Lessons Learned from Initial Open Enrollment Applied to Major Changes for Upcoming Open Enrollment Nov. 15 to Feb. 15
SACRAMENTO, Calif. — Covered California announced it has begun the renewal process for 1.12 million individuals who enrolled in plans in the exchange last year and unveiled substantial new improvements to facilitate enrollment in coverage for 2015.
“Last year, we succeeded in signing up millions of Californians in health coverage through Covered California and Medi-Cal,” Covered California Executive Director Peter V. Lee said. “We learned a great deal in the process, and in this second open enrollment we are building on those lessons using effective and concrete changes.”
The first wave of renewal notices was sent to consumers on Wednesday. Consumers who complete the renewal process will hear from their insurance plans in December. Their selected health plan will send a statement reflecting coverage starting Jan. 1, 2015. Consumers who take no action will be renewed into their existing plan.
Individuals who have health coverage through Medi-Cal renew their coverage throughout the year, on a rolling monthly schedule. Medi-Cal will contact them directly if they need to take action. Unless they are contacted by Medi-Cal, these individuals do not need to go to the Covered California website to renew or apply.
Covered California also provided updated enrollment numbers for 2014 on Thursday. Of the Californians who selected a plan during the initial open enrollment, 1,140,000 (or 81 percent) had their coverage take effect by paying their first month’s premium. Today, a total of 1.12 million individuals have effectuated coverage and will be part of the renewal process. Covered California expects this number to increase as special enrollment continues and as recent enrollees effectuate their coverage, with about 1.3 million Californians participating in the renewal process through the end of the year.
For more information about the enrollment numbers, see the October 2014 “Individual Market Enrollment Report” online at http://news.CoveredCA.com/p/covered-california-individual-market.html.
“This is our very first experience with renewal, and we will learn things during this process just as we learned a great deal about open enrollment during 2013-2014. We do believe many significant improvements have been made that will assist our consumers during both renewal and open enrollment this year,” Lee said.
In the meantime, Covered California continues to gear up for open enrollment, which will begin Nov. 15 and continue through Feb. 15. Open enrollment is the next opportunity for all Californians to benefit from new insurance rules, including the requirement that insurance be offered regardless of health status. In addition, this is the window of time when Californians can buy subsidized coverage starting in 2015.
Covered California has adopted changes, guided by a newly released report titled “Covered California Open Enrollment 2013-2014: Lessons Learned,” to improve consumers’ experience. The report commissioned by Covered California offers an in-depth look at Covered California’s work during the first open-enrollment period. It is available online at www.CoveredCA.com/resources/PDFs/10-14-2014-Lessons-Learned-final.pdf.
“We know this open-enrollment period will be more challenging in some ways. Consumers will only have three months to enroll, compared with the six months they had last time. This is complicated by our knowledge that many who are uninsured have adapted to a culture of coping and have become accustomed to living without health insurance,” Lee said.
With less than one month before open enrollment begins, consumers can begin the process of shopping for 2015 coverage. They can find out if they are eligible for financial assistance and find out how much a health plan will cost them, by using Covered California’s Shop and Compare Tool (on CoveredCA.com atwww.CoveredCA.com/shopandcompare/#calculator). Covered California also offers a full listing of the plans and their rates in the booklet “Health Insurance Companies and Plan Rates for 2015” (online at www.CoveredCA.com/PDFs/CC-health-plans-booklet-2015.pdf)
Following are the top lessons learned and the ways that Covered California is improving its work for the coming open-enrollment period.
The volume of consumer interest and interactions exceeded expectations and challenged all systems and service channels. As a result:
- Covered California will start open enrollment with more than double the number of Service Center representatives — state employed and contractors — to dramatically reduce wait times and help consumers enroll. More than 1,300 representatives will help consumers over the phone, by chat or by processing their paper applications or documents. The majority of these representatives are state employees working in Rancho Cordova and Fresno, but two private vendors — Faneuil and Maximus — will operate call centers to boost capacity during this period. Last year, Covered California began open enrollment with 381 Service Center representatives and ended with 709.
- While the vast majority of consumers are served in their own languages by Covered California staff, the capacity of the Service Center will be expanded more in order to serve callers in Spanish, Chinese and other languages without the use of interpreters. This year Covered California will have 254 Service Center representatives able to serve consumers in languages other than English, compared with 55 during open enrollment in 2013.
- Service Center hours — including phone service and online chat — have been expanded to accommodate consumers after hours, with representatives now available from 8 a.m. to 8 p.m. Monday through Friday and from 8 a.m. to 6 p.m. Saturday. In addition, the Service Center will be open on many Sundays during open enrollment, including every Sunday from Nov. 16 through Dec. 15.
- Covered California is working with health plans to make it possible for consumers to make their first premium payment online as soon as they have selected a plan. This will give consumers peace of mind that they have evidence that their payment has been received and that they will have coverage in place.
- To meet high consumer demand, Covered California spent $22.6 million to upgrade the enrollment portal infrastructure to allow for greater user capacity and speedier page loads so that consumers do not have to return later to complete an application.
- For self-service, Covered California is redesigning its interactive voice response (IVR) system to handle more consumer calls while decreasing wait times and updating consumers on wait times when they are placed on hold.
- Covered California is continuing to make significant improvements so that notices consumers receive are clearer, explanations on the website are better — in both English and Spanish — and the consumer experience is more seamless.
Many consumers are new to insurance and need extensive education about health insurance terminology, how to enroll in coverage and how to use insurance. As a result:
- Advertising this year features real Californians speaking to the ways that coverage has benefited them as a result of the Affordable Care Act, including testimonials from people who were able to get vital care as a result of their coverage. The volume of advertising will taper down in the coming two weeks and then ramp up significantly before open enrollment starts on Nov. 15.
- Realizing that Certified Enrollment Counselors and Certified Insurance Agents are some of the agency’s strongest connections to consumers, Covered California is giving these valued partners enhanced and expanded tools to educate enrollees, including biweekly webinars, training from subject matter experts, a bimonthly newsletter to highlight best practices and modifications to the enrollment process, and an updated glossary of terminology.
- This year, Covered California will expand dedicated call lines to help Certified Insurance Agents and Certified Enrollment Counselors help consumers during the application process.
Most consumers relied on a variety of touch points, including in-person assistance, to successfully complete enrollment. As a result:
- Covered California’s partners will open more than 200 storefronts in retail locations, such as malls, to help serve consumers on a drop-in basis that meets their scheduling needs. Consumers can get help at these sites to enroll, renew and learn more about health coverage options.
- Covered California will begin the open-enrollment period with more than 12,000 Certified Insurance Agents, 10,000 county eligibility workers, and 6,400 Certified Enrollment Counselors to help educate and enroll consumers. To get free, confidential, in-person assistance, consumers should visit CoveredCA.com and click “Find Help Near You.”
- Enrollment of African-Americans, Latinos and Asian-Americans will be emphasized and broadened through targeted advertising in relevant media outlets, through Navigator grants supporting in-person enrollment guidance from expert communicators specializing in outreach to underserviced communities, and through engagement of African-American churches to host community-wide enrollment events.
“We are extremely excited about the changes we have put in place, and we look forward to building on the enthusiasm around open enrollment this year as we did last year,” Lee said, noting that more than 70 events are scheduled in the Los Angeles area alone between now and Nov. 15. “The Affordable Care Act is working, and it is changing the lives of people for the better.
“At the same time, we know we have more work to do. We want Covered California to deliver best-in-class customer service, and we know we’re not there yet,” Lee said. “But we’re getting better every week, and we will continue to learn and improve.”
Covered California offers a range of choices of private health insurance plans. Consumers can choose the health plan and level of coverage (Bronze, Silver, Gold or Platinum) that best meets their health needs and budget.
About Covered California
Covered California is the state’s marketplace for the federal Patient Protection and Affordable Care Act. Covered California, in partnership with the California Department of Health Care Services, was charged with creating a new health insurance marketplace in which individuals and small businesses can get access to affordable health insurance plans. Covered California helps individuals determine whether they are eligible for premium assistance that is available on a sliding-scale basis to reduce insurance costs or whether they are eligible for low-cost or no-cost Medi-Cal. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget. Small businesses can purchase competitively priced health insurance plans and offer their employees the ability to choose from an array of plans and may qualify for federal tax credits.
Covered California is an independent part of the state government whose job is to make the new market work for California’s consumers. It is overseen by a five-member board appointed by the governor and the Legislature. For more information about Covered California, please visit www.CoveredCA.com.
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