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Colorado Insurance Exchange Week One: Few Enrollments, Lots Of Interest

Despite a relatively low number of people buying coverage in its first week, the board in charge of Colorado’s health insurance exchange is generally pleased with how it’s running.

Connect for Health Colorado, which is branding itself as C4HCO, says it had 162,941 unique visitors to its website October 1-7. Of those, 226 purchased health coverage for themselves and dependents, totaling 305 covered lives.

Connect for Health has set a goal of signing up 136,000 in the health law’s first open enrollment period ending March 31, 2014. The Colorado Health Institute estimates that 829,000 of Colorado’s 5 million residents are uninsured, 243,000 of whom will be eligible for Affordable Care Act subsidies to help them afford coverage starting next year.

Another 160,000 of the uninsured will be eligible for Medicaid, according to a state estimate.

The small number of buyers “doesn’t come as a surprise,” says C4HCO CEO Patty Fontneau. Buying health insurance “is a complicated process and people have months to be able to go through and figure out what works best for them, and we’re encouraging them to do so.”

Fontneau characterizes the effort so far as a “success,” citing the 18,174 people who created accounts on C4HCO’s shopping site. That’s because, she says, it’s a step beyond just shopping anonymously. Unlike the federal exchange, Colorado’s site users can compare specific plans and prices, including their final cost after a possible subsidy, all without entering personal information. The amount of a subsidy depends on the buyer’s income.

“You don’t have to create an account to do much of anything on our site,” she says, “so for people to have created an account (entering personal information) means that they’re serious in continuing the shopping process with us.”

The C4HCO board heard criticism of their site’s functionality from Karen Spink, who works for a northern Colorado nonprofit which gets grant money from the board to help people enroll. She said users who know they don’t qualify for a subsidy “are very frustrated” when they have to wait 90 minutes or more for the site to officially determine that, before letting them follow through with actually purchasing a policy. She said one user was told a determination would take 7-10 days.

Spink’s feedback was based on her organization helping a total of 37 people face to face.

“Overall we’re seeing mixed responses,” to the exchange Spink says, “from overwhelmed to nervous to worried about costs. Some are absolutely thrilled at the cost of plans, others, who are not getting subsidies think (health insurance) is completely unobtainable for them.”

Spink also said one user was put on hold for 45 minutes after contacting C4HC’s phone-in customer service center. Exchange officials say the time it takes callers to be helped has dropped from an average of over five minutes to between one and two minutes, and that they want to drive that time down further.

Fontneau says the call center is giving its more than 180 attendants additional training based on customer feedback, and trying to “balance getting the additional training out to our service representatives, and not pulling them off the phone as our volumes are coming in.”

Most board members appeared happy with C4HCO’s operations so far, and accepted Fontneau’s assessment that enrollment numbers in the first week are not a great indicator of future success or failure. But board member Eric Grossman, an executive at the health IT company TriZetto, noted that only about 1 percent of site visitors became buyers in the first week. He applauded the staff for keeping the site operating over 97 percent of the time, but pushed for improvements.

“Ninety-seven percent is still 45 minutes (per day of downtime), which is not insignificant,” he said.

A technology supervisor said the 3 percent downtime now is because the site is being updated to fix glitches and add functionality on a weekly basis. She said fixes could be done once a month soon.