- Associated Press - Monday, January 5, 2015

HONOLULU (AP) - Hawaii’s largest health insurer says it’s still having substantial problems with the state’s health exchange.

The staff at Hawaii Medical Services Association has spent 27,940 hours working on technical issues with the Connector, and a fifth of those hours were spent in the last two months, Elisa Yadao, senior vice president of the company, told The Associated Press.

“There’s a fundamental issue here that really does need to get resolved, and the fact that we’re a year into the Connector and we’re still experiencing these difficulties is troubling,” Yadao said.

Jeff Kissel, CEO of the Hawaii Health Connector, apologized for the problems, and said his team is focused on providing the best service they can. Kissel said the vast majority of new enrollments are trouble-free, and that most issues have to do with last year’s enrollments.

“It has been plaguing us, and I would not be honest with HMSA or the public if I didn’t admit that those problems still have to be resolved,” Kissel said.

The health exchange was scheduled to automatically renew all of its members with HMSA on Nov. 8, but because of technical problems, used the month of November to work on fixing automatic renewal issues, Yadao said. Then on Dec. 1 the Connector asked HMSA to complete the work, leaving the company with an unplanned project to finish in a short period of time, she said.

“That is a system deficiency that we are still working to resolve,” Kissel acknowledged, adding that he expects the problem to be fixed within a month or two.

But the problems processing last year’s renewals bled into the new enrollment period, which began Nov. 15, Yadao said. She claims her insurance company has received few new enrollments through the Connector, and she worries that customers may have signed up for plans that she doesn’t know about, because the information hasn’t made its way from the Connector to her office, she said.

“If we haven’t gotten the files, we don’t know that we’re supposed to be providing them coverage,” Yadao said.

There are, on average, 55 HMSA customers who have unresolved issues with the exchange, Yadao said. Also, the Connector is less than halfway through a project to update “change in circumstance” events, which cover things like adding a spouse or child to coverage, she said.

The exchange has set up a special service desk to help resolve problems with insurers, Kissel said. He has been hoping to improve performance enough to win back some of the business of HMSA, which left the employer side of the exchange in August but continued to sell plans to individuals.

“We have changed our approach, which is consistent with putting the people in front of the systems,” Kissel said. “I check on it daily, and I see the issues being resolved.”

The Connector has made progress, and grew in the number of people served by 50 percent in the last few months. On Monday, there were 15,552 people enrolled in health insurance plans through the Hawaii Health Connector, which is more than Kissel expected, he said.

“Our people are now starting to report real success stories of individuals who are having their lives changed by having access to health insurance,” Kissel said. “While I apologize to everyone in the community who has been inconvenienced by this, I can tell you that saving and extra life is a price well worth paying.”


Follow Cathy Bussewitz on Twitter at https://twitter.com/cbussewitz

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