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Projections for Colorado health insurance marketplace to be revised

December 10, 2013 Updated: December 10, 2013 at 12:20 pm

A Colorado insurance executive questioned the ability of the state's health insurance marketplace and Medicaid website to handle any possible surge of customers later in December.

The number of people covered on exchange-based insurance plans grew to 15,074 through Saturday, amid a wave of more than 700 enrollments a day in December, Connect for Health Colorado officials announced Monday.

Despite the recent jump in sign-ups, totals have been weaker than originally expected, and marketplace officials said they are working internally to create new enrollment projections.

Officials' worst-case scenarios initially pictured 22,215 people enrolling in December. Their mid-range enrollment projection was 40,372 people enrolling this month.

The projection revisions didn't worry Steve ErkenBrack, a marketplace board member and president of Rocky Mountain Health Plans, because "the fact of the matter is nobody has done this before," he said.

But he voiced concerns that people who dropped their old plans in favor of exchange-based insurance may end up without coverage Jan. 1, due to an inability of the exchange and Medicaid systems to process a spike in applications.

"A lot of our efforts the past year have been focused on how do we get people to come," ErkenBrack said. "But now we're trying to deal with how do we service the people who want to come, and make sure that they're going to have continuous coverage."

Coloradans have until Dec. 23 to enroll, if they want that coverage to begin Jan. 1.

Marketplace officials also recently gave enrollees a new, 10-day reprieve for paying their first premium to their carrier. Originally, consumers needed to pay their first month's payment by Jan. 1. On Friday, the exchange delayed that deadline until Jan. 10.

The delay means that Coloradans have until that date to remain in good standing with their insurance carrier, if they purchased a plan on the exchange by the Dec. 23 deadline, said Myung Kim, a marketplace spokeswoman.

People have until March 31 to enroll, as long as they don't mind their coverage beginning later in the year.

But before Coloradans can pay, they must first enroll. And anyone looking to receive federal subsidies as a part of that enrollment first must fill out a Medicaid form and receive a denial number - a process that troubled ErkenBrack.

He pushed marketplace officials to seek a waiver from the federal government, one that would help ease the burden of having to be turned down by Medicaid in order to receive a subsidy.

More than 70 percent of the time, Medicaid denial forms are being returned to customers immediately, said Susan Birch, executive director of the Colorado Department of Healthcare Policy and Financing. The agency had a 30-percent immediate denial rate in October.

Medicaid officials cleared about 1,000 applications a day last week, about the same number as the agency received. But as of Monday morning, it had about 2,300 applications waiting to be resolved - most of which include mistyped information, requiring officials to backtrack and resolve each issue.


EDITOR'S NOTE: This story has been changed to correctly state initial insurance enrollment projections, which are 22,215 enrollment in December as a worst-case scenario, and 40,372 this month as a mid-range projection.

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