9,666 7,087 7,688 18,122 1,656 1,292 1,483 6,812 375 385 351 1,135 (5,238) (6,486) (6,170) (14,548) (1,529) (1,655) (1,242) (4,646) (286) (330) (287) (1,031) 230,241 230,533 232,364 238,207 234,450 233,536 234,104 10,000 30,000 50,000 70,000 90,000 110,000 130,000 150,000 170,000 190,000 210,000 230,000 250,000 270,000 (20,000) (15,000) (10,000) (5,000) 0 5,000 10,000 15,000 20,000 25,000 30,000 35,000 40,000 Adds Terms Adds Terms Adds Terms Adds Terms October November December January Added to ConnectorCare Added to Unsubsidized QHP Added to QHP with APTC Termed from ConnectorCare Termed from Unsubsidized QHP Termed from QHP with APTC Enrollment as of Report Date Enrollment as of Initial Report Date z CCA Board Report Metrics • “Adds” is defined as the total number of members who begin coverage for that month and were not enrolled in coverage during the prior month as of the report date. Movement between program types is not considered an “Add”. • “Terms” is defined as the total number of members who are no longer covered for that month and were enrolled in coverage during the prior month as of the report date. Movement between program types is not considered a “Term”. • The enrollment lines show the total number of members who have coverage for that month. • “Enrollment as of Report Date” (blue line) is defined as the total number of members with coverage in that month as of the current report date and reflects retroactive adds and terms in the coverage month they take effect. These enrollment counts are dynamic. • “Enrollment as of Initial Report Date” (gray line) is defined as the total number of members who were enrolled in coverage as originally reported in the CCA Board Report Metrics published for that month, excluding retroactivity. These enrollment counts remain static month to month to visualize the effect of retroactivity. Total Non-Group Medical Enrollment: Current Rolling Quarter** Total Non-Group Medical Enrollment: Year-to-Date **Rolling Quarter time span includes previous three months and current month Closed Enrollment This report was reformatted in August 2016 with an updated methodology that tracks changes in enrollment (i.e., adds and terms) based on the member’s benefit start date. Previous reports tracked changes in enrollment as of the coverage month they took effect. For example, if an unsubsidized member began coverage in January and then failed to pay her premium for February and March coverage, in April she will be retroactively terminated as of February 1 and she will be reported as a term in the month of February; previously, she would have been reported as a term in April. Open Enrollment *Reporting period through January 2, 2017 Source: Dell Financial Management System (FMS) All Spans Extract – January 3, 2017 January 5, 2017* 191,030 202,139 208,820 213,626 217,402 215,095 219,262 225,596 230,241 230,533 232,364 238,207 196,554 208,374 215,222 214,894 223,778 219,788 224,016 230,412 234,450 233,536 234,104 10,000 30,000 50,000 70,000 90,000 110,000 130,000 150,000 170,000 190,000 210,000 230,000 250,000 270,000 (20,000) (15,000) (10,000) (5,000) 0 5,000 10,000 15,000 20,000 25,000 30,000 35,000 40,000 45,000 Adds Terms Adds Terms Adds Terms Adds Terms Adds Terms Adds Terms Adds Terms Adds Terms Adds Terms Adds Terms Adds Terms Adds Terms February March April May June July August September October November December January Added to ConnectorCare Added to Unsubsidized QHP Added to QHP with APTC Termed from ConnectorCare Termed from Unsubsidized QHP Termed from QHP with APTC Enrollment as of Report Date Enrollment as of Initial Report Date
Transcript
9,666 7,087 7,688
18,122 1,656 1,292 1,483
6,812
375 385 351
1,135
(5,238) (6,486) (6,170)
(14,548)(1,529) (1,655) (1,242)
(4,646)
(286)(330) (287)
(1,031)
230,241 230,533 232,364 238,207
234,450 233,536 234,104
10,000
30,000
50,000
70,000
90,000
110,000
130,000
150,000
170,000
190,000
210,000
230,000
250,000
270,000
(20,000)
(15,000)
(10,000)
(5,000)
0
5,000
10,000
15,000
20,000
25,000
30,000
35,000
40,000
Adds Terms Adds Terms Adds Terms Adds Terms
October November December January
Added to ConnectorCare Added to Unsubsidized QHP Added to QHP with APTC
Termed from ConnectorCare Termed from Unsubsidized QHP Termed from QHP with APTC
Enrollment as of Report Date Enrollment as of Initial Report Date
z
CCA Board Report Metrics
• “Adds” is defined as the total number of members who begin coverage for that month and were not enrolled in coverage during the prior month as
of the report date. Movement between program types is not considered an “Add”.
• “Terms” is defined as the total number of members who are no longer covered for that month and were enrolled in coverage during the prior month
as of the report date. Movement between program types is not considered a “Term”.
• The enrollment lines show the total number of members who have coverage for that month.
• “Enrollment as of Report Date” (blue line) is defined as the total number of members with coverage in that month as of the current report date
and reflects retroactive adds and terms in the coverage month they take effect. These enrollment counts are dynamic.
• “Enrollment as of Initial Report Date” (gray line) is defined as the total number of members who were enrolled in coverage as originally reported
in the CCA Board Report Metrics published for that month, excluding retroactivity. These enrollment counts remain static month to month to
visualize the effect of retroactivity.
Total Non-Group Medical Enrollment: Current Rolling Quarter**
Total Non-Group Medical Enrollment: Year-to-Date
**Rolling Quarter time span includes previous three months and current month
Closed Enrollment
This report was reformatted in August 2016 with an updated methodology that tracks changes in enrollment (i.e., adds and terms) based on the
member’s benefit start date. Previous reports tracked changes in enrollment as of the coverage month they took effect. For example, if an
unsubsidized member began coverage in January and then failed to pay her premium for February and March coverage, in April she will be retroactively
terminated as of February 1 and she will be reported as a term in the month of February; previously, she would have been reported as a term in April.
Open Enrollment
*Reporting period through January 2, 2017 Source: Dell Financial Management System (FMS) All Spans Extract – January 3, 2017
Non-Group Medical Enrollment – Unsubsidized QHP and APTC
Non-Group Medical Enrollment – ConnectorCare
26%
0%
3%
2%1%
14%54%
BMC HealthNet Plan (26%)
CeltiCare (0%)
Fallon Community Health Plan (3%)
Health New England (2%)
Minuteman Health (1%)
Neighborhood Health Plan (14%)
Tufts Health Direct (54%)
•70,232 individuals are enrolled in non-group
medical Unsubsidized QHP (60,033) or QHP with
APTC (10,199) plans.
•18,214 December ConnectorCare members lost
ConnectorCare eligibility in 2017 and are now
enrolled in January Unsubsidized QHP or APTC
coverage. Conversely, 1,937 December
Unsubsidized/APTC members are now
ConnectorCare eligible and enrolled in January
ConnectorCare coverage.
•74% of members are enrolled in either
Neighborhood Health Plan (22%), Tufts Health
Direct (37%), or BMC HealthNet Plan (15%), with
all other carriers each representing less than 10%
of the enrolled population.
•167,975 individuals are enrolled in non-group
medical ConnectorCare plans.
•18,214 December ConnectorCare members lost
ConnectorCare eligibility in 2017 and are now
enrolled in January Unsubsidized QHP or APTC
coverage. Conversely, 1,937 December
Unsubsidized/APTC members are now
ConnectorCare eligible and enrolled in January
ConnectorCare coverage.
•94% of members are enrolled in one of three
carriers: Tufts Health Direct (54%), Neighborhood
Health Plan (14%) and BMC HealthNet Plan
(26%), with all other carriers each representing
less than 5% of the enrolled population.
Enrolled Members by Metallic Tier and Standardization
Enrolled Members by Plan Type Enrolled Members by Carrier
8%
16%
34%
25%
17%
Plan Type 1 (8%)
PlanType 2a (16%)
Plan Type 2b (34%)
Plan Type 3a (25%)
Plan Type 3b (17%)
z
*Reporting period through January 2, 2017 Source: Dell Financial Management System (FMS) All Spans Extract – January 3, 2017
January 5, 2017*
375 385 351 1,135
(1,529) (1,655) (1,242) (4,646)
1,656 1,292 1,483 6,812
(286) (330) (287) (1,031)
15,288
2,926
(1,141)(796)
50,104 50,473 51,679
70,232
51,544 51,845 52,372
0
10,000
20,000
30,000
40,000
50,000
60,000
70,000
80,000
(8,000)
(3,000)
2,000
7,000
12,000
17,000
22,000
27,000
Adds Terms Adds Terms Adds Terms Adds Terms
October November December January
Added to QHP with APTC Termed from Unsubsidized QHPAdded to Unsubsidized QHP Termed from QHP with APTCRedetermined Unsub from ConnectorCare Redetermined APTC from ConnectorCareRedetermined from Unsub to ConnectorCare Redetermined from APTC to ConnectorCareEnrollment as of Report Date Enrollment as of Initial Report Date
(5,238) (6,486) (6,170)(14,548)
(2,926)
(15,288)
9,666 7,087 7,688 18,122
796 1,141 180,137 180,060 180,685
167,975
182,906 181,691 181,732
25,000
50,000
75,000
100,000
125,000
150,000
175,000
200,000
(33,000)(28,000)(23,000)(18,000)(13,000)
(8,000)(3,000)2,0007,000
12,00017,00022,000
Adds Terms Adds Terms Adds Terms Adds Terms
October November December January
Termed from ConnectorCare Redetermined from ConnectorCare to APTCRedetermined from ConnectorCare to Unsub Added to ConnectorCareRedetermined ConnectorCare from APTC Redetermined ConnectorCare from UnsubEnrollment as of Report Date Enrollment as of Initial Report Date
CCA Board Report Metrics
Non-Group Dental Enrollment
• 68,646 individuals are enrolled in
non-group dental plans.
• 51% of enrolled dental members
have selected Low Standardized
plans.
• 86% of dental members are
enrolled in Delta Dental of
Massachusetts plans, with Altus
Dental representing the remaining
enrolled population.
86%
14%Delta Dental of MA (86%)
Altus Dental (14%)
34,684
14,774
18,793
217 1700
5,000
10,000
15,000
20,000
25,000
30,000
35,000
40,000
LowStandardized
Low Non-Standardized
HighStandardized
PediatricStandardized
Pediatric Non-Standardized
Enrollment by Benefit Configuration Enrolled Members by Carrier
z
3,576 2,473 2,343
8,846
(2,413) (2,459) (1,581) (1,101)
62,980 62,464 62,060
60,108 60,122 60,88568,646
0
10,000
20,000
30,000
40,000
50,000
60,000
70,000
80,000
(5,000)
(2,500)
0
2,500
5,000
7,500
10,000
Adds Terms Adds Terms Adds Terms Adds Terms
October November December January
Adds Terms Enrollment as of Initial Report Date Enrollment as of Report Date
*Reporting period through January 2, 2017 Source: Dell Financial Management System (FMS) All Spans Extract – January 3, 2017
January 5, 2017*
CCA Board Report Metrics
Small Group Medical Enrollment**
363419
492
1050
100
200
300
400
500
600
Platinum Gold Silver Bronze
5%5%
4%
23%
4%4%
33%
11%
11%Blue Cross Blue Shield of MA (5%)
BMC HealthNet Plan (5%)
CeltiCare (0%)
Fallon Community Health Plan (4%)
Harvard Pilgrim Health Care (23%)
Health New England (4%)
Minuteman Health (4%)
Neighborhood Health Plan (33%)
Tufts Health Direct (11%)
Tufts Health Premier (11%)
67%
13%
12%
5% 3% Delta Dental of MA (67%)
MetLife (13%)
Altus Dental (12%)
Blue Cross Blue Shield of MA (5%)
Guardian (3%)
73%
26%
1%
High Low Pediatric-only
16 7 7 6
3 17 1 10 6 4 2 4 0
(4)(4)
(4) (1) (1) (3) (1) (2) 0 (1) (3)(2)
159 162 165 170 172 186 186 194 200 203 202 194
759 755 783 857 879987 975
1,029 1,064 1,069 1,0671,012
(400)
(200)
0
200
400
600
800
1,000
1,200
1,400
(25)
0
25
50
75
100
125
150
175
200
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s
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s
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s
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s
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s
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s
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Term
s
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Term
s
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ds
Term
s
February March April May June July August September October November December January
Group Adds Group Terms Group Enrollment Member Enrollment
