State health exchange officials, gearing up for the second round of open enrollment this fall, plan to communicate more, brace for an onslaught of last-minute enrollees and rely on the help of a network of community health groups in order to make sure Coloradans are able to sign up for health insurance under the Affordable Care Act.

With slightly more than four months to go until the next open-enrollment period begins for the state’s health-insurance exchange, Connect for Health Colorado, exchange officials have been taking stock of what lessons they learned during last year’s first historic, often tumultuous open-enrollment period.

The program began Oct. 1 and closed March 31. During that time, 118,628 Coloradans signed up for coverage via Connect for Health Colorado.  Since the close of open enrollment, those with “qualifying events,” such as a job change or marriage, have continued signing up. Enrollment now tops 137,000, said Linda Kanamine, director of communications at the exchange.

The exchange kept pace with its projections and fell in the middle of the pack when compared with other state-run exchanges’ enrollment numbers, according to data from the Centers for Medicaid and Medicare Services. Colorado ranked fourth for enrollment out of 17 state-run exchanges.

BizWest asked the exchange what lessons it learned from last year’s launch, and how they would apply to the next enrollment period, which begins Oct. 1.

Lesson One: Insurance is a complex product and requires extensive, clear communications coupled with a vast and diverse support network.

With premiums, co-payments, deductibles and a myriad of other terms in use, insurance is a complicated product to explain, even when a broker is sitting one-on-one with a consumer. Connect for Health Colorado’s website seeks to explain the products offered, and has brokers and “navigators,” who are available to help customers find the right products, but consumers still have trouble understanding the exchange itself and what different elements of each plan mean.

“Consumers get many confusing messages through the media,” Kanamine said. “We need to continue with public education campaigns and targeted communications statewide.”

The second time around, the exchange will benefit from name recognition and an established network of partners to help get the word out, Kanamine said, but education and awareness programs will have to continue to ensure success.

Lesson Two: Purchasing insurance is a last-minute decision for many.

While the open-enrollment period lasted six months, the exchange saw a rush of activity in the final few weeks as people who had procrastinated hurried to get covered before the enrollment period ended. Exchange officials expect to see a similar trend in the second enrollment period and are girding for the last-minute spurt of activity.

“Even after people are convinced of the value of insurance, they’ll still wait until the last minute to buy,” Kanamine said. “We need to plan and make resources available to support customers when they’re finally ready to make a purchase.”

“Connect for Health Colorado learned a lot about having enough resources when that rush hits,” said Adam Fox, director of strategic engagement at Colorado Consumer Health Initiative, a Denver-based organization that has supported health care reform.

Lesson three: Relationships make Connect for Health Colorado successful.

The exchange’s assistance network, a collection of health-care agencies in communities all over the state, allowed for face-to-face contact with consumers at a local level. Customers could talk with trained experts in their home towns to get information about the individual and small business exchanges.

For example, the Health District of Northern Larimer County launched Larimer Health Connect on the same day that Connect for Health Colorado opened, offering health coverage guides at multiple locations. The program has been used by many residents within the Health District, especially the low-income populations, said Richard Cox, district spokesman.

Low-income and non-English-speaking populations often benefit most from these programs, Kanamine said, since many of them have emigrated from places where having insurance is not a cultural norm.

Lesson four: This concept is brand-new, so expect change.

The first open-enrollment period came with its fair share of shifts and changes in policy and directives from the federal government, which ended up pushing back the deadline for receiving coverage by Jan. 1, 2014, several times. In addition, things such as the employer mandate were delayed, slowing the progress of the small-business exchange.

These changes taught exchange officials to be flexible, Kanamine said, changing plans quickly and frequently to keep up. That is expected to continue in the next enrollment period as well.

“Our technology and support systems will have to adjust quickly, while we remain focused on the overall goal of increasing coverage,” she said.

One planned change is to integrate PEAK, a website that allows for streamlined Medicaid application and enrollment, into Connect for Health.

Colorado had a waiver from the federal government to keep PEAK separate from the exchange, Fox said, but in the second open-enrollment period, a “single determination” system will be used to tell people if they belong in Medicaid or in the private insurance market.

Lesson five: The exchange can move forward from a solid foundation.

“Connect for Health Colorado was successful in meeting goals in the first open enrollment,” Kanamine said. “We need to remember that and build on what worked well.”

“It will be easier for them to hit the ground running,” Fox said. Consumers, insurers and regulators are all more familiar with the exchange than they were last year, so the process should be smoother all around.

But the exchange still has its share of challenges to face, including funding. Earlier this month, the exchange’s board approved a fee on all insured Coloradans that will add $13 million to the exchange’s coffers to help fill a gap that will occur next year when federal funding ends.


Molly Armbrister can be reached at 970-232-3129, 303-630-1969 or marmbrister@bizwestmedia.com. Follow her on Twitter at @marmbristerBW.