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Covered California October Board Meeting

Last week Covered California’s Board reviewed the progress made in the first few weeks of open enrollment, along with the issues that remain. Below is a summary of topics discussed at the October 24 meeting.

Progress since launch (as of Oct. 19)

  • 125,929 applications started
  • 2.2 million unique visitors to CoveredCA.com
  • More than 156,779 calls to the call centers
    • Average wait time of 4:32, with much shorter wait times between Oct. 13-19
    • More than 18,000 calls were quick sorted to the counties
    • 87% of calls have been in English
  • Website “glitches” are in various stages of correction.
    • Provider search had significant issues and limited availability, but is now online for doctors
    • System successfully connects to the Federal Hub
    • Website/CalHEERS has been up and running 90% of the time. It is taken down for maintenance during off hours periodically

Improvements to come

  • SHOP plan selection and employer/employee sign-up will be available mid-November
  • CalHEERS integration with SAWS for Medi-Cal expected January 1
  • These and other improvements to the website will likely cause downtimes of 2-3 days, which may not be announced in advance
  • Hiring for call centers continues to support the incoming demand
  • The Fresno call center is scheduled to open November 18
  • Covered California will request a supplement to the establishment grant from the Department of Health and Human Services by November 15 to fund
    • Information technology
    • Marketing and Sales
    • Business Services
    • Appeals
    • Clinical Analytics
    • Consumer Protection

Outreach and enrollment efforts

  • There is significant backlog of agents, certified enrollment counselors (CECs), and plan-based enrollers who have registered but not completed the training and certification process. County eligibility workers have been fully certified.

Screenshot 2013-10-31 14.59.36

  • Covered CA aims to simplify the enrollment entity and CEC application process through efforts like providing fingerprinting at the trainings
  • Agents, even non-CECs, can receive $58 for successful Medi-Cal enrollment
  • There have been 1,500 outreach events since July, reaching 650,000 consumers & small businesses
    • 50% of outreach contacts became leads (33,391)
  • 120 organizations are community partners (not grantees), with an additional 137 organizations in process of becoming partners
  • Navigator program guidelines to be developed and announced within next month
  • Advertising efforts launched statewide October 1, using traditional, digital, and social broad reach media. In November, local targeted outdoor media and direct mail will launch
  • “Welcome to answers” handouts being developed, aimed at specific audiences like young invincibles
  • Consumer market study conducted by NORC at the University of Chicago
    • Few people know about Covered CA
    • Many know about coverage of people with pre-existing conditions
    • When given information, most are receptive/interested in Covered CA

Quality Rating System

  • Limited HEDIS (effectiveness and quality) and CAHPS (consumer assessments) data available
    • Only 4 out of 12 insurance companies had highly similar networks (80%+ similarity)
    • Generally these companies are in limited geographic areas (e.g. Los Angeles has only 1 plan with full data – most regions have 1, max 2)
    • Extensive debate about if information should be released for only the four plans, if just CAHPS data should be released for more plans, or if QRS should be delayed until complete and accurate data is available
    • Staff recommended that both HEDIS and CAHPS data is necessary to fully inform consumers. This information would not be available until open enrollment 2015, thus QRS would be delayed until then
    • The board voted to have the staff examine if CAHPS data alone could be provided in 2014. Stay tuned

SHOP applications available

Topics discussed for future action

  • SHOP appeals regulations
  • Consumer protections
  • Identify proofing policy

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