Health Insurance Limbo: The Latest On Mass. ‘Connector’ Sign-Up

Screenshot of Mass. Health Connector website

Screenshot of Mass. Health Connector website

More than 44,000 Massachusetts residents (as of Dec. 24) who have applied for coverage through the Massachusetts Health Connector are in limbo. The vast majority have applied for subsidized insurance and are waiting to find out:

• If they qualify for free or subsidized coverage
• If they are eligible for a subsidized plan, what are their options?
• If they don’t qualify for government help, do they have to start all over again?

Many people submitted applications months ago. The Connector, the Massachusetts health insurance exchange, has had a lot of problems with its website – to the point that the state is reviewing its legal options against the contractor. Here, we address some of the most common questions from Massachusetts residents who’ve applied for insurance assistance. Connector spokesman Jason Lefferts helped us with the answers:

1) I submitted an application for subsidized coverage. When will I find out if I qualify?

The state expects to send most of the more than 44,000 outstanding applicants a letter by January 1st. The letter will say either:

a) You are approved for a subsidy or
b) the Connector hasn’t processed your application yet and is putting you, temporarily, into a MassHealth (Medicaid) plan.

The Connector is giving priority to applicants who may qualify for an insurance subsidy and aren’t already enrolled in Commonwealth Care. Health plans for everyone who is already in Commonwealth Care have been extended through March.

2) If I qualify for subsidized coverage, how do I choose a health plan?

Lefferts says you’ll be able to select a plan on the form included with your letter and send that form in with a payment. If you want help, you have to dial the Connector’s call center. You can review plan details (and look up which doctors are included in each plan) on the Connector site, but you can’t select a plan or make a payment there.

If you get a letter before Dec. 31, try to select a plan and make a payment quickly. You will be covered for all of January as long as your payment for the month is received by Jan. 10, 2014.

3) What if I haven’t heard from the Connector by Dec. 31?

Again, the Connector says that if your income was less than $45,960 this year, you will have insurance coverage on Jan. 1, even if your application is still in process.

You will be covered one of two ways: through your current Commonwealth Care plan (until the end of March) or through temporary MassHealth coverage.

4) What if I hear back from the Connector but don’t qualify for an insurance subsidy?

You’ll have to go back to the Connector website, or to one of the insurance websites, and select a plan. The best way to see all your options, says Lefferts, is browse plans on the Connector site. But you can’t buy coverage online, you have to call the call center.

5) If I haven’t started the sign-up process yet, what is the fastest and easiest way to begin?

Lefferts says the Connector website is still your best option.

6) What are you doing to shorten the wait/hold time at the call center?

The Connector has added call reps (there are just under 200 now), but with 9,000 calls a day, there will continue to be delays.

“We apologize for the delays,” says Lefferts. The Connector has added call reps (there are just under 200 now), but with 9,000 calls a day, he says there will continue to be delays.

7) Will the call center be open through the holidays?

The call center was closed on Christmas, but will now be open every day through Dec. 31 and possibly on New Year’s Day as well. The center is open from 7am to 7pm weekdays and 9am to 3pm on weekends. Lefferts says the best time to call on weekdays is before 9am and after 5pm.

Check the Connector’s Updates page for more details.

And my personal plea is that you keep trying, even though this process is very frustrating. Terrible things can happen when people don’t have health insurance.

Think we should add any questions to the list? Let us know in the comments.

Please follow our community rules when engaging in comment discussion on this site.
  • Danya Hache

    At the end of March my husband lost his job and was not offered Cobra. We ended up calling the Health Connector because we couldn’t get onto the web page to fill out the application. Instead, we spoke with someone at the Health Connector and completed the application over the phone. In April, my husband got a letter from the Health Insurance Processing Center giving him temporary coverage. However, there was NO mention of me. I have spent hours on the phone being passed back and forth between the Health Connector and Mass Health. Each one is blaming the other. For some reason, Mass Health cannot “see” our original application and therefore, don’t know what our answers were to the questions. Now, (today) I am told that we need to fill out a paper application (which is supposed to be mailed today). I don’t understand why these two agencies cannot share the information. Needless to say, I am extremely upset. I am afraid that we will be penalized for my not being covered. I don’t know how to proceed or how long it will take them to process the new application, etc.

  • djkmann1

    Here is the actual story, which needs to be addressed both by MA Health Connector and by journalists:

    As of 12/26/2013, 2,800 out of 250,000 to 265,000 residents have been able to successfully sign up in Massachusetts. That is 1.12% at best. The website and process has been a complete failure by any measure.

    http://obamacaresignups.net/

  • MelissaL

    Instead of using the Connector website (given all of the warnings I’d heard about it), I downloaded and printed the application form, filled it out and sent it by mail. Was told last week, after I called Health Care for All for assistance after striking out in reaching anyone at the Connector on my own, that my filled-out form had been received and will be processed. Until then, my current coverage will remain in effect. Might be a way to avoid the uncertainty that a lot of people have after loading their information into the website.

  • jefe68

    I wonder if Massachusetts will follow Vermont’s lead and move to a single payer system. It really is the only way to go. The ACA does not solve health care costs, the absurd fee for service system we use, nor does it control medical device costs or pharmaceuticals which are out of control in the US.

    In regards to the politics of all of this, it’s really interesting to note how far the GOP has moved away from it’s own ideas on healthcare and the Democrats have moved to the center. The excerpt below is from none other than Richard Nixon and it was a letter penned for Congress in 1974. What’s so interesting is how much the ACA is akin to Nixon’s ideas from almost years ago. The sad thing is here we are decades later with more or less the same problems that plagued the nation in 1974.
    We are still having the same conversation while not really not doing what is best for the nation in the long term.

    Without adequate health care, no one can make full use of his or her talents and opportunities. It is thus just as important that economic, racial and social barriers not stand in the way of good health care as it is to eliminate those barriers to a good education and a good job.

    Three years ago, I proposed a major health insurance program to the Congress, seeking to guarantee adequate financing of health care on a nationwide basis. That proposal generated widespread discussion and useful debate. But no legislation reached my desk.

    Today the need is even more pressing because of the higher costs of medical care. Efforts to control medical costs under the New Economic Policy have been Inept with encouraging success, sharply reducing the rate of inflation for health care. Nevertheless, the overall cost of health care has still risen by more than 20 percent in the last two and one-half years, so that more and more Americans face staggering bills when they receive medical help today.

    http://www.kaiserhealthnews.org/stories/2009/september/03/nixon-proposal.aspx

  • Jay Jon

    Here’s one problem this article decides to completely ignore. You only get this “temporary coverage” if your application is complete, but not processed, by December 31. However, as anyone who has tried to use the system knows, the application process is filled with error messages. So what happens if you think you completed the application, because you did wade through the errors and validation issues and got the “you’re finished!” message, but you’re nervous because with all those errors through the process something perhaps got lost in translation? You don’t know if your application made it to the Connector accurately because you can no longer see it, you worry because the error messages and validation problems make it seem quite likely that the application program did not capture the information and send it correctly to the Connector, but NO ONE at the Connector will tell you whether your application is complete. They say they can’t tell, they can’t access your application. So you just have to wait to see whether you get that letter. If nothing arrives, you’re out of luck. The website is so plagued with glitches the application process is nearly impossible. The customer service center involves long wait times – over an hour whenever you call – but in addition, the reps refuse to say anything. Seriously, anything. All I have ever been able to get is “I can’t access your application, I don’t know the status, but we’re mailing letters, yours probably went in the mail.” They told me that a month ago (whatever letter she was referencing never came) and they told me that last week, too.
    So, question to add: Will the Connector give its representatives the tools to actually answer the questions callers have? Or will we continue to wait for hours on hold only to be told they can’t tell us anything? Will representatives ever be able to tell us the status of our applications (i.e., complete but not processed; processed and decision pending; incomplete and reapplication necessary; etc….)

    • mumtothree

      Agreed. The first response, after the lengthy wait, is “Have you tried our website?” Well, yes – that’s why I’m calling a real person, who I hope has some better answers than the website.

    • Martha Bebinger

      Jay Jon – sorry for the delayed response. I will post an answer on how to determine the status of your application as soon as I get it.

  • commenty_mcgee

    This system is a total joke and this article doesn’t investigate anything, it just carries water for the incompetents running this broken system. NO ONE has heard anything from the connector and they’ve been saying we will in “7-10 days” for about two months now. But you just uncritically take them at their word that everyone will get something by Dec. 31? Give me a break. Talk to anyone on the Mass Health Connector facebook page and you will see no one is happy. What does that even mean that you will be automatically covered by temporary Mass Health if you make under 45K a year? Do you think anyone is going to actually be able to use that insurance to do anything useful? Just keep trying? Are you serious? WE KNOW TERRIBLE THINGS CAN HAPPEN WITHOUT HEALTH INSURANCE, THAT’S WHY WE’RE FRANTICALLY TRYING TO PURCHASE IT BEFORE DECEMBER 31ST DESPITE THE FACT THAT THE STATE IS MAKING IT IMPOSSIBLE TO DO SO.

    • http://byrondennis.typepad.com/theabcsofmedicare/ Dennis Byron

      mcgee

      Martha was one of the first journalists in the state to expose the problems on the Massachusetts exchange. I’m sure she had to hold her nose as she joined the Herald in exposing the issue. But she did it. She was weeks ahead of the Globe and the far lefty water carriers at the South Middlesex News and Cape Cod Times and Berkshire Eagle (none of whom have even mentioned the problems yet I don’t think)

  • mumtothree

    Q1. If after waiting months for an answer and it turns out we DO qualify for a 2014 premium tax credit but will definitely not qualify for 2015 (because of smaller family size), must we purchase a 2014 plan from the Connector or can we simply decline involvement and go directly to an insurer to purchase a plan?

    Answer from the Connector: You can always go to an insurer to purchase a plan. However, the only way to access subsidies is through the Health Connector.

    Q2. I thought that plans purchased prior to passage of the ACA were grandfathered. We have purchased the same Commonwealth Choice plan since 2010, before the law’s enactment. After an hour on hold with the Connector, the agent confirmed that yes, our policy was grandfathered, but no, I could not keep it. (Isn’t that the definition of grandfathering in this context?) What’s the real answer? Massachusetts is throwing subscribers off their current (good) plans. What is the reasoning behind that?

    Answer from the Connector: The option announced by the President last week applies to people who have had their plans canceled by the carrier and believe their options are unaffordable. Those people must apply for a hardship waiver through the federal government to be exempted from the federal individual mandate and to enroll in a catastrophic plan.

    Q3. When I completed an application for our family in October, I was required to input a lot of personal information for all members of our family, including dob, address, ssn, income. If I didn’t put it all in, at one time, the site said I would have to start over from scratch. Have they fixed that so that you can put aside an electronic application and pick it up again later? E.g., how many parents have all their kids’s SSNs off the top of their heads? Tax return handy? Addresses for college students?

    Answer from the Connector: There is currently a save option on the website that allows people to return to a partially completed application.

    Q4. Given the extent of recent data breaches, what precisely is the Connector’s policy on data security, privacy and sharing, and retention of information? E.g., if I do not qualify for a premium tax credit, how long is our personal data retained, and can/must I do anything to make sure that the Commonwealth does not keep it any longer than is necessary? I would like a more complete answer than, “Don’t worry, your information is safe with us.” Please give various scenarios.

    Answer from the Connector: I’m working on getting you details on the data retention policy. The Health Connector takes the security of personal information very seriously, and the security of the system was closely tested as part of the federal government’s approval process. To date there have not been any data breaches in the Massachusetts system.

    • http://byrondennis.typepad.com/theabcsofmedicare/ Dennis Byron

      Mumtothree

      On your question 2, it is a mystery concerning why Governor Patrick did not honor President Obama’s request to grandfather better policies — both your Choice policy but also Commonwealth Care policies. My guess is that 800-pound gorilla in the room, Blue Cross, did not participate in Commonwealth Care and therefore will lose out on the gravy train if all people who wanted to were allowed to stay on their Commonwealth Care plan. Once that decision was made, then they couldn’t have let Choice people keep their Choice plan while kicking theoretically less well off Care people of their plan. But that’s just a guess

    • Martha Bebinger

      Hi mumtothree – I am pasting the responses I got from the Connector after each of your questions. When I get more on Q4, I’ll update that answer. Thanks for raising these issues.

      • mumtothree

        Thanks, Martha – glad that WBUR and you are our fast track to some answers.

        I actually got letters (several, one for each family member, all addressed to me) from the Connector / MassHealth stating that I will have “temporary health coverage beginning January 1, 2014, until your application is processed, … to determine if you qualify for a Health Connector plan or for MassHealth.” Hmmm. I assume that I am not being kicked off my CommChoice plan until the actual shut-off date of March 31.

        Follow-up to Q2: The question I was asking had little to do with last week’s announcement, which concerns sub-standard existing policies, but rather a long-ago provision in the law concerning grandfathered policies which meet most if not all of the ACA requirements, as all CommChoice plans do. Classic “give an answer to a different question.”

        Putting that aside, though, who exactly is the carrier? When I called the Connector, they said our carrier was Tufts. When I called Tufts, they said they haven’t canceled anything (yet), the Connector did. The Connector is individual subscribers’ equivalent of an employer. Apparently the Connector has to send cancellation notices to the insurers, who then send letters to the subscribers. They have known for months that they (the Connector) are cancelling CommChoice subscribers, but they won’t send the letters to the insurance companies until February. I still maintain we should have been grandfathered and find it ironic that Massachusetts itself is refusing to honor the President’s promise that if you like your policy, you can keep it. ACA also requires 90 days notice, so in theory I should receive an actual cancellation letter from ??? by 12/31/13 for cancellation effective 3/31/14.

        The answer to Q4 was pretty much what I expected, “we take this very seriously,” blah blah blah. Interesting they invoke the feds. Thought that testing was one of the big problems with HealthCare.gov. And the fact that there have been no data breaches so far is not very reassuring. Anxiously awaiting elaboration.

        • Martha Bebinger

          Hi mumtothree – if you have CommChoice now, but expect to to qualify for a tax credit, it sounds like you’ll be in better shape financially with a new plan than you would be if you stayed with your current plan. But am I missing something?

          I assume you keep your CommChoice plan too, as long as you pay the premium. Do you want me to ask about your specific case?

          Here’s the answer from the Connector on how long they keep your info. Seems like a long time to me, but I’ve never looked into this statute. I’ll past the answer higher up as well.

          Response from the Connector: State law mandates we retain info for six years, federal law mandates we hold it for 10.

          • mumtothree

            Hi Martha.

            I asked the Connector in writing to withdraw my application and delete all the information, and they said they would. This is after I asked via telephone whether I could change or delete information and they had said no.

            Another price data point: I got a letter today suggesting that I buy, from the Connector, a comparable policy to my CommChoice policy being cancelled. For a family: my current premium is $1959, the new premium would be $3171, a 62% increase. Premium is based on geography, age, and non-smoking (no one in my family smokes). I haven’t moved and, well, yes, I’m a year older but not one which would make any difference. I can’t believe that the coverages that people are complaining about (pregnancy, pediatricians) are driving such a huge increase. Your thoughts?

  • http://byrondennis.typepad.com/theabcsofmedicare/ Dennis Byron

    1. Q. A large portion of the people currently on Commonwealth Care are scheduled to be moved to Medicaid. Have all those people been notified? (In other words, if I am on Commonwealth Care now and have not been notified that I have been moved to Medicaid, does that mean that I am in the category above that has to do something by March 31 but who will be able to use my previous Commonwealth Care insurance until then)

    2. Q. Do I still have to pay for my previous Commonwealth Care policy through March even though I will likely find out when all is said and done that I will get a much lower priced ConnectorCare policy?

    (Aside: I am not sure if that scenario is possible. I know there is no non-ConnectorCare PPACA-related insurance less expensive than Commonwealth Care. I do not know if there are ConnectorCare policies less expensive than Commonwealth Care policies? Either way, there do not appear to be any ConnectorCare policies better than Commonwealth Care in terms of benefits — the higher deductibles/tiered-networking issue everyone talks about — so most people will likely be choosing more expensive policies)

    3. Q. If I have to keep paying until this is all straightened out but should have been able to get a lower priced plan if it had all worked right, will I get my “overpayment” back?

    4. If I previously had individually purchased full price insurance (not Commonwealth Choice) or no insurance — that is, I am not a current Commonwealth Care customer– and I think I applied (the web site seemed to work for me) but I did not hear from the state, what is my status? (In other words, was one of the web glitches that it appeared to work from my perspective but in fact did not.)

    It may not make sense to get too exercised over all of this. You’re talking about much less than one percent of the Massachusetts population here, all of whom would have to suddenly and simultaneously need healthcare services in the next month. And it sounds like if any one who in any way ever touched the system still falls through all these filters the state has set up, they’ll make good retroactively.

    The only likely person to get hurt would be the improbable case of someone who never had insurance by his or her own choice (despite the state’s previous mandate) but then decided this fall that he or she now wanted it and then applied but the application got lost figuratively or literally… and then they would to need services (again long odds)

    • commenty_mcgee

      “Do I still have to pay for my previous Commonwealth Care policy through
      March even though I will likely find out when all is said and done that I
      will get a much lower priced ConnectorCare policy? ”

      There is NO WAY ConnectorCare will be cheaper for you. From everything I have been able to find out (which admittedly isn’t that much since the website is so terrible) it looks like my new cheapest available plan will be about twice as expensive per month compared to my Commonwealth Care plan, and will have a $6,000+ deductible.

      • http://byrondennis.typepad.com/theabcsofmedicare/ Dennis Byron

        Thanks.

        To be clear, this does not apply to me personally. I am just taking Martha’s suggestion to add some possible questions people might have.

        I agree with you based on my research that ConnectorCare will not be cheaper, I cannot confirm that for the same reason you can’t (I haven’t even tried to go on the new Massachusetts exchange web site because I didn’t want to screw up someone that really needs it).

        However I don’t think the ConnectorCare vs. RomneyCare comparison is as bleak as you think based on a handout on the Connector Authority’s website. I think you are comparing now-unavailable-for-new-purchase Commonwealth Care plans vs. the policies that people with between 300%-400% of FPL will qualify for once they can use the exchange. But people who were on Commonwealth Care (meaning they had less than 300% FPL) can also choose ConnectorCare plans that look to be the same as to about 20% worse than CommonwealthCare in terms of benefits. Like you, I cannot figure out how much they cost so there is no way to truly compare them.

        • commenty_mcgee

          I hope you’re right but at this point I am not expecting much.

          • Diane

            A navigator peaked my interest after posing a question on the MASS heath connector FB site. I had complained about the pricing, deductibles, etc. etc. that dramatically increased according to the exchange prices vs. present Commonwealth Care plans. The navigator responded that the new plans will be comparative to the present plans if income levels are under the 300% FPL. I was confused because the pricing on the exchange didn’t reflect what she had stated. Therefore I went to one of the insurers websites (BMC) and I found the pricing for the Connector Care listed. There are no metal plans for Connector Care (bronze-platinum) and look to be priced according to the FPL just as MA had been doing for years. I would imagine anyone between the 138%-300% FPL in MA will have the option to choose between the Connector Care plans or the metal plans but I haven’t been able to find anything in print about it. I do recall in the recent past reading an article where MA did receive funds from the Fed that they still had in surplus and they would put it towards the new plans. Perhaps this is why those under the FPL of 300% and not eligible for Medicaid will be able to continue those plans. Will the Connector Care plans continue indefinitely? Who knows but from what I saw it looks like they will at least through 2014. I would suggest anyone that is presently under the 300% FPL, presently has Commonwealth Care to go to their present insurers’ website and see if there is a Connector Care plan posted on the site like BMC does.

    • Martha Bebinger

      Hi Dennis – here’s what I got from the Connector in response to Q1:

      The
      notices to the folks who are moving to MassHealth have been sent out.
      In all likelihood, if someone hasn’t received that notice and is
      currently in CommCare, they are in the pool of folks who have until
      March 31 to figure things out.

      Do you know of someone who should have received this notice but didn’t?

      I didn’t see your other questions earlier today. They were behind a page break, which I didn’t notice. That said, it will be hard to get firm answers for Q2 and 3. There will be many different scenarios, depending on which ConnectorCare plan each person chooses, right? And why are you assuming coverage will be cheaper next year?

      On Q4 – the status question – I’ll post what I get tomorrow.

      Hope all is well.

      • http://byrondennis.typepad.com/theabcsofmedicare/ Dennis Byron

        Thanks Martha

        As I said in answer to mcgee my questions are hypothetical (because — as you know — I am well into Medicare). No case I know falls into the hypotheticals I posed (again almost everything I run into is a Medicare issue). I was just taken you up on your request to add questions to the list. I think some of the other people who answered you had actual personal questions however.

        In answer to your question, in my aside I note that I assume that no ConnectorCare policy would be less expensive than one of this year’s Commonwealth Care policies but there is no way to know because the prices aren’t listed anywhere that I can find. (I don’t want to screw up the exchange further by entering a dummy account.)

        But the Connector Authority should be able to answer my basic questions 2 and 3 very directly and — I would think — based on the RomneyCare law or policy for the past five years. Instead of wording it the way I worded it, use the hypothetical that a person has had a NHP CommonwealthCare Type 3 in 2013 and will pay for it through March (at say $150 a month) as the process continues. If his or her new Masshealth application or verification form that he or she had to submit in the last few months because of PPACA (that he or she would have had to submit anyways under RomneyCare) shows he or she now qualifies for a free Type 1 ConnectorCare or even Medicaid. In that case, will the person get the $150 a month back?

        Happy new year

        • Martha Bebinger

          Ahhh – I get it – I’ll ask.