The Massachusetts Health Connector is the state’s health insurance exchange or marketplace, which provides access to affordable, quality health insurance for residents and small businesses of Massachusetts. In response to the unprecedented impacts of the coronavirus, the Health Connector continues to serve the residents of the Commonwealth, whether they are existing members or enrolling with the Health Connector for the first time.
For your reference, please find important messages and updates to Health Connector policies in response to COVID19 crisis, below, and please visit http://www.mahealthconnector.org/covid-19 for more information.
LOSS OF EMPLOYMENT
As individuals lose employment, they may also lose access to their employer sponsored health insurance. As incomes are reduced, individuals may benefit from the opportunity to apply for subsidies or compare plans side by side and select a health plan that suits their needs best. Additional health insurance resources for those who have recently lost their employment can be found at http://www.mahealthconnector.org/wp-content/uploads/health-coverage-after-a-job-loss-eng.pdf and in Spanish at http://www.mahealthconnector.org/wp-content/uploads/health-coverage-after-a-job-loss-esp.pdf
Please keep in mind that loss of health insurance coverage (that meets minimum standards) as a result of job loss is considered a qualifying life event (QLE) year-round and will always open a special enrollment period (SEP) for an otherwise eligible resident.
SPECIAL ENROLLMENT PERIOD (SEP) AVAILABLE THROUGH MAY 25th
The Health Connector established a Special Enrollment Period for any otherwise eligible individual who does not currently have health insurance coverage, or may have experienced changes in circumstances, to enroll in health insurance.
Typically, a person who does not have a qualifying life event is only able to enroll in coverage during Open Enrollment, which occurs in the fall. This SEP provides access to health insurance coverage for those individuals who may not have enrolled during Open Enrollment 2020.
Individuals can access the SEP through their on-line account and more information can be found here:
IMPORTANCE OF REPORTING INCOME CHANGES
The Health Connector is urging members to make changes to their online application to reflect any changes in circumstances, such as losing a job, reduced hours, or other reduced income.
Many Health Connector members receive state and federal subsidies that make monthly health insurance premiums more affordable. The Health Connector is communicating with members to remind them to return to their online accounts to update their information (income, etc.) as it may result in a lower monthly premium.
Individuals who may not have received financial subsidies previously may be newly eligible for financial assistance to make health insurance premiums more affordable. All members should return to their accounts to report any changes in circumstances.
HELPING PEOPLE STAY IN COVERAGE
The Health Connector has paused terminations or reduction of subsidies that would otherwise result from members not responding to requests for information.
The Health Connector is also taking emergency steps to prevent termination and suspension of health care services for members, currently in delinquency, that have been unable to pay premiums in March and would otherwise have had their April coverage terminated. The Health Connector has created a temporary premium deferral program that allows individual and small employer members to hold off on making premium payments until a later date. The Health Connector is contacting members who are eligible for the premium deferral program in their May premium invoice to inform them of next steps.
IMPORTANT DATES FOR MEMBERS
For new members, the monthly 23rd deadline remains critical for plan selection and payment. The Health Connector is unable to make adjustments that would introduce flexibility with respect to this initial enrollment deadline.
For existing members, updates and changes to their information that are submitted after the 23rd will now be honored to take effect on the first of the next month (i.e. change of information submitted on 4/24 – 4/30 will be effective for 5/1). Previously, if a member made an update to their application that changed their subsidy benefit after the 23rd of the month, it would not take effect beginning the next month (i.e. change of information submitted on 4/24 – /30 will be effective for 6/1).
ENSURING COVERAGE FOR COVID-19 RELATED CARE
In accordance with Division of Insurance requirements, all plans issued through the Health Connector are required to cover services for telemedicine and reduced cost-sharing for testing and treatment related to COVID-19. More information regarding the steps the Division of Insurance has taken can be found here https://www.mass.gov/doc/bulletin-2020-02-addressing-covid-19-coronavirus-testing-and-treatment-issued-362020/download.
CALL CENTER ASSISTANCE
New and existing members are encouraged to update their accounts online https://www.mahealthconnector.org/ or call customer service for assistance 1-877-MA-ENROLL(1-877-623-6765) as the four Health Connector Walk-In Centers in Springfield, Worcester, Brockton and Boston have been temporarily closed to support public health. Navigator and Certified Application Counselors continue to be available, but with limited in-person availability. They have the ability to assist consumers remotely, and individuals should always call first to discuss the best way to access assistance.
Also, please be aware of a coronavirus assessment tool developed by the Baker-Polito Administration available at www.mass.gov/online-health-tool. While this tool should never substitute professional medical advice, testing or treatment, it may help you assess your symptoms and determine appropriate next steps, including telemedicine screening.