOP), a feature mandated by the Patient Protection and Affordable Care Act.

With HealthPass at the reins, Connecticut is one of only a few states whose SHOP exchange, true to its name, will provide employers and their employees with multiple health insurance options from which to choose.

Bowing to the administrative burdens of health care reform, the U.S. Department of Health and Human Services ”” which will operate health insurance exchanges for 33 states ”” recently said it would delay by one year a requirement that multiple insurance products be available through the SHOP exchanges by 2014.

In recent testimony before the U.S. Senate Health, Education, Labor and Pension committee, the CEO of Connecticut”™s health insurance exchange noted that “the hallmark of health reform has been the concept of shared responsibility.”

But, Kevin Counihan added, “Increasingly, shared responsibility must be accompanied by shared patience.”

“We must have the patience to recognize the implementation of the (Affordable Care Act) will take time to be fully realized, that premium rate adjustments will stabilize, that enrollment and health plan choices will be enhanced, and that outreach and communication activities will continue to be more effective,” Counihan said April 11, according to prepared testimony.

Counihan, CEO of Access Health CT, said HealthPass was chosen to run Connecticut”™s SHOP exchange largely because of its experience in navigating the complexities of insurance exchanges with multiple products.

“Having a firm that is experienced at this, has a good service reputation, works effectively with the participating health plans, is supported by a good technology platform ”” all those things are extremely valued,” Counihan told the Business Journal. “That”™s one of the reasons that we”™re outsourcing this as opposed to building it on our own.”

HealthPass will manage Connecticut”™s SHOP exchange under a 36-month agreement that began April 12. The exchange will launch enrollment in October with coverage taking effect Jan. 1, 2014.

Under the Affordable Care Act, businesses with up to 100 employees will be able to buy insurance through the SHOP exchanges, while states have the ability in 2014 and 2015 to restrict participation to businesses with 50 or fewer employees.

Counihan has pledged that multiple products will be marketed through the state”™s SHOP exchange, but said the actual plans that choose to participate likely won”™t be known until May or June.

Philip Vogel, senior vice president of CBIA Service Corp., said that any time a new system is being built and implemented, “there”™s always a learning curve.”

CBIA Service is a division of the Connecticut Business & Industry Association, which launched one of the nation”™s first private health insurance exchanges in 1995.

CBIA Health Connections, which offers health insurance products to companies with up to 100 employees, can now provide coverage to “thousands of small businesses and tens of thousands of employees,” Vogel said.

But Vogel, who has been with CBIA since its insurance exchange was formed, said there were growing pains and predicted the state would experience similar challenges in its efforts to build a SHOP exchange.

“We feel we are a resource for those small businesses in a time where there”™s heavy competition and they need to focus on their core businesses,” Vogel said. “That”™s what we”™ve built over a 20-year timeframe and it”™s taken a lot of years to build the system.”

Chris Bruhl, president and CEO of the Business Council of Fairfield County, echoed Counihan”™s call for patience, saying, “This is the beginning of the journey.”

“Whether or not the total affordability curve is bent in the right direction over the next three to five years is very hard to predict,” Bruhl said. “I think everyone is hoping for that, but we”™re not able to guess at that.”

Bruhl described the exchange as “a complex venture with multiple moving parts.”

“For those among our members, either companies who provide benefits to their employees or providers of the insurance or health providers themselves, I think the elements of the Affordable Care Act are largely understood … but they”™ll also say that making this much change in a complex system is going to introduce some unexpected outcomes.”

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