2016 Open Enrollment Update

Board of Directors Meeting, December 10, 2015

Update: Open Enrollment 2016

When we last provided an update to the Board, Open Enrollment had recently

begun and early indicators suggested a stable experience for our members

Our next major milestone was automatically enrolling 2015 members into 2016

plans and, after extensive testing, auto-enrollment was completed at the beginning

of December to default into a 2016 plan those individuals who had yet to shop on

their own

Separately, we are seeing more than 16,000 new individuals enrolling for QHP

coverage effective January 1, 2016, with many more actively shopping and

preparing to pay by the December 23 deadline

Today we will provide you with some additional updates beyond the above related

to the customer experience for this year’s Open Enrollment period

2

More than one month into Open Enrollment, we continue to experience stable

operations and enrollment activity for both new and renewing members.

August September October November December January

9/16-10/5

First round of prod-like testing

12/7-12/11 Invoices

mailed for 1/1 renewals

(~135k)

12/23 Jan.

enrollment

deadline

Open Enrollment Timeline

11/20 – 11/25

Auto enrollment for

passive renewals

Renewals technical

release (6.5)

8/19-9/4

Preliminary notices

generated & mailed

(~120k)

10/7- 10/16 2016

Final Eligibility

1/31 March

enrollment deadline

(in OE)

1/23 Feb. enrollment

deadline

11/21-11/24

Carrier 834 files sent for

renewal population

8/24-9/16

“What to Expect”

for members

(~135k)

11/2

Mailing to Bronze members (~7k)

11/9-11/30

Eligible & unenrolled Open Enrollment reminder (~149k)

11/2-11/6

Message to shop (unsub) (~28k)

11/9-11/20

“Where to get help” (subsidized) (~120k) 1/1-1/15

OE is ending reminder (plan

in cart) (volume TBD)

10/5-11/2

DOR mailing to self-

reported uninsured

(~115k)

11/1-12/21

Paid Messaging Phase 1

1/1-1/22

Paid Messaging Phase 2

11/1-1/31

Call Center hours extended for Open Enrollment

11/2 Walk-in Centers launch (six sites)

11/1 Provider search go-live

1/1

Coverage effective for 2016

10/14-10/28

Renewal notices

generated & mailed

(~135k)

10/19-11/7

Second round of prod-like testing

10/19 Technical release (7.0) shopping improvements

10/26 7.0 post production release

Open Enrollment 2016

Renewals

Member Web Improvements

Operational Readiness

Outreach & Communications 3

12/2-12/16

Shopping information

(unsub) (~28k)

Renewing Enrollment & New

Enrollment Activity

Auto Renewals

Prior to launching the auto-enrollment process, approximately 8,300 renewing individuals

actively selected a new plan for 2016 and thus were not part of the auto-enrollment batches

Excluding those that had already shopped or were otherwise not eligible for auto-enrollment,

approximately 129,000 applications were passively renewed in this process (representing

approximately 160,000 members eligible for auto-renewal)

Those members that actively select a different plan after auto-enrollment was processed will

be enrolled in their newly selected plan instead of the one that they were passively renewed

into so long as they make their first premium payment

We sent invoices to renewing members between December 4th through 8th; as such, we

expect to see additional shopping activity for our renewing population over the next few

weeks leading up to the deadline

5

While members will still be able to switch plans at any time during Open

Enrollment, members who did not actively switch their plan in November

were “auto-enrolled” into their pre-determined 2016 plan.

These figures are very early indicators of Open

Enrollment activity this year; we expect them to

increase as we near closer to the December 23

deadline

“New” members are those that were not enrolled

in MassHealth for 2015, and either obtained a

program determination in 2015 but never

enrolled or have never been with us before (in

this new system)

Application and Enrollment

Reporting: Renewing and New

6

Half-way through Open Enrollment, more than 180,000 individuals are

enrolled in a QHP for January 1, 2016.

As we are currently in a period with a lot of member movement, these figures are early-

estimate approximations and will likely change as January 1 approaches

For example, individuals in ConnectorCare in 2015 who were re-determined into a different

program for 2016 could provide updated information in the month of December that

redetermines them back into ConnectorCare

Data through December 8, 2016.

Application and Enrollment

Reporting: Renewals

7

Renewing members are generally staying in similar coverage for 2016. It is

still early yet, though; our experience suggests that most member movement

will occur on or about the December 23 deadline.

*Data as of December 7, 2015.

Total 2016 Enrollment, by Metallic Tier*

Catastrophic Bronze Silver Gold Platinum Connector

Care

Shopping/ Not

Yet Re-

enrolled

20

15

En

rollm

en

t

Catastrophic 76% 12% 0% 0% 0% 2% 9%

Bronze 0% 84% 2% 1% 0% 3% 10%

Silver 0% 0% 86% 1% 0% 1% 11%

Gold 0% 0% 5% 84% 0% 1% 10%

Platinum 0% 0% 1% 7% 82% 1% 9%

To encourage shopping for members that might be experiencing significant rate or benefit

changes, we have launched an email campaign designed to encourage close attention to key

considerations for shopping

Phase I Phase II Phase III Phase IV**

“What are limited /

smaller networks?”

“Cost sharing: What

does it all mean?”

“What is a Metallic

Tier?”

“There’s still time to

switch! Are your

benefits right for you?”

**To be sent in January to 2015 Bronze plan members that didn’t switch.

Customer Experience Update

Service Center Performance

0

20,000

40,000

60,000

80,000

100,000

120,000

140,000

160,000

180,000

200,000

Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Nov-15 Dec-15 Jan-16

Ca

lls

Calls Offered

Jan 2015 – Nov 2015 = Actual Dec 2015 – Jan 2016 = Forecasted

OP

EN

EN

RO

LLM

EN

T *

* Updated forecast

1,153

1,669

1,281

149 81 28 12 32 27 20 8

0

200

400

600

800

1,000

1,200

1,400

1,600

1,800

2,000

Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15

Se

co

nd

s

Average Speed to Answer (ASA), in Seconds

32.2%

40.3%

35.6%

5.6% 3.2%

0.9% 0.4% 1.0% 0.3% 0.7% 0.2%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15

Abandonment Rate

9

Service Center Performance:

Open Enrollment Month One

TOP CALL DRIVERS

Application /

Eligibility

36%

Enrollment

27%

Billing/

Payments

16%

Account

Change

9%

Other 1%

0

1,000

2,000

3,000

4,000

5,000

6,000

11/1 11/8 11/15 11/22 11/29

Calls Handled

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

11/1 11/8 11/15 11/22 11/29

% Calls Answered

0%

1%

2%

3%

4%

5%

11/1 11/8 11/15 11/22 11/29

% Abandoned

0

5

10

15

20

25

11/1 11/8 11/15 11/22 11/29

Speed of Answer (Seconds)

General

Questions

11%

10

Consumer, Partner, and Media Feedback

“The online portion of applying for insurance is very confusing,

But the staff today were excellent, knowledgeable, and friendly.”

-- November 4, 2015 walk-in

“Everything is going very well here. Your staff are doing

excellent.” -- November 24, 2015 Brockton Neighborhood

Health Center staff

“MassHealth, Health Connector walk-in center in

Springfield offers enrollment help”

-- December 3, 2015 Springfield Republican

Walk-In Center Performance

1,319

736

302 317 224

760

0

200

400

600

800

1,000

1,200

1,400

Boston Brockton Fall River Lowell Springfield Worcester

Walk-Ins by Location

Billing &

Payments

5%

Account

Changes

6%

Application &

Eligibility

26%

Document

Processing &

Verification

7% Enrollment

13%

General

Questions

43%

Reasons for Walk-In

0% 0% 2% 7%

91%

0%

20%

40%

60%

80%

100%

Overall Satisfaction – November 2015

Very Dissatisfied Dissatisfied

Neither Satisfied nor dissatisfied Satisfied

* On a scale of 1 to 5, with 1 being very dissatisfied and 5 being very satisfied, how satisfied are you with the overall service provided to you by the Health Connector today?

* Until Nov 28 * Until Nov 28

11

1 3 8

20

58

39

13

32 24

0

20

40

60

80

100

July August September October November December

Urgent Services and Ombudsman Inventory

Urgent Services Ombudsman

• Cases resolved, year-to-date = 3,817

• As of December 1, 2015, the online

ombudsman form has been re-designed to

direct members with general issues to the

appropriate self-service or customer service

channels

Urgent Services and Ombudsman

* Until Nov 30

Current Total Inventory : 198

Analysis of Ombudsman Service

355 423

538

381 310

350

266 249 229 171 191

152 167

Jan Feb March April May June July August Sept October MTD Nov

US Ombuds

Summary of Ombudsman Cases :

1. 46% routine requests; members did not

attempt to call customer service first

2. 5% general feedback/suggestions from

members

3. 49% members who need assistance from

ombudsman team 12

Call Center Satisfaction Survey:

November Results

20% 17% 16% 23%

32% 40% 39%

51% 42% 39%

64% 22% 21%

18%

22%

22%

21% 23%

18% 31%

31%

13%

13%

7% 11%

15%

14%

15% 7%

11% 8% 12% 7%

11%

10% 15%

13%

11%

7% 10%

11% 7% 9% 6% 34%

44% 40%

27% 22% 18% 20%

8% 12% 10% 10%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov

Overall Satisfaction by Month

76% 85%

74%

8%

6%

11%

4%

4% 6% 3%

2% 3%

9% 4% 6%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

CSR Satisfaction CSR Friendliness CSR Knowledge

CSAT Score – November 2015

1 2 3

~7% increase in Overall Satisfaction compared to prior month

84% of respondents were satisfied or completely satisfied with Customer Service

Representatives (CSRs)

91% of respondents found CSRs friendly

85% of respondents found CSRs to be knowledgeable

13

2016 Open Enrollment: Year-over-

Year Comparison (first 30 days)

94

75

0

20

40

60

80

100

2014 2015

Calls Offered (Thousands)

20% Fewer Calls Received

Year-over-Year

14

843 819

0

200

400

600

800

1,000

2014 2015

Average Handle Time (AHT) (Seconds)

AHT 24 Seconds Reduced

Year-over-Year

7%

0%

0

2

4

6

8

2014 2015

Abandoned Calls (%)

Abandonment Rate Reduced YoY

2014: 7.8% II 2015: 0.2%

149

14

0

50

100

150

200

2014 2015

ASA (Seconds)

ASA 135 Seconds Reduced

Year-over-Year

Our year-over-

year comparison

to date illustrates

a much-improved

member

experience this

Open Enrollment.

Customer Feedback:

We are listening…

Yes I found the representative that I talked to very courteous very knowledgeable and very helpful so far this is been a very

pleasant experience. So thank you.

The customer services representative was very helpful and there was no long wait time to get a live person on the phone and

they seem to be very knowledgeable on the questions that I ask. Have a good day.

I'm very happy with the service today. I was picked up right away and the young lady that's helping very nice. Unfortunately I

don't remember her name but the service was good and I didn't [speak] with you since last year when the service was a little

aggravating but this time it's been a pleasure. Thank you. Bye.

The rep was patient and knowledge and was helpful and answered all the questions and made it an easy process so we are

more than satisfied. Thank you.

This is the fourth call I've made to mass health connection and I've been on the website and I was very confused and things are

getting crazy because I need to put in a premium payment by the 23rd. Anyway it's it was my fourth call. The three other calls I

spoke to people who could not find me in the system the claim that my husband was the head of the household and I couldn't

talk to me. But anyway today I got Steve and Steve it was wonderful. Steve found me in the system. He talked me through some

plans. We agreed on a plan he signed me up. Steve needs a raise. Thank you.

Today I wasn't somewhat satisfied with the customer service. I've been calling for a month and 1/2 now to straighten out my

health insurance and I just keep getting the run around. I've not received a health insurance card. My voided check is not been

applied to my account and overall I would say now so has way too much paper work and it's very complicated to deal with.

15

Open Enrollment 2016

Reminder…

17

The payment deadline for coverage effective January 1,

2016 is December 23rd

New members can enroll in coverage, and existing

members can change their current plan for any reason,

until January 31, 2016