ConnectiCare’s role in 2017 health exchange stuck in legal limbo

This is a picture of Access Health's New Britain store

Arielle Levin Becker / The CT Mirror

Access Health’s New Britain store

The question of whether the largest insurer on Connecticut’s health insurance exchange will participate in 2017 fell into legal limbo late Monday afternoon.

ConnectiCare Insurance Co., which already is contesting a Department of Insurance rate decision in court, challenged the matter through a second venue Monday, the department’s administrative appeal process.

The Insurance Department immediately began consultations with Attorney General George Jepsen’s office on how to proceed given the two-track challenge.

And the state’s health exchange, Access Health CT, announced it would wait temporarily for the insurance department to resolve the rate appeal.

“ConnectiCare is actively working to stay on Access Health CT,” ConnectiCare President and CEO Michael Wise wrote in a statement. “We have asked Access Health CT to extend their deadline so we can continue to work together to ensure that the over 50,000 Connecticut citizens we serve can keep their health plan.”

Insurance Department spokeswoman Donna Tommelleo said, “The Department does recognize the need for an expedited action, however there are questions over complexities that still may exist with litigation the carrier filed last week.”

“Therefore the department is in consultation with the Attorney General’s office to determine the interrelationship between this new administrative appeal and the Superior Court litigation before moving forward,” Tommelleo added.

“Access Health CT’s number one priority has always been and continues to be our customers,” Lt. Gov. Nancy Wyman, who chairs the exchange’s governing board, and Jim Wadleigh, CEO of Access Health CT, wrote in a statement Monday. “We are a national leader in healthcare because we are 100 percent committed to ensuring that Connecticut residents have access to affordable, high-quality healthcare. This is certainly a challenge, but AHCT will continue to adapt to the changing healthcare market with an eye on ensuring our consumers the best options.”

Wyman and Wadleigh, who had set a deadline of Monday to set exchange participants for 2017, also noted that they had received a letter from ConnectiCare last Friday indicating it would not participate next year. But that was before the company launched its administrative appeal on Monday.

ConnectiCare charged last week in its lawsuit that the department did not approve adequate rates for its health exchange plans for the coming year.

The company originally sought to increase its premiums by an average of 14.3 percent, then increased its request to 17.4 percent in early August, and eventually to 27.1 percent. The department approved a 17.4 percent hike.

Access Health CT CEO James Wadleigh

Access Health CT CEO James Wadleigh

ConnectiCare says that new data became available after Aug. 4 that shows the 17.4 percent request is not adequate. The company projects $20 million in losses from their exchange plans this year.

The fate of the Farmington-based ConnectiCare could have a huge impact on the exchange, which already has lost two of its four carriers.

UnitedHealthcare and the state’s health insurance co-op, HealthyCT, are already in position to withdraw from the exchange after this year. They insure about 13,000 customers on the exchange, which is about 12 percent of the total.

ConnectiCare covers about 48,000 customers, or about half of all of those on the exchange.

If ConnectiCare departs, that would leave Anthem as the only option on the exchange. About three-fourths of all plans sold through Connecticut’s exchange in 2016 qualified for federal subsidies to offset at least a portion of the cost.

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