Only nine Marylanders have signed up for the states retroactive health insurance

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By Jenna Johnson, Published: March 1 E-mail the writer

Only nine Marylanders have signed up for temporary, retroactive health insurance made possible by emergency legislation aimed at helping people who tried to get coverage through the state’s faulty online health insurance marketplace, encountered problems and were stuck with medical bills to pay.

Two months ago, state officials predicted that as many as 5,000 people might need the help, which would have cost the state millions of dollars. Since then, the four health insurance companies participating in the state exchange offered their own retroactive insurance, helping about 300 households — and turning the state’s option into a last-resort for special cases.

The small number of enrollees “is a sign that there are not so many people who are having so many challenges that they are going that route,” said Joshua Sharfstein, Maryland’s secretary of health and mental hygiene, at a budget hearing Wednesday. “We’ve been doing an enormous amount of work — a lot of elbow grease — to try to patch different parts of the system so that we can get through open enrollment.”

But at budget hearings and an oversight meeting this week, a few lawmakers questioned whether the low number of is really a sign of success. Some asked what the state is doing to promote the option. Senate Minority Leader David R. Brinkley(R-Frederick) said Monday that he has diminishing confidence in the exchange’s ability to make any accurate predictions.

On Friday, federal health officials announced they will bend some of their rules in the coming month to help those living in states where the exchanges that have not been working well, which could include Maryland. The government plans to help pay for certain health plans that consumers buy on their own — not through the exchange — and help make that insurance retroactive.

Maryland was one of 14 states that decided to build its own online health insurance marketplace, a key feature of President Obama’s Affordable Care Act, rather than rely on the federal version. But Maryland’ssite crashed on its first day and has yet to work as planned, greatly hindering enrollment in private health insurance plans.

As of Feb. 22, 35,636 Marylanders had enrolled in a private health plan through the exchange, far behind the original goal of having at least 150,000 people signed up by the end of March. Earlier this week, state officials announced that their goal was based on faulty research and that a better estimation is 75,000 to 100,000 people. Enrollment for those plans opened Oct. 1 and will close March 31. The next enrollment period, for insurance starting in 2015, will open Nov. 15.

The exchange has been working better than when it first launched,with technology officials saying that they have fixed hundreds of glitches and continue to work on hundreds more. But when the New Year rolled around, thousands of Marylanders who needed health insurance were still without it.

In early January, Maryland Gov. Martin O’Malley (D) and Lt. Gov. Anthony G. Brown (D) asked lawmakers to help those people. The administration proposed legislation to expand enrollment in a state-run insurance program — called the Maryland Health Insurance Plan — that was established a decade ago to help high-risk individuals who couldn’t get coverage elsewhere. People in dire need of health insurance could enroll in this program and receive coverage that is retroactive to Jan. 1 or the first day of following months. The premiums of these plans are often higher than in private plans, which was expected to motivate people to not stay for long.

As lawmakers weighed that option, the four insurance companies participating in the exchange provided their own retroactive health insurance. For one week in mid-January, Marylanders could register to receive insurance that would be retroactive to Jan. 1. More than 1,300 households expressed interest. Of those, 562 were found to be eligible for Medicaid and nearly 300 households enrolled. All of those applications had to be manually processed and did not go through the exchange.

Once that happened, state officials said there was less of a need for the state to also offer retroactive insurance, but they said there could still be a few hundred people who require the help.

When O’Malley signed the legislation into law in late January, he said: “If it affects just one family, it is worth the effort, especially depending on the condition or the size of a hospital bill or other treatment bill incurred.”

Carolyn A. Quattrocki, the exchange’s acting executive director, told lawmakers Mondaythat about 7,000 applications are still stuck in Maryland’s system. As for the exact number of people who are not getting the health insurance they seek, a spokeswoman for the exchange said Friday that they do not have “any reliable estimate.”

------The primary reason people are going to the exchanges is because they are eligible for subsidies or credits.  Even with the financial help for lower income people in the Maryland Health Insurance Plan the costs are considerably higher than those through the exchanges.  It seems most are willing to wait for exchange plans instead.  If you are not eligible for a subsidy, and in need of coverage, there is NO reason to subject yourself to the hassles of going through the exchanges.....BBS

Carefirst Indvidual Medical Plans

WEREN'T ABLE TO GET COVERAGE THROUGH THE EXCHANGE? O'MALLY INTRODUCES THE BRIDGE PLAN

Maryland Health Insurance Plan Bridge Program

On January 30, 2014 Governor Martin O’Malley signed Senate Bill 134 - Maryland Health Insurance Plan – Access for Bridge Eligible Individuals. The bill allows “Bridge Eligible Individuals” as defined in § 31-101 of the Maryland Insurance Article to obtain temporary health insurance through the Maryland Health Insurance Plan (MHIP) with retroactive coverage.

MHIP Bridge Program Policies and Procedures

• Individuals eligible for health insurance through Medicaid, Medicare or an employer sponsored plan are not eligible for the MHIP Bridge Program.
• Applications must be submitted by March 31, 2014 (a postal date mark constitutes the submission date).
• MHIP Bridge coverage will be terminated on the effective date of a Bridge Eligible Individual’s enrollment in a qualified health plan (member must provide notice in writing to CareFirst for voluntary termination to occur).
• A MHIP member whose coverage was terminated December 31, 2013 or thereafter and are eligible for the Bridge Program will be reinstated in their last MHIP plan option with no deductible reset.
• Bridge Program applicants must submit the following documents for enrollment consideration:

1. Proof of Maryland residency
2. MHIP Standard enrollment application form
3. Tax return document and/or other proof of income if applying for enrollment in one of the MHIP+ plan options
4. MHIP Bridge Program Application Addendum (Addendum must contain applicant’s signature, a written description of when and how the applicant attempted to enroll through the Maryland Health Connection (MHC) and coverage effective date choice to be considered complete)

Enrollment Coverage Choice Will Be as Follows:

Date Application Received       Effective Date of Coverage Options
Jan. 1 – Feb. 15, 2014                  January 1, 2014 or February 1, 2014
Feb. 16 – Mar. 15, 2014               February 1, 2014 or March 1, 2014
Mar. 16 – Mar. 31, 2014               March 1, 2014

• All MHIP Bridge Program enrollees’ coverage will be terminated on March 31, 2014, unless that date is extended by the MHIP Board of Directors.
• Bridge Program application forms can be downloaded from Marylandhealthinsuranceplan.net
• A paper copy will be mailed to the individual upon request by calling 1-888-444-9016.
• Enrollment applications must be mailed to CareFirst at Maryland Health Insurance Plan, Enrollment and Billing, 10455 Mill Run Circle, RR-380, Owings Mills, MD 21117-9685.
• CareFirst will process applications within 3 business days of receipt of a complete application.
• If the application is incomplete, CareFirst will notify MHIP staff daily and MHIP staff will reach out to the applicant to obtain the missing information in a timely fashion to facilitate a prompt enrollment.
• CareFirst will mail an approval letter and a payment slip to the individual.
• Upon receipt of payment from the individual, CareFirst will effectuate coverage and mail an ID card. Coverage is not effective until full payment is received.
• Members and providers can confirm coverage with CareFirst prior to an ID card being received by calling 1-888-444-9016.
• Certificates of Coverage will be mailed to new enrollees with terms of plan and coverage dates.
• MHIP and the Maryland Health Benefit Exchange (MHBE) will work together to assist Bridge Program enrollees in getting coverage through the MHC. An existing MOU and data sharing agreement between MHIP and MHBE will facilitate this process. Bridge Program eligible individuals will be placed on a priority list and given assistance with transitioning, as soon as possible, into a qualified health plan through MHC. MHBE will manage the priority list.
• MHBE will use social media, direct contact and other communication outlets to inform individuals of the MHIP Bridge Program as an option of choice should other options not be available for the individual.

*From MHE-2/2014