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ConnectorCare changes for 2017

Much higher premiums tied to plan choices even for the very poor

Bad news from the Connector at yesterday's board meeting. Since the Connector started offering coverage in 2006, its enrollees below the poverty level, like MassHealth enrollees, have been able to choose from any available managed care organization (MCO) with no premium charge. No more. People at all income levels will still have access to at least one "affordable" MCO -- for people below 150% FPL, affordable means no member premium contribution--but other choices may mean substantially higher premiums.

This will primarily affect the 43,000 people enrolled in Neighborhood Health Plan (24% of all ConnectorCare members) and the 5400 enrolled in Health New England. NHP is owned by Partners & the only plan to include the flagship Parners' hospitals and affiliated doctors in its network. HNE is owned by Baystate Health with 5 hospitals in Western Mass.  NHP is the "affordable" plan only on the Islands and Baystate Health hospitals are in "affordable plans" only in the Franklin County region not in the rest of Western Mass.This means a person with little or no income now enrolled in NHP in Boston or HNE in Springfield for 2017 will either have to change plans (& probably change doctors) or go from no premium to $ 152 per month for one person $304 per month for a couple. 

The Boston Globe has the story on today's front page quoting HCFA's Suzanne Curry on how disruptive this will be.

Tables showing the Connector Care monthly premium contributions for 2017 by Region and Plan Type are attached. PT 1 is for people under 100% fpl. PT 2A 100-150% fpl; PT2B 150-200% fpl; PT 3A 200-250% fpl; and PT 3B is 250-300% fpl. 

Warning from IRS for those who got advance premium tax credits in 2015 but have not yet filed 2015 taxes: File or lose 2017 advance premium tax credits.

In Massachusetts, that means ConnectorCare members in 2015 will lose ConnectorCare for 2017 unless they filed their federal taxes and "reconciled" the tax credit  paid to their health plans to reduce premium charges for 2015.

We guesstimate as many as 10,000 ConnectorCare enrollees may need to get their 2015 returns filed soon to avoid a break in coverage in 2017.  Many of these late filers probably have income below tax filing thresholds and are only required to file because their insurance company received an "advance premium tax credit" when they enrolled in ConnectorCare. Unfortunately, much of the free tax preparation help during tax season is not available off-season for late filers.

A copy of the IRS notice and more information is available on the IRS website here.

File Attachment: 
PDF icon ConnectorCare 2017 Contributions.pdf461.14 KB