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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 **Rolling Quarter time span includes previous three months and current month 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. *Reporting period through July 2, 2017 Source: NTT Data Financial Management System (FMS) All Spans Extract – July 3, 2017 10,874 9,756 9,601 9,051 1,857 1,600 1,859 1,923 523 513 409 394 (7,710) (8,120) (4,289) (5,086) (2,200) (2,510) (1,258) (1,747) (485) (525) (365) (410) 239,363 240,074 246,031 250,156 244,756 245,748 248,851 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 (28,000) (23,000) (18,000) (13,000) (8,000) (3,000) 2,000 7,000 12,000 17,000 22,000 27,000 32,000 37,000 Adds Terms Adds Terms Adds Terms Adds Terms April May June July 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 219,042 225,202 228,875 227,998 226,190 226,698 231,294 236,505 239,363 240,074 246,031 250,156 224,016 230,412 234,450 233,536 234,104 238,207 246,831 246,073 244,756 245,748 248,851 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 (30,000) (25,000) (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 August September October November December January February March April May June July 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 July 6, 2017*
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Page 1: July 6, 2017* CCA Board Report Metrics...z CCA Board Report Metrics •“Adds” is defined as the total number of members who begin coverage for that month and were not enrolled

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

**Rolling Quarter time span includes previous three months and current month

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.

*Reporting period through July 2, 2017 Source: NTT Data Financial Management System (FMS) All Spans Extract – July 3, 2017

10,874 9,756 9,601 9,051

1,857 1,600 1,859 1,923

523 513 409 394

(7,710) (8,120)(4,289) (5,086)

(2,200) (2,510)(1,258) (1,747)

(485) (525)(365) (410)

239,363 240,074 246,031 250,156

244,756 245,748 248,851

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

(28,000)

(23,000)

(18,000)

(13,000)

(8,000)

(3,000)

2,000

7,000

12,000

17,000

22,000

27,000

32,000

37,000

Adds Terms Adds Terms Adds Terms Adds Terms

April May June July

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

219,042 225,202 228,875 227,998 226,190226,698 231,294 236,505 239,363 240,074 246,031 250,156

224,016 230,412 234,450 233,536 234,104 238,207 246,831 246,073 244,756 245,748 248,851

10,00030,00050,00070,00090,000110,000130,000150,000170,000190,000210,000230,000250,000270,000

(30,000)(25,000)(20,000)(15,000)(10,000)

(5,000)0

5,00010,00015,00020,00025,00030,00035,00040,00045,000

Ad

ds

Term

s

Ad

ds

Term

s

Ad

ds

Term

s

Ad

ds

Term

s

Ad

ds

Term

s

Ad

ds

Term

s

Ad

ds

Term

s

Ad

ds

Term

s

Ad

ds

Term

s

Ad

ds

Term

s

Ad

ds

Term

s

Ad

ds

Term

s

August September October November December January February March April May June July

Added to ConnectorCare Added to Unsubsidized QHP Added to QHP with APTC

Termed from ConnectorCare Termed from Unsubsidized QHP Termed from QHP with APTCEnrollment as of Report Date Enrollment as of Initial Report Date

July 6, 2017*

Page 2: July 6, 2017* CCA Board Report Metrics...z CCA Board Report Metrics •“Adds” is defined as the total number of members who begin coverage for that month and were not enrolled

Enrolled Members by Carrier

5%

17%

4%

3%

4%

5%

19%

37%

6% Blue Cross Blue Shield of MA (5%)

BMC HealthNet Plan (17%)

CeltiCare (0%)

Fallon Community Health Plan (4%)

Health New England (3%)

Harvard Pilgrim Health Care (5%)

Minuteman Health (5%)

Neighborhood Health Plan (19%)

Tufts Health Direct (37%)

Tufts Health Premier (6%)

CCA Board Report Metrics

4,313

85,2694,123

21,069

20,999

3,952

1,144387

0

10,000

20,000

30,000

40,000

50,000

Platinum Gold Silver Bronze Catastrophic

Standardized - Platinum Non-Standardized - Platinum

Standardized - Gold Non-Standardized - Gold

Standardized - Silver Non-Standardized - Silver

Standardized - Bronze Non-Standardized - Bronze

Standardized - Catastrophic

Non-Group Medical Enrollment – Unsubsidized QHP and APTC

Non-Group Medical Enrollment – ConnectorCare

33%

1%

3%

2%1%

10%

50%

BMC HealthNet Plan (33%)

CeltiCare (1%)

Fallon Community Health Plan (3%)

Health New England (2%)

Minuteman Health (1%)

Neighborhood Health Plan (10%)

Tufts Health Direct (50%)

• 51,499 individuals are enrolled in non-group

medical Unsubsidized QHP coverage and 9,765

individuals are enrolled in QHP with APTC plans.

• 1,296 members who were enrolled in June

ConnectorCare plans are now enrolled in

Unsubsidized QHP or APTC coverage for July.

• 72% of members are enrolled in either

Neighborhood Health Plan, Tufts Health Direct,

or BMC HealthNet Plan, with all other carriers

each representing less than 10% of the enrolled

population.

• 652 members who were enrolled in

Unsubsidized/APTC plans in June are now

enrolled in July ConnectorCare coverage.

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

523 513 409 394 (2,200) (2,510) (1,258) (1,747)

1,857 1,600 1,859 1,923

(485) (525)(365) (410)

58,886 58,22660,460 61,264

61,841 60,910 61,671

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

Adds Terms Adds Terms Adds Terms Adds Terms

April May June July

Added to QHP with APTC Termed from Unsubsidized QHP

Added to Unsubsidized QHP Termed from QHP with APTC

Enrollment as of Report Date Enrollment as of Initial Report Date

(7,710) (8,120)(4,289) (5,086)

10,874 9,756 9,601 9,051

180,477 181,848 185,571 188,892

182,915 184,838 187,180

25,000

50,000

75,000

100,000

125,000

150,000

175,000

200,000

(22,000)

(17,000)

(12,000)

(7,000)

(2,000)

3,000

8,000

13,000

18,000

23,000

Adds Terms Adds Terms Adds Terms Adds Terms

April May June July

Termed from ConnectorCare Added to ConnectorCare

Enrollment as of Report Date Enrollment as of Initial Report Date

*Reporting period through July 2, 2017 Source: NTT Data Financial Management System (FMS) All Spans Extract – July 3, 2017

July 6, 2017*

Page 3: July 6, 2017* CCA Board Report Metrics...z CCA Board Report Metrics •“Adds” is defined as the total number of members who begin coverage for that month and were not enrolled

CCA Board Report Metrics

Non-Group Dental Enrollment

87%

13%Delta Dental of MA (87%)

Altus Dental (13%)

36,106

15,888

20,177

130 830

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

*Reporting period through July 2, 2017 Source: NTT Data Financial Management System (FMS) All Spans Extract – July 3, 2017

3,216 3,020 2,908 3,194

(2,859) (3,222)(1,027) (1,361)

72,238 72,258 72,289

68,868 68,666 70,548 72,384

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

April May June July

Adds Terms Enrollment as of Initial Report Date Enrollment as of Report Date

July 6, 2017*

Page 4: July 6, 2017* CCA Board Report Metrics...z CCA Board Report Metrics •“Adds” is defined as the total number of members who begin coverage for that month and were not enrolled

CCA Board Report Metrics

Small Group Medical Enrollment**

323404

521

1050

100

200

300

400

500

600

Platinum Gold Silver Bronze

5%6%

4%

17%

4%

4%

29%

18%

Blue Cross Blue Shield of MA (5%)

BMC HealthNet Plan (6%)

CeltiCare (0%)

Fallon Community Health Plan (4%)

Harvard Pilgrim Health Care (17%)

Health New England (4%)

Minuteman Health (4%)

Neighborhood Health Plan (29%)

Tufts Health Direct (18%)

Tufts Health Premier (13%)

71%

5%

14%

6% 4% Delta Dental of MA (71%)

MetLife (5%)

Altus Dental (14%)

Blue Cross Blue Shield of MA (6%)

Guardian (4%)

72%

27%

1%

High Low Pediatric-only

1 10 6 4 2

6 6 5 3 1 5 5 (1) (2) 0 (1) (3) (4) 0 0 (6) (1) (7) (1)

186 194 200 203 202 204 210 215 212 212 210 202

975 1,029 1,064 1,069 1,067 1,073 1,105 1,125 1,118 1,140 1,1441,095

(400)

(200)

0

200

400

600

800

1,000

1,200

1,400

(25)

0

25

50

75

100

125

150

175

200

Ad

ds

Term

s

Ad

ds

Term

s

Ad

ds

Term

s

Ad

ds

Term

s

Ad

ds

Term

s

Ad

ds

Term

s

Ad

ds

Term

s

Ad

ds

Term

s

Ad

ds

Term

s

Ad

ds

Term

s

Ad

ds

Term

s

Ad

ds

Term

s

August September October November December January February March April May June July

Group Adds Group Terms Group Enrollment Member Enrollment

29 29 33 32 47 76 71 46 82 54 46 27(22) (37) (27) (41) (36) (14) (51) (69) (29)(87) (72) (32)

1,385 1,377 1,383 1,374 1,385 1,447 1,467 1,444 1,497 1,464 1,438 1,353

6,157 6,104 6,330 6,286 6,400 6,405 6,464 6,386 6,233 6,264 6,237 5,803

(6,000)

(4,000)

(2,000)

0

2,000

4,000

6,000

8,000

(100)

(50)

0

50

100

150

200

250

300

350

400

Ad

ds

Term

s

Ad

ds

Term

s

Ad

ds

Term

s

Ad

ds

Term

s

Ad

ds

Term

s

Ad

ds

Term

s

Ad

ds

Term

s

Ad

ds

Term

s

Ad

ds

Term

s

Ad

ds

Term

s

Ad

ds

Term

s

Ad

ds

Term

s

August September October November December January February March April May June July

Group Terms Group Adds Group Enrollment Member Enrollment

Enrolled Groups by Metallic Tier Enrolled Groups by Carrier

Enrolled Groups by Metallic Tier Enrolled Groups by Carrier

Small Group Dental Enrollment**

** July counts do not include BCBS membership and reference a subset of data resulting in preliminary enrollment counts

** Group adds and terms represent a point-in-time snapshot of small group membership and may not include membership retroactivity

July 6, 2017*

*Reporting period through July 1, 2017 Sources: SBSB SHOP Database – July 1, 2017; NTT Financial Management System (FMS) – July 3, 2017

Page 5: July 6, 2017* CCA Board Report Metrics...z CCA Board Report Metrics •“Adds” is defined as the total number of members who begin coverage for that month and were not enrolled

CCA Board Report Metrics

Customer Experience

z

July 1, 2017*

*Reporting period through June 30, 2017Source: NTT Data

90

80

87

75

70 7

4

70

74

74

68

98

13

4

12

9

82

10

0

71 7

5 77

0

25

50

75

100

125

150

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

Th

ou

san

ds

Call Volume 2016 v. 2017

2016 2017

4.9

%

4.7

%

7.7

%

3.9

%

2.5

%

1.9

%

6.9

%

9.0

%

13

.1%

3.6

%

0.7

% 1.4

%

7.2

%

2.0

%

3.4

%

0.3

%

1.0

%

0.3

%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

Abandonment Rate 2016 v. 2017

2016 2017

15

1

12

4 17

4

98

59

46

14

8

20

9

29

5

83

21 4

3

18

4

58

10

0

13 3

5

13

0

50

100

150

200

250

300

350

400

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

se

co

nd

s

Average Speed to Answer 2016 v. 2017

2016 2017

76%

85%77%

7%

7%

9%4%

2%4%3%

3%3%

10%3%

7%

0%

20%

40%

60%

80%

100%

CSR Satisfaction CSR Friendliness CSR Knowledge

Customer Satisfaction Score – June 2017

Questions

--How satisfied are you with how our customer service

representative resolved your issue today?

---How friendly and courteous our customer service representative

was today?

--How satisfied are you with the knowledge of the customer service

representative you spoke with today?

--How satisfied are you with the overall service provided to you by

the Health Connector today?

Very dissatisfied Dissatisfied Neither dissatisfied or satisfied

Satisfied Completely satisfied

59%

59%

60%

62%

60%

62%

61%

62%

68%

63%

63%

62%

61% 66% 65% 67% 70% 66%

13%

13%

13%11%

12%10%

13%12%

13%

11%12%

10%13%

12% 13% 10%7%

12%

8%7%

7%7% 7%8%

8%7%

6%

8% 8%

10%8%

7% 6% 7% 9% 7%6%

4%5%6% 4%

6%4%5%

2%7% 5%4% 6%

6%4% 4%

5% 5%

14%

17%

15%14%

17%

14%

14%

14%

11%11%

12%

14%12%

9%12% 12%

9% 10%

0%

20%

40%

60%

80%

100%

Jan

-16

Jan

-17

Fe

b-1

6F

eb

-17

Ma

r-1

6M

ar-

17

Ap

r-1

6A

pr-

17

Ma

y-1

6M

ay-

17

Jun

-16

Jun

-17

Jul-1

6Ju

l-1

7

Au

g-1

6A

ug-1

7

Se

p-1

6S

ep

-17

Oct-

16

Oct-

17

No

v-1

6N

ov-1

7

De

c-1

6D

ec-1

7

Overall Customer Satisfaction 2016 v. 2017

Page 6: July 6, 2017* CCA Board Report Metrics...z CCA Board Report Metrics •“Adds” is defined as the total number of members who begin coverage for that month and were not enrolled

CCA Board Report Metrics

Customer Experience

z

July 1, 2017*

*Reporting period through June 30, 2017Source: NTT Data

15

5

16

0

20

5

16

6

13

7

11

2

11

3

10

9

86

88 93 1

101

42

13

5

24

1

17

7

17

2

11

1

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

Number of Urgent Services Cases Received (Monthly)

2016 2017

90

93

12

5

98

87

74 75 8

6

75

10

6

11

1

12

3

20

3

13

1

12

7

86

72

56

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

Number of Ombudsman Cases Received (Monthly)

2016 2017

2

18

1 1

3

18

Mar-17 Apr-17 May-17 Jun-17

Inventory Aging

Urgent Services Ombudsman

Total Open Cases as

of 7/1/2017: 43


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