Craig’s Story

January 6, 2014

Broker Issues with Access Health CT
By Senator Kevin Kelly (R-21), Ranking Member of the General Assembly’s Insurance and Real Estate Committee

Implementation of the Affordable Care Act in Connecticut is not perfect. While the Access Health CT team celebrates the insurance exchange’s successes, they avoid addressing problems people face during enrollment. I was not a supporter of the Affordable Care Act, but now that it is the law of the land I want to make sure implementation is done right.

I want to make sure people like Craig, an independent insurance broker from Mystic, is able to easily enroll his clients through Access Health CT – something Craig struggled to do since the site launched in October.

From October 31 to December 11, whenever Craig tried to sign up a client through Access Health CT he got an error message at the end of the application, after the client was already qualified to purchase a health plan with or without subsidies. The error message said the same thing every time: “enrollment ineligible.”

Craig sought help. He contacted the broker helpline, and was greeted with an automated message that instructed him to leave a voicemail so that someone could call him back in 24 hours, or to call the general help line for immediate assistance.

No one ever called him back from the broker helpline.

The general helpline kept him on hold for hours and provided no answers.

Craig contacted the Access Health CT broker liaisons, Phil Boyle and Chris Mele, but still did not get very far. Mele told Craig they “were just not set up as an organization to help assist brokers.” Craig was shocked to hear such a response from Mele, Senior Manager of Broker Marketing and Compliance.

After numerous phone calls, emails and, in his own words, generally being a thorn in their side, Craig’s cases were escalated up the IT ladder.

Finally, on Friday December 13, after losing weeks of productivity, the web glitch was resolved in the cases Craig shared with Access Health CT. However, Craig continued to experience other minor glitches and “general system errors.” These were resolved more quickly, but further delayed Craig’s efforts, preventing him from signing up all his clients by the December 23 deadline.

Craig is frustrated. Since voicing his complaints he was glad to see the website glitches resolved and commended Access Health CT for setting up a real IT broker help line, which Craig was alerted to via email on December 19. But why did the help come so late? And why did Access Health CT deny that there were any web issues when Craig was experiencing so many errors?

Craig says the broker issues extend beyond web glitches.

Today, he is most concerned about slow communication between Access Health CT and Anthem, the main provider his clients signed up for. He is worried that his clients will not receive billing information from Anthem in time to meet the January 10 payment deadline. As a broker he wants to aid his clients, but feels helpless.

When Craig contacted Anthem about communicating with his clients, he was alerted to another problem. Anthem told Craig he was not the broker of record on his clients’ accounts. If he wanted to receive credit for these accounts, he would have to fill out a separate “Agent of Record” form for each.

How could that important piece of information about the broker be missing from Anthem’s records when it was reported through Access Health CT? And with only a few days until the payment deadline, what more can Craig do to make sure his clients will actually be covered?

For Connecticut’s brokers, and the thousands of small businesses and individuals they serve, we need to answer these questions.