Dawn’s Story

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

In the final days before the December 23 deadline to apply for coverage starting January 1, Access Health CT struggled to meet the needs of individuals trying to enroll. With more deadlines approaching, including the January 15 deadline to sign up for coverage starting February 1, we need to figure out how we can better help people in those final hours.

Last minute confusion before the December deadline impacted many people, including Dawn from Stratford.

Dawn is a supporter of the Affordable Care Act and looked forward to Access Health CT bringing affordable care to Connecticut. However, implementation of the policy was not always smooth and Dawn, like many others, experienced multiple enrollment issues.

On Saturday December 21, Dawn received an automated phone call saying that her application for health insurance through Access Health CT was still in progress. Dawn was confused. She completed her online application on December 10 and mailed in the required paperwork as proof of income. She was tech-savvy and followed all the steps. What was preventing her application from being complete? And why was she just hearing about it so close to the deadline?

Dawn called the help number mentioned in the phone message, waited on hold and was redirected to the main menu, which indicated that the call center’s hours were only Monday-Friday.

If no one was in the call center on the weekends, why would Access Health CT give her that number to call on a Saturday?

Dawn turned to the website but could not find any indication of what she was missing or confirmation of completed enrollment.

On Monday morning, December 23, Dawn called Access Health CT again. She was put on hold and directed to an automated message that said the call center was busy and gave her two options: (1) choose to be called back at a later time on the number she was calling from or (2) choose to be called back at a later time on another number.

Dawn was shocked that there was no third option to stay on the line to wait for the next representative. She needed help and was willing to wait for it, but that was not an option.

Why not just calmly wait for Access Health CT to call her back? Because the message also said that Access Health CT would call back by the next business day. The next business day would do no good. The deadline was just a few hours away.

In the end, Dawn did not get her questions answered before the deadline. Luckily, she was properly signed up for insurance and the message she received saying her application was incomplete was incorrect. Although her insurance was in order, the system still put her into a panic in those final hours.

What can we learn from Dawn’s experiences?

In addition to improving the call center, we must also improve the website.

According to Dawn the site was initially easy to navigate, but it was not clear where to find information about her enrollment status after signing up, so it was hard to confirm whether or not she had insurance. It also was not clear how many proof of income documents were required to complete enrollment. So, although Dawn mailed in what was requested, she was not totally certain if she sent enough documents to verify her account. When Dawn logs in to Access Health CT today she still cannot determine what, or if, any further documentation is still needed.

Dawn wishes she could have received a message to her Access Health CT website “inbox” that confirmed her successful enrollment to avoid the stressful last minute confusion. She also wishes she had more help getting in touch with her insurance company. While she was able to find Anthem’s phone number in a news article after Access Health CT shared the information in a press release, she would have liked that information included along with the notification of successful enrollment to be sent to her directly and much earlier.

The healthcare policy is no longer up for debate, but we must continue to discuss and refine implementation of the policy. We must learn from Dawn and other people’s stories to improve the system before the next deadline. The clock is ticking.