Access Health CT is seeking a change in its enrollment rules to tighten regulations for people trying to buy health insurance after its annual open-enrollment period, which this year ends Jan. 31.
The move is being made after the state health insurance exchange found that many people were abusing the system by waiting to buy insurance only after becoming sick - thereby incurring higher than usual medical costs - and dropping the insurance after they recover, thus increasing premiums for all customers.
Potential customers are asked to sign up for individual market coverage through Access Health during the open-enrollment period unless they qualify for a specific exception, such as having lost their insurance midyear due to divorce, being laid off or other such circumstances. Those people then are typically offered a 60-day period to sign up for coverage.
Access Health now allows people to begin receiving coverage before verifying that they qualify for the exception, meaning that people could get 30 days of coverage even if they did not actually qualify for the midyear enrollment.
The exchange now plans to change how the verification process is undertaken - specifically, to confirm each person qualifies for the 60-day period before coverage begins. Access Health's board was expected to vote on the proposal on Jan. 26.
- Kevin Zimmerman