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Connecticut health insurance exchange / marketplace

CT: 204K newly enrolled; SEP in April

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More than 204,000 Connecticut residents newly enrolled in health coverage during the 2015 open enrollment period. Between Nov. 15 and Feb. 15, 41,864 people enrolled in qualified health plans (QHPs) and 162,494 individuals enrolled in Medicaid through the state-run marketplace.

Access Health CT greatly exceeded its goal of enrolling an additional 70,000 people in health coverage for 2015. According to a CT Mirror article, Access Health CT enrolled 256,666 residents in health coverage in 2014. Of that number, about 139,000 were previously uninsured, and about 80 percent enrolled in Medicaid.

The 2015 enrollment total will continue to grow as Access Health CT announced a special enrollment period (SEP) for individuals who are just learning of the tax penalty for people who do not have health insurance. The requirement for insurance went into effect in 2014, but many people were unaware of the penalty until they filled out their 2014 tax forms. The penalty-related SEP will run from April 1 through April 30.

SEPs are also available to individuals who experience a qualifying life event, such as getting married or losing a job. Individuals not eligible for a SEP must wait for the next open enrollment period, which begins in November 2015.

If you qualify for Medicaid (HUSKY), you can enroll anytime throughout the year.

2015 health plans and premiums

Four health insurers are offering individual and family plans through Access Health CT for 2015. Anthem, Connecticare and HealthyCT are returning from 2014, and UnitedHealthCare joined the exchange for 2015.

Regulators in Connecticut pushed back on the 2015 rates proposed by insurers. Connecticare and Anthem both requested increases of more than 10, which regulators reduced to 3.1 percent or less. HealthyCT received approval to reduce its rates an average of 8.5 percent.

According to the Commonwealth Fund, 2015 rates on Access Health CT decreased 1 percent on average for individual coverage and 2 percent on average for family coverage.

Penalties going up for those not insured

The penalty for not having health insurance will increase for 2015. The fee is the greater of 1) two percent of yearly household income or 2) up to $975 for families ($325 per adult and $162.50 per child under 18). The fee will be assessed when you file your 2015 taxes in 2016.

Learn more about the penalty and who is excluded.

History of Connecticut’s exchange

Connecticut was one of the early adopters in implementing a health insurance marketplace. Gov. Malloy signed legislation in 2011 to create the Connecticut Health Insurance Exchange, which was rebranded as Access Health CT in February 2013. The U.S. Department of Health and Human Services (HHS) approved Connecticut’s blueprint for a state-run exchange in December 2012.

Access Health CT describes itself as an active purchaser, but did not negotiate 2014 rates with health plans. Prompted by concerns over high premiums, Connecticut legislators revisited the issue during the 2014 session. SB-11 would have allowed Access Health CT to negotiate with insurers for plans sold in 2016. However, the bill did not pass. Connecticut’s Fairfield County made the Kaiser Family Foundation list of the top 10 most expensive health insurance markets in 2014.

Access Health CT has been one of the nation’s most successful marketplaces. Signs of that success include:

  1. Connecticut’s uninsured rate dropped by 50 percent: from 7.9 percent in 2012 to 4 percent in 2014.
  2. Connecticut launched a consulting business through which other states can license Access Health CT’s technology or pay Access Health CT to manage various marketplace functions. According to an article in the CT Mirror, nine states have expressed interest.
  3. Access Health CT’s former CEO, Kevin Counihan, was tapped to take over as the CEO of the federal exchange, HealthCare.gov. Jim Wadleigh took over the CEO role. Wadleigh previously served as the exchange’s chief information officer.

Connecticut health insurance exchange links

Access Health CT
860-757-5300

State Exchange Profile: Connecticut
The Henry J. Kaiser Family Foundation overview of Connecticut’s progress toward creating a state health insurance exchange.

Connecticut Health Reform Central
Information about exchange planning and development