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You are here: Home / Anderson On Health Insurance / Early roll-outs for 2015 open enrollment

Early roll-outs for 2015 open enrollment

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Just a couple of technical notes that are making me more confident about the roll-out of the Exchanges for the 2015 Open Enrollment period.

Maryland is going to a window-shopping model:

　The second year of Maryland’s health insurance marketplace for individuals and families begins on Nov. 9 when consumers will have access to a newly redesigned website that enables “anonymous browsing,” the ability to compare plans — without registering personal information — before enrolling. This feature is being launched earlier than originally planned to enhance the shopping experience for Marylanders

SHOP is being beta tested in Missouri and Illinois before national launch:

Missouri and Illinois will be two of five states to get an early look at the federal health insurance marketplace for small businesses, theCenters for Medicare and Medicaid Services announced Wednesday.

Businesses with fewer than 50 full-time workers in the five states will be able to access the Small Business Health Options Program, or SHOP, in late October, ahead of the start of open enrollment on Nov. 15.

Vermont’s Exchange website is down for maitenance right now:

VermontHealthConnect.gov is unavailable for a period of extended maintenance. If you have immediate needs, please contact our Customer Support Center at 855-899-9600 (toll-free) from 8am to 8pm Monday-Friday and 8am to 1pm on Saturday.

The soft launch of SHOP is a typical launch process for big releases.  A select set of users are allowed to use production processes and figure out what they can blow up.  Programmers and analysts then have time from the limited release to fix show-stopping bugs before most of the user base can access the system.  Vermont is using cyclical and predictable down time to get their back-end straightened up and formalized systems put into place instead of quasi-effective short term kludges that will destroy the code if not replaced while Maryland is adapting a best practice for load management. 

Will November 15th be perfect?  Hell no, but we know most of the state exchanges and healthcare.gov work well enough at the basic functionality (let’s not talk about 820s right now), so seeing these types of stories in the past month that we’ve transitioned from crisis to normal operating procedures.

Reader Interactions

9Comments

  1. 1.

    Ruckus

    Richard
    Do you know when the rollout for CA under 50 employers might be? My boss is interested. He has 6-8 employees and would like to provide health insurance but so far hasn’t seen which way might be the best to go.

  4. 4.

    Xantar

    I work for the Maryland Health Department, and overall the rollout of the new Exchange this year is doing most of the things they should have done last year. They still don’t do outreach the way I think they should, but we count our blessings.

    I think it’s also worth noting from Richard’s link that Maryland is doing a soft rollout of the new system. On November 15 itself there will be some sign-up events for people to test out the system under real world conditions. Then case workers and Navigators will slowly be given access over the next few days until November 19 when access is granted to the general public to sign up themselves. This way, the Maryland Health Connection will be able to monitor for bugs and fix them before they get out of hand.

    The biggest problem for us is implementing the “no wrong door” policy for health sign-ups. It means the county Departments of Health, Departments of Social Service, the state call center, and the Navigators all have to be on the same page and give consistent answers to customers. Given the normal tendency of government types to engage in turf-protecting, that’s going to be a tall order.

  5. 5.

    mai naem mobile

    I know somebody who works for the subcontractor of the mktplce enrollment people. This actually made me feel good about it. He said they’re extremely strict about the consumers’ info. For example, if you are going from different screens and you decide to write down some info on a post-it so that you don’t have to go out of a window, you can get terminated. Cell phones are an absolute nono because they don’t want people sending info. And don’t even think about looking up people you know.Thats automatic termination.

  7. 7.

    Violet

    Hi, Richard, Saw this article in the NYT yesterday about “added doctors” during surgery. Seems they often aren’t in-network, the patient doesn’t even know about them and the bill for them can be huge:

    Before his three-hour neck surgery for herniated disks in December, Peter Drier, 37, signed a pile of consent forms. A bank technology manager who had researched his insurance coverage, Mr. Drier was prepared when the bills started arriving: $56,000 from Lenox Hill Hospital in Manhattan, $4,300 from the anesthesiologist and even $133,000 from his orthopedist, who he knew would accept a fraction of that fee.

    He was blindsided, though, by a bill of about $117,000 from an “assistant surgeon,” a Queens-based neurosurgeon whom Mr. Drier did not recall meeting.

    Seems to be a way to do an end run around insurance companies:

    The practice increases revenue for physicians and other health care workers at a time when insurers are cutting down reimbursement for many services. The surprise charges can be especially significant because, as in Mr. Drier’s case, they may involve out-of-network providers who bill 20 to 40 times the usual local rates and often collect the full amount, or a substantial portion.

    “The notion is you can make end runs around price controls by increasing the number of things you do and bill for,” said Dr. Darshak Sanghavi, a health policy expert at the Brookings Institution until recently. This contributes to the nation’s $2.8 trillion in annual health costs.

    Are you hearing anything about this? The article indicates some insurance companies are paying and some aren’t. New York is looking to pass a law prohibiting this kind of thing. It’s not limited to surgeons, as the article gives an example of the person who helps a hip replacement patient walk for the first time after surgery–turns out they might be a physical therapist and bill at a very high rate.

    It’s so impossible as a consumer to navigate all the ins and outs of the medical system. Especially in a crisis situation you can’t ask “are you in network?” and “Is there anyone else involved I don’t know about and if they’re not in-network, tell them to go away.” It’s just not possible.

  8. 8.

    VFX Lurker

    @Violet:

    Especially in a crisis situation you can’t ask “are you in network?” and “Is there anyone else involved I don’t know about and if they’re not in-network, tell them to go away.” It’s just not possible.

    I’m on employer-provided health insurance right now. If I get a choice of insurers in the future, I’ll pick Kaiser Permanente for this reason. As far as I know, there’s no risk of being out-of-network if I get services done at a Kaiser facility while covered under Kaiser insurance.

  9. 9.

    BlueNC

    @MomSense: Depends on your definition of “generous”. The tax credit is available only if your average employee salary is less than $50,000.

    http://www.irs.gov/uac/Small-Business-Health-Care-Tax-Credit-for-Small-Employers

    A small business with an owner salary of $100K and two employees at $25K would not be eligible. The only scenario where it really works is either a) a business with lots of low-income employees to balance out the (presumably) highly compensated owner, or a business that is struggling (and therefore not paying the owner much).

    I have a small business with less than a dozen employees, and while a few people would be eligible for subsidies on the individual market, we get no help whatsoever in the group market.

    THAT SAID, the situation is vastly better now than it was before the ACA because:

    * We can shop for plans with some confidence that they won’t have huge loopholes.
    * We are not rated based on our (tiny) group, but using community rating.

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