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November 16, 2014 11:00 PM

Health insurers exhale after smooth start to open enrollment

Bob Herman
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    A flood of calls and applications in the first days of Obamacare's second open-enrollment period didn't crash the enrollment websites like last year, but it will take a few days to check the accuracy of the information insurers are getting from the exchanges.

    Still, the relatively glitch-free beginning was a relief to the agencies, companies, and not-for-profit organizations working to sign up more people for health insurance and renew existing customers' plans.

    “It's really exciting, you can almost smell it in the air,” said Shawn Dorgan, an executive at Land of Lincoln Health, a not-for-profit co-op plan funded with money from the Patient Protection and Affordable Care Act.

    Land of Lincoln has enrolled “several hundred people” since open enrollment began this past Saturday, and the plan is already receiving payments from consumers, said Dorgan, who is in charge of finding and renewing members. About 6,000 people visited Land of Lincoln's website over the weekend with no apparent technology issues—an auspicious start for a plan that hopes to have 50,000 covered lives for 2015.

    HHS Secretary Sylvia Mathews Burwell said that as of Monday morning more than 1 million people had visited HealthCare.gov, which is managing the exchanges for 34 states and supporting three other state-based exchanges. The government's health insurance call center fielded more than 200,000 phone calls over the weekend.

    Several media reports have described minor hiccups along the way, such as people having trouble setting up accounts and remembering passwords. But many health insurers interviewed for this story said the enrollment period was positive so far, a stark contrast from a year ago. At this time last year, HHS and CMS were doing damage control after HealthCare.gov crashed multiple times and left many consumers and payers frustrated. President Barack Obama said earlier this month, though, that his staff was “double- and triple-checking” the tech infrastructure for this round.

    Some in the industry said the government's window-shopping feature on HealthCare.gov, which allowed people to view plans and prices the week before open enrollment actually began, helped immensely.

    “The first 48 hours went very smoothly,” said Lisa Rubino, a senior vice president at Molina Healthcare who oversees the company's exchange business. Molina offers ACA plans in nine states, covering almost 17,000 exchange enrollees. “We didn't see many of the glitches we saw last year,” she said. “I think all of the work CMS did in terms of testing really paid off.”

    Insurers in state-based marketplaces had similar observations. In Massachusetts, for example, payers helped about 3,600 individuals and families select health plans in the first two days. That total is about 11% of all people who enrolled on the Massachusetts exchange last year. Nearly 2,200 people enrolled in an ACA-compliant health plan, dental plan or Medicaid plan on Kynect, Kentucky's insurance exchange, over the weekend. MNsure, Minnesota's exchange, said 500 people got health insurance over the weekend with minimal technology problems.

    “At a high level, the consumer experience on both the federal exchange and MNsure are much better than last year with just a few minor glitches online and much shorter wait times on the phone,” said Dannette Coleman, a senior vice president at Medica, a health plan that sells individual policies in Minnesota, North Dakota and Wisconsin.

    However, Coleman cautioned that it is still too soon to know whether there are any accuracy issues with the electronic enrollment data files. She said they expect to find out more over the next few days.

    The focus now for insurers is continued advertising and marketing to new and current consumers, many of whom had no idea open enrollment began Saturday and runs through Feb. 15.

    “Our biggest challenge is making sure people shop,” Dorgan said. “Everybody has to get out there and shop, whether you have insurance or not.”

    Large companies like Cigna Corp. and Health Net have been actively promoting sign-up tips on Twitter. In Minnesota, exchange officials designated this week as Financial Help Week to boost education around the ACA's premium and cost-sharing subsidies. People with incomes between 100% and 400% of the federal poverty level are eligible for federal premium subsidies in the form of tax credits. Cost-sharing subsidies, which go toward deductibles and coinsurance, are available for those earning between 100% and 250% of poverty.

    “Most Minnesotans qualify for some form of financial assistance, and we want to make sure every Minnesotan that qualifies is taking advantage of this help,” MNsure CEO Scott Leitz said in a statement.

    Dec. 15 is a big deadline for insurers. They must sign up people by then for coverage to take effect Jan. 1. But Molina Healthcare's Rubino said she expects the biggest rush will come after the holidays, when people will turn their attention away from another kind of shopping.

    Follow Bob Herman on Twitter: @MHbherman

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