OLR Research Report


October 25, 2013

 

2013-R-0402

HEALTH EXCHANGE EMPLOYEES AND THEIR ROLES

By: Kevin E. McCarthy, Principal Analyst

You asked for the following information regarding the Connecticut Health Exchange and related entities:

1. the number of employees that work directly for the exchange, where they work, and the type of work they do;

2. the number of employees that work for private companies on contracts with the exchange (i.e., employed by Maximus in a call center), where they work, what they do, and the price of the contract; and

3. the number of employees that are grant-hires through the exchange, where they work, what they do, and the source and amount of the grant.

We answer each question in turn.

EXCHANGE EMPLOYEES

The exchange is a marketplace that offers health insurance and coverage options to individuals, families, and small employers. It currently has 57 direct staff, who are based at 280 Trumbull Street in Hartford. The employees work in the following roles or areas: executive (2), plan management (5), operations (9), marketing (15), finance (5), information technology (5), administration (8), legal (6), and analysis (2). The exchange's webpage, http://www.ct.gov/hix/cwp/view.asp?a=4295&q=506358, lists the job titles of individual staff members. The exchange also operates a storefront location in New Britain and will be opening one in the next few weeks in New Haven.

CONTRACTOR EMPLOYEES

The exchange has contracts with a wide range of entities to provide services in such areas as customer service, information technology, and legal services. Links to the contracts are available at http://www.ct.gov/hix/cwp/view.asp?a=4296&q=506834.

The primary service contract is with Maximus Health Services.

On February 13, 2013, the exchange entered into a contract with Maximus to serve as its primary customer service center. In this role, Maximus helps state residents determine their eligibility for, and enroll in, a qualified health plan. The service center also helps consumers who use the exchange's Web portal and the interactive voice response telephone system. Maximus has 23 customer service representatives who work from the same address as the exchange. Additional Maximus employees in New York City handle calls if there is a back-up.

The contract runs until August 31, 2016 and Maximus can extend it for one two-year period. According to Maximus, the value of the base contract is $15 million. The exchange can terminate the contract without cause after providing at least 60 days' notice. The exchange can also terminate the contract for cause, as specified in the contract. The contract is available at http://www.ct.gov/hix/lib/hix/ExecutedContract.pdf.

GRANT HIRES

The exchange has provided grants to two types of organizations called navigators and assisters, described below, to help with its outreach efforts. According to Kate Gervais, manager of the exchange's Navigator and Assister Outreach Program, the exchange does not anticipate that these organizations will hire staff for their exchange-related responsibilities and instead will use their existing staffs. She anticipates that much of this work will be short term in nature.

In August 2013, the exchange awarded grants to six regional navigator organizations that will be responsible for developing and implementing regional outreach strategies for the exchange. The regions and organizations are:

1. Fairfield County (Southwestern Area Health Education Center);

2. Hartford County, plus Cromwell, Middlefield, Middletown, and Rockfall (Hispanic Health Council);

3. the remainder of Middlesex County and New London County (Eastern Area Health Education Center, Inc.,);

4. Litchfield County (New Opportunities);

5. New Haven County (City of New Haven Department of Health); and

6. Tolland and Windham Counties (The Access Agency).

The grants provided to these organizations ranged from $25,000 to $40,000.

The exchange awarded $6,000 grants to approximately 300 community-based organizations that are called “assisters” under the federal Affordable Care Act. These include civic organizations, faith-based groups, businesses, labor organizations, and health care organizations. They will provide one-on-one education and enrollment services to consumers. Assisters are distributed based on concentrations of the uninsured throughout the state. The exchange's website listing the assisters and their locations is not yet available; we will provide this information to you as soon as possible.

Navigators and assisters must complete up to 40 hours of training and pass a certification test and a background check. Navigators will provide support and direction to assister organizations in their region.

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