MAXIMUS to take on navigator role for Connecticut health insurance exchange


Connecticut has awarded a $15 million contract to MAXIMUS to run the customer contact center operations for the state’s health insurance exchange, Access Health CT, the state’s Health Insurance Exchange (HIX). The award is a three-year, five-month base contract starting on March 1, 2013 and runs through August 31, 2016. Thereafter, the contract also has a two-year option which the state may exercise following the completion of the base contract period.

Under the contract, MAXIMUS will serve as the primary customer service center to all Connecticut residents who will use Access Health CT to determine their eligibility for, and enroll into, a qualified health plan. Operating under a no-wrong-door model, MAXIMUS’ staff will help consumers navigate health plan information to determine which health plan best meets their unique needs. The service center will also leverage self-help options such as Web portal assistance and interactive voice response (IVR). Access Health CT is scheduled to go-live for open enrollment on October 1, 2013.

Navigators are coming online as part of the federal health care reform initiative. Many states are looking for ways to hire customer support and health care system navigators who can work with the 30 million uninsured patients that will now be looking at health insurance. Finding qualified applicants is often daunting as the health care system, even with reform, is not known for its ease of use or even intelligibility.

State requirements for health care reform stipulate that navigators must be available for the exchanges. The number of people required to be on hand as navigators will vary by state population size, but large states like California or Texas will need navigators in the thousands. Smaller states like Connecticut will likely only need a few hundred. Companies in this space like MAXIMUS, Deloitte, Accenture or Xerox all have worked on call center style support systems before for other human services like earned benefits, such as SNAP or TANF. They are emerging as go-to sources for these new support centers as well.

“We view our customer service centers as the face of Access Health CT. It’s a critical and very visible function, and we are looking forward to partnering with MAXIMUS,” said Kevin Counihan, Chief Executive Officer, Access Health CT. “The decision to purchase insurance is an important one, especially for those who have not had insurance in the past, and we want to make sure our customer service center representatives are sensitive to this. The fact that MAXIMUS is already working with several states, including New York, on ACA and related health insurance customer call center programs is a big advantage.”

In Connecticut, MAXIMUS will be opening a new office in Hartford and connecting with the 300,000 eligible CT citizens that need to get enrolled in a health insurance plan. Connecticut was granted conditional approval for its state-run health insurance exchange by the Department of Health and Human Services in January.