Connecticut Health Insurance Exchange

As of Feb. 18, 2014, 59,485 completed applications and 126,653 individuals enrolled.

An exchange is, in its simplest form, a portal where a consumer can find information about, compare and contrast health plans. It would offer consumers information on coverages, premiums, deductibles and position them to purchase health coverage.

Most plans have envisioned them as a web-based system. Exchanges are an integral part of the federal health-care reform measures signed into law through the Patient Protection and Affordable Care Act. All states are mandated to have an exchange in place by Oct. 1, 2013. If a state fails to do so, the federal Department of Health and Human Services is directed to step in and provide exchange services in the state.

Exchanges are not a brand-new idea, and are not being created solely at the behest of the new health-care law, and are not associated with any particular political ideology. Indeed, both Massachusetts and Utah created state health exchanges prior to the PPACA in 2006 and 2007, respectively.

The PPACA does not direct states to form exchanges in any specific manner. They may be stand-alone state agencies, divisions of an existing state agency, such as a Department of Health or Department of Insurance. They also may be formed as an independent quasi-public entity.

Connecticut has chosen to do a state-based exchange—Access Health CT—which is a quasi-governmental marketplace for health plans, as part of the federal health-care reform. Open enrollment is scheduled to start in October 2013.

Officials of the exchange have stated that insurance brokers and agents will be able to collect commissions for bringing individual clients to the exchange once it gets up and running this fall. The directors of Access Health CT also are moving ahead with plans to launch the state's Small Business Health Options Program marketplace in October, despite the federal government's proposed delay of the program's full rollout until 2015. Access Health CT announced that it has selected New York-based HealthPass and Chicago-based Bswift Inc. to provide technology and administrative support for the state's exchange.  

Access Health CT is awaiting insurers to file proposed rates on health plans they intend to sell on the state’s public exchange. The firm deadline comes at the end of July, when the exchange must report to federal health officials all of the health plans that will be available to customers starting Oct. 1, 2013. Healthy CT was the first to file proposed rates for health plans that will be sold through the public exchange. On Aug. 5, 2013, Aetna informed state officials that it would pull out of Connecticut's health insurance exchange.

PIACT exclusive health exchange briefing with key exchange staff

PIACT hosted a complimentary, exclusive briefing on these issues and more on Wednesday, Oct. 2, 2013, at the Crowne Plaza in Southbury. Phil Boyle, the business-to-business outreach manager for the exchange, shared the latest news and inside scoop on the exchange’s operations and its interaction with the state’s health insurance producer community. To access the PowerPoint presentation: click here.​​​​​​​

QuickSource documents

QS90746—Q&A on health-care exchanges

Ask PIAs

900354-00—Exchanges—broker compensation
900358-00—Producer health exchange certification

Common forms

EBSA’s government-approved model notice (for those with a health plan)
EBSA’s government-approved model notice (for those without a health plan )
CMS forms list

Agent/broker certification

Connecticut certification information
PIACT health update—I'm now certified, what's next?
Agent and broker training outline and summary

Additional resources

Exchange

Access Health Connecticut; Spanish Access Health Connecticut website
Access Health Connecticut Healthy Chat upcoming sessions
CMS health insurance marketplace guidance
CCIIO in-person assistance in the health insurance marketplace
Fact Sheet: Helping consumers apply and enroll through the marketplace
CMS-9955-F: Patient Protection and Affordable Care Act; exchange functions: standards for navigators and non-navigator assistance personnel; consumer assistance tools and programs of an exchange and certified application counselors
HHS, SBA and IRC joint website on health-care changes for employers
Frequently asked questions about private exchanges
NAIC consumer alert: Insured, but no proof: what to do if you haven't received your proof of insurance coverage
NAIC consumer alert: State health exchanges: what you need to know to (re)enroll

Role of agents/brokers

Role of agents, brokers and web-brokers in health insurance marketplaces
Resources for agents and brokers in the health insurance marketplace
Financial and health information accuracy disclaimer
AccessHealth CT compliance and disciplinary policy for certified indepedent brokers

Employee notices

PIA health update—Employer ntoices required before Oct. 1

Department bulletins/news

CID and Access Health CT extend deadline for carrier determinations
Bulletin HC-91: Rating factors established by Connecticut for individual and small employer group health insurance policies subject to the Affordable Care Act
CID Bulletin IC-35: The Affordable Care Act and the Connecticut Health Insurance Exchange
CID press release: The road to health-care reform: don't be fooled by misleading advertising
CID press release: Insurance Department—on the road to health-care reform: low premium/high deductible plans for young adults
CID health insurance rate filings
CID press release: On the road to health-care reform: policies sold through exchange subject to state laws
CID press release: On the road to health-care reform: subsidies can help lower costs
CID press release: On the road to health-care reform: don't fall into the coverage gap
CID press release: Statement from Insurance Commissioner Katharine L. Wade on health insurance rate filings for 2019

FAQs

CMS FAQ: Centers for Medicare & Medicaid Services Program integrity proposed rule
CMS FAQ: Enrollment and transaction
CID FAQs on rate filing, rate reviews and approval of health insurance rates in Connecticut
Frequently asked questions regarding Medicare and the Marketplace—Aug. 1, 2014

Navigators

Navigators training final rule
Fact sheet: navigator funding opportunity announcement
Funding opportunity: navigator grants
Overview of applying for the cooperative agreement to support navigators in federally facilitated and state partnership marketplaces
Navigators and in-person assistors: state policy and program design considerations
State laws governing navigators may be at risk
New federal regulations lower standards for health insurance navigators, puts consumers at risk

Statute/regulation

State decisions on health insurance exchanges and the Medicaid expansion, 2014
Exchange final rule

SHOP

SHOP final rule
Overview of FF-SHOP issuer testing—July 8, 2014
FF-SHOP updates and live Q&A
FF-SHOP updates and live Q&A—Oct. 23, 2014
FF-SHOP updates and live Q&A—Nov. 6, 2014
FF-SHOP updates and live Q&A—Nov. 13, 2014
FF-SHOP updates and live Q&A—Jan. 27, 2015
FF-SHOP updates and live—Q&A Feb. 3, 2015
FF-SHOP updates and live Q&A— March 10, 2015
FF-SHOP updates and live Q&A—Oct. 13, 2015
FF-SHOP new issuer updates and live Q&A—Oct. 22, 2015
FF-SHOP updates and live Q&A—Nov. 3, 2015
FF-SHOP updates and live Q&A—Nov. 17, 2015
FF-SHOP updates and live Q&A—Nov. 10, 2015
New issuer webinar series: FF-SHOP new issuer open Q&A—Feb. 26, 2015

Miscellaneous

HealthCare.gov
Health insurance marketplace, July 9, 2013, program
IRS completes health penalty rules for noncompliance
NAIC consumer alert: Understanding the exchange