As the open enrollment period for the Massachusetts Health Connector (MHC) rolls into its third week, health insurance advisors at the Vineyard Healthcare Access program (VHA) are reporting that, contrary to the mayhem of last year’s open enrollment, the new and improved Massachusetts Health Connector is performing as advertised.
“It’s a world of difference,” Sarah Kuh, VHA director told The Times. “It’s working just like it was originally supposed to, but never was until now. You can’t even compare the functionality.”
Ms. Kuh said that as of Wednesday, VHA has submitted applications for 188 Islanders and 62 are enrolled in a health plan. She said that the vastly improved website, while not totally bug-free, has helped the VHA staff serve Islanders more efficiently. “We can sit down with people and complete an application and 75 to 80 percent of the time, we can get them through the entire process, and enrolling them in a health plan, in one sitting,” she said, adding that the application process usually takes about an hour and a half.
Paul Munafo of Vineyard Haven had a consultation at VHA two weeks ago. In a conversation with The Times, he was effusive in his praise for the VHA staff. “Last year when we tried to sign up on the website, it was a disaster. I was on a transplant list and I needed insurance for expenses that were perhaps going to come. We got such a runaround we had to get our own insurance through HSA. We ended paying $1,300 a month. This year was like we’ve landed in Oz. It was flawless. We’re saving approximately $500 a month now. For us, that’s huge. Mary Leddy [a staff member at VHA] is awesome; I can’t say enough about her. She knows more about insurance than anybody I’ve ever met. We’re very lucky to have Vineyard Healthcare Access.”
Island navigators
Earlier this year, VHA applied for a grant to fund the specialized training needed to qualify as a “navigator” for MHC for Dukes County. In August, VHA was selected as one of five new navigators in the state — there are 15 navigators statewide. All four of the VHA client services staff, Ms. Kuh, Ms. Leddy, Maria Mouzinho, and Vani Pessoni are Certified Massachusetts Navigators. They can advise the insured and the uninsured, small businesses owners, the self-employed, and seasonal workers. The multilingual staff can assist all Island residents.
The current lead time for a consultation at the VHA is four to six weeks. “People who receive no subsidies — meaning they have private insurance through the Health Connector — have a December 23 deadline,” Ms. Kuh said, but she stressed that accommodations can still be made for people with that deadline. “We do have ways of squeezing people in as needed,” she said. “We’ve also been training a new staff member who should be certified by next week. That will open up availability as well.”
Most people have a deadline of January 23, 2015, according to Ms. Kuh.
“For people who are clearly over income for any subsidies or tax credits, they don’t have to go through the Health Connector, they can go to a broker. That’s usually pretty efficient.”
Eligibility
People who make under 400 percent of the federal poverty level (FPL) as determined by the Department of Health and Human Services (DHHS) are potentially eligible for health care subsidies. The poverty line for an individual is $11,670, so an individual making under $46,680 may qualify, as could two people making under $62,920; families of three or four have limits of $79,160 and $95,400, respectively.
Applicants must bring last year’s tax returns and the last two or three pay stubs and any other income information, such as Social Security payments. For seasonal workers, the last pay stub of the season is required.
“There are instances where proof of residency is required, which can be satisfied by a utility bill,” Ms. Kuh said. “If proof of income or proof of residency is required, applicants will have 90 days to submit that information. When people are not U.S. citizens born in the U.S. — if they’re either naturalized citizens or have a different immigration status — we need their green card and certificate of naturalization.”
Federal I.D. proofing, a major bugaboo in last year’s open enrollment, has been fixed, according to Ms. Kuh. “This is part of what wasn’t working in the old system but is working now,” she said. “When people put in their information, like their Social Security number, this system matches that to certain federal information. When that fails, then the online application can’t continue, then people do have to verify their identity. This requires another appointment to complete the application, but it doesn’t happen often.”
Check yourself
The three-month enrollment period ends February 15, but different subgroups have different deadlines, so Ms. Kuh advises Islanders to confirm their deadline as early as possible. She also recommends that people try the Health Connector website on their own. “Obviously we want to be available for everybody who wants our help, but it’s worth the try to do it own their own because the website is working this time.”
Joanne Metayer Lambert, a pre-school teacher from Oak Bluffs, has followed Ms. Kuh’s advice. “We have an appointment with Mary Leddy on December 15,” she told The Times. “I’m working on the [Health Connector] website now to begin our new application, and it’s very user friendly. We’ll go to Mary to finalize it and make sure all the t’s are crossed. Mary has been a huge help in the past. Thank goodness we have that office.”
