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Connecticut Health Insurance Exchange Partners with the Office of the Healthcare Advocate


News provided by

Connecticut Health Insurance Exchange

Feb 11, 2013, 09:00 ET

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--Agreement to Run CT's In Person Assistance Programs to Reach the Underserved--

HARTFORD, Conn., Feb. 11, 2013 /PRNewswire-USNewswire/ -- The Connecticut Health Insurance Exchange and the Office of the Healthcare Advocate have agreed to a partnership to administer Connecticut's Navigator and In Person Assistance Programs (NIPA).  The NIPA is a key initiative to engage, educate and enroll individuals, who are often in underserved parts of the state, in health insurance coverage.  NIPA encompasses the Navigator program, which is a required outreach component of the Affordable Care Act (ACA), as well the In-Person-Assistor program, which was added to the final blueprints for state exchanges issued by the Department of Health and Human Services, to further strengthen community based outreach.  The two programs will be closely coordinated to offer a seamless and diverse contingent of well-trained civic, faith-based and community groups to educate residents and small businesses about their health coverage options and enroll them in coverage through the Exchange.

The Office of the Healthcare Advocate (OHA) has a long standing tradition of working on behalf of Connecticut consumers to ensure access to quality insurance by educating consumers about their rights under various health plans, helping them enroll in coverage and directly handling grievances and appeals when coverage is denied. OHA also engages in statewide community based outreach and education to small businesses and community organizations as well as executing multimedia marketing campaigns.  Since 2010, OHA has been the federally designated Consumer Assistance Program (CAP) under the ACA.

"The OHA mission aligns closely with our goals, making this partnership a great fit," said Kevin Counihan, Chief Executive Officer of the Exchange. "We look forward to working closely with them to establish a transparent and effective community based assistance program, and leverage their substantial expertise to execute it effectively."

"We believe that doing everything possible to reach the non-insured and underinsured in Connecticut is imperative, and our work with the Exchange to create a robust NIPA effort will be very important to success," said Vicki Veltri, the State Healthcare Advocate.

The innovative partnership between the Exchange and OHA is the first of its kind in the country and has been lauded by the Center for Consumer Information and Insurance Oversight (CCIIO) as a potential model for other states in establishing their NIPA programs.

The Exchange has applied for a federal grant to support the NIPA program, and is awaiting approval.  Once approved, the Exchange will set up a competitive request for proposal process to solicit the best IPA organizations.  It will also develop a comprehensive training program to train and certify individuals performing IPA duties leading to the Exchange's launch in October 2013.

About the Connecticut Health Insurance Exchange

The Connecticut Health Insurance Exchange (the Exchange) was created by the Connecticut Legislature in 2011 and is a quasi-public agency to satisfy requirements of the federal Affordable Care Act. The mission of the Connecticut Health Insurance Exchange is to increase the number of insured residents in Connecticut, promote health, lower costs and eliminate health disparities. Its vision is to provide an on-line eligibility, shopping and enrollment experience for state residents and small businesses.

The Exchange will ensure that participating health plans available during October 2013 open enrollment meet certain standards and facilitate competition and choices by rating the quality of each plan. Individuals and families buying coverage through exchanges may qualify for premium tax credits. The exchanges also will coordinate eligibility and enrollment with state Medicaid and Children's Health Insurance Programs. More information is available by visiting www.ct.gov/hix

About the Office of the Healthcare Advocate

Since 2002, OHA has assisted and educated nearly 10,000 health insurance consumers to choose the right health plan by helping them understand the coverage that is provided in public and private insurance plans. OHA has provided direct assistance to nearly 25,000 residents through: direct advocacy on appeals and grievances with insurance companies, third party administrators and employers, facilitating coordination among government agencies that serve health care consumers, and engaging policy advocacy to strengthen consumer rights and enforce insurance industry oversight, recovering nearly $50 million for consumers. OHA routinely accepts cases from individuals and families affected by denials in coverage, treatment, or services from private health insurers, group health plans, federal employee benefits health plan, public programs (Medicaid and CHIP), Connecticut's High Risk Pool (HRA) and other public health coverage.   OHA also provides assistance to small businesses in securing small business tax credits under the ACA and for coverage questions for their employees.  More information is available by visiting www.ct.gov/oha

SOURCE Connecticut Health Insurance Exchange

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