State health exchange wins OK from Washington

Connecticut's plan for a state-run health insurance exchange is one of six to win early approval from the federal government, Lt. Gov. Nancy Wyman's office announced Monday.

The approval from the Department of Health and Human Services for plans submitted by Connecticut, Maryland, Massachusetts, Oregon, Colorado and Washington means these states can continue moving ahead with creating online marketplaces for private insurance plans that will be offered to individuals and businesses under the Affordable Care Act.

"We're just totally thrilled to be part of this select group of six states," said Jason Madrak, spokesman for the Connecticut Health Insurance Exchange, a panel established by Gov. Dannel P. Malloy and headed by Wyman. "So many other states sat on the sidelines, but we couldn't be more thrilled to be out in front."

Connecticut submitted an 800-page plan for how it will implement and operate the exchange, drawing on $116 million in federal grants to design and build it and secure the necessary information technology, marketing and operational expertise to develop the system, the announcement said. The state will seek additional grants to establish services to educate and enroll people through the exchange, Madrak said.

The six states that received approval Monday submitted their plans in October, a month ahead of the original Nov. 16 deadline set by the federal government. The deadline has since been extended until this Friday. In addition to the six approved Monday, eight other states and Washington, D.C., have said they intend to submit plans by the new deadline, but HHS officials said Monday that they remain optimistic that more plans than that will be submitted by then. States that opt not to create state-run exchanges will default to a provision of the act that allows the federal government to run the exchange for them.

"While other states waited for events such as the Supreme Court ruling or the election to spur action, Connecticut did the right thing and aggressively pushed forward with launching a state-based exchange for its residents," Gov. Malloy said in the statement. "To do anything less would have been a disservice to those in our state who don't have insurance, or struggle to afford the coverage they have."

An estimated 9.6 percent of Connecticut residents are uninsured. Malloy signed the bill enabling the creation of the exchange last year.

Madrak said that thus far, there are two insurers committed to offering coverage through the exchange - Anthem Blue Cross Blue Shield and Healthy CT, a physician-run nonprofit - and both will offer multiple types of policies. The state will be soliciting additional commitments from other insurers in January, Madrak said.

The early approval gives Connecticut an advantage in securing contracts from vendors to operate the call centers and provide the information technology services for the exchange, he added.

Residents will be able to purchase insurance through the exchange starting next fall, and coverage would begin in January 2014.

"We couldn't be happier to receive this approval," said Kevin Counihan, chief executive officer of the exchange. "But with only nine months left until open enrollment in 2013, there is little time for celebrating. We look forward to engaging with all of our stakeholders and partners to ensure we meet our deadlines, and deliver a vibrant, effective exchange for the state."

At a forum in New London last week, Counihan explained that rates for insurance in the exchange will determined as a percentage of income, with subsidies provided to those with low incomes. The maximum monthly premiums would not exceed 9 percent of monthly income, or about $432 per month for a family of four with an income that's 200 percent of the federal poverty level - about $46,100. There will be four tiers for each plan offered, from the most expensive "platinum" plan that covers 90 percent of health care costs, to the "bronze" plan that covers 60 percent but has the lowest premiums.

There also will be maximum deductible of $2,000 for an individual, $4,000 for a family, and maximum out-of-pocket costs of $5,000 for an individual and $10,000 for a family, he said.


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