The Paid Leave Podcast

Shopping for Your Healthcare with Access Health CT.

• The Connecticut Paid Leave Authority • Season 3 • Episode 28

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In this episode we take a look at shopping for your healthcare in Connecticut. This is the time of year that Connecticut residents are looking to enroll or change their health insurance and or dental insurance. Access Health CT enrollment fairs are currently going on across Connecticut through December and into January.

 Access Health CT is the state’s official health insurance marketplace and Access Health CT has helped over 1 million individuals and small businesses get health insurance since it started in 2013.Their efforts have played a crucial role in reducing Connecticut’s uninsured rate dropping from 9.2% to 5.2%. 

Caroline Ruwet, is the Director of Marketing at Access Health CT. We discussed their enrollment fairs that are going on across Connecticut and how they devised their marketing strategy to cover the entire state. We talked about healthcare disparity, and what they are trying to do to reduce healthcare bias. We talked about their small businesses and how they help them navigate healthcare.

For information about Access Health CT please go to: Accesshealthct.com

For information or to apply for benefits please go to: ctpaidleave.org

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Nancy Barrow:

Hello Connecticut, and welcome to The Paid Leave Podcast. The title basically says it all. I'm Nancy Barrow, and I will be delving into this new state program and how it can help you and your family. This podcast will give you information you should know about Connecticut Paid Leave and maybe just a little bit more. Connecticut Paid Leave brings peace of mind to your home, family and workplace. Welcome to The Paid Leave Podcast. This is the time of year that people are looking to enroll or to actually change their health insurance or dental insurance. And Access Health enrollment fairs are currently going on across Connecticut. Access Health is the state's official health insurance marketplace, and they have helped over 1 million individuals and small businesses get health insurance since their start in 2013 their efforts have played a crucial role in reducing Connecticut's uninsured rate from 9.2% to 5.2%. Access Health and Connecticut Paid Leave have partnered to help each other's messages get out to workers in Connecticut. Caroline Ruwet is the Director of Marketing at Access Health and Caroline, welcome to The Paid Leave Podcast.

Caroline Ruwet:

Thank you for having me. Really appreciate it!

Nancy Barrow:

For Connecticut residents who aren't familiar with what you do, can you explain what Access Health does.

Caroline Ruwet:

Yeah, so like you mentioned, Access Health CT is the state's official health insurance marketplace, and we're the place where you can come to shop, compare and enroll in health or dental insurance. And that's particularly important for people who might not have health or dental coverage made available to them through an employer, right? That's typically how Americans and Connecticut residents get their health insurance. So if you don't have that, sometimes it can feel like there's not a lot of options, but there are, and here in Connecticut, Access Health CT is where you can come. So we have over or we have 22 plans actually, to choose from during the open enrollment period this year, so for coverage starting in January and going through December, and there's six different, what we call standalone dental plans. And this is important, because some people might even have health insurance available through them, through an employer, but maybe it's a small business and they just don't have the resources to offer something like a dental plan. If that's the case for you, you can come to access healthct.com and enroll in just a dental plan. Wow. And so, yeah, it's a really good option for a lot of people, or maybe you work two part time jobs, right? So you don't get health insurance through an employer. This is a great option for you to come in. And then I would also tell people, there's a couple of different types of insurance or coverage options available to you, but you just have to fill out one application. Oh, you go out one application, and then it'll let you know what you're eligible for, and that might be a health a traditional health insurance plan from a carrier like anthem or Connecticut, or it might even be Medicaid. So if you qualify for Husky Health here in Connecticut, we can help you get enrolled in that too. So you don't have to go knock on a lot of different doors to figure out, you know, what kind of coverage you might be eligible for. One stop shopping here and we can figure out what the best plan is for you.

Nancy Barrow:

And what did people do before 2013 before you guys started? What did people do?

Caroline Ruwet:

Yeah. So there are very limited options. Probably the most popular one would be to go to work directly with an insurance carrier, going to somebody like an anthem or a Connecticut that does business in your state, and looking for a health plan to pay for directly through that. Here's the big difference, though, Access Health CT is the only place where you can get financial assistance to help you pay towards the cost of your insurance or coverage before 2013 that wasn't available, and so you would be paying the entire cost of that premium, that monthly payment, right? And so now, with financial help available, these are federal subsidies and potentially some state subsidies if you qualify for some programs like the covered Connecticut program, that really lessen the cost for you. And so it's a much better option. And if you know, you were somebody that's been in this boat since, you know, before 2013 and you haven't come in to figure out what your options were, because you thought you would be paying, you know, just as much as you were before, chances are you're going to get a significant decrease in cost. In fact, nearly 90% of our customers get some sort of financial assistance to help offset the cost of that monthly payment. So there is financial assistance, and most people do qualify.

Nancy Barrow:

And who exactly do you cover? Do you cover kids? Do you cover, you know, everybody in Connecticut, and do they have to be a Connecticut resident?

Caroline Ruwet:

Yes. So for Access Healt CT, you do need to be a Connecticut resident. But other states have state based exchanges, or if they don't have a state based exchange, they follow the federal model. So every state has a version of us, but in order to get coverage through Access Health CT, you do need to be a resident, and we do cover about a variety of people for our health insurance plan. So if you don't qualify for Medicaid, we're. We're really looking at folks between 18 and 65 okay, because once you turn 65 you're eligible for Medicare, right? Okay? And if you're below 18, chances are you're going to qualify for the Children's Health Insurance Program, which is the part of Medicaid, also known as chip so we also enroll people in those Medicaid programs, part of Husky health as well as the Children's Health Insurance Program. So if you are up to age 65 we can help you. There is one exception, because healthcare is complicated, right? Always an exception, but this is an important and nuanced one that you might be interested in. We can offer a dental plan, those stand alone dental plans, to anybody. Chances are, your children's health insurance, and even some of the insurance products you can purchase through us do have some dental available to you, but if you want to increase that, you can buy a standalone dental plan, and they're also available for Medicare eligible folks. So if you're 65 or older, you're on just the basic Medicare maybe you can't afford to buy up to Medicare Advantage or something like that that has much stronger dental coverage for you, you can purchase a dental plan through Access Health DC. So again, if you're 65 or older and you're looking for better dental coverage, come in and check out your options. You can enroll through us, and it's a really good opportunity.

Nancy Barrow:

Well, let's talk about sole proprietors, who are not insured by a company, and they're obviously looking to have their coverage. How do they navigate finding the best insurance that's affordable to them?

Caroline Ruwet:

Yeah, it's a complicated process. There's really no way around that. And if you're you know, a sole proprietor, chances are a lot of your time and resources is being spent on developing your business. And so we can imagine it's a frustrating process in general, but then just layering that on the lack of time can be really frustrating. My best advice is to work with a certified broker. So certified brokers are actually licensed by the state of Connecticut. They have to do a lot of coursework to truly understand the ins and outs of the health insurance industry and specifically how it operates in the state of Connecticut, they have to pass them tests in order to get their license, so they truly know what they're doing, and they're not just somebody who's looking at this from the outside. They're free to work with so there's nothing that you have to put into it, and the reason for that is because they get a commission from the insurance company when you enroll, and so the insurance company is actually baked that into their monthly premiums. The actuaries and all those people who figure out how much insurance is going to cost, they figure that out ahead of time, and that broker only gets paid per month that you're enrolled. So they really want to make sure that they're asked they're asking you the right questions to get you in the right plan, because if you leave that plan, maybe, or something like that, then their commission goes away. So there's a lot invested on their side to make sure that they find a plan that's right for you. Yeah, their motivation, yeah. And they're also the only type of person that can help you and suggest a plan you can work with a certified application counselor. Those are people that really understand our application and things like that, but they can't actually suggest a plan for you, because they don't have that education. They don't have background that brokers do, which is why there's such an advantage to that. And you can find one on our website. If you go to our website and hit, get help. There's a whole field that you can pull out about brokers so that you can limit, you know, maybe the town that they're in, the languages that they speak. Maybe that's a barrier for some folks too. You can find a broker that speaks Spanish, for example, or one that's, you know, only within five miles of where you live, in case you don't have transportation, and you want to make sure that you can get there. So they're very, very accessible, very knowledgeable, and really good resources for those, you know, solo proprietors as it were.

Nancy Barrow:

And how many are there across Connecticut? Is there a huge number of them?

Caroline Ruwet:

There are, there are 1000s of brokers. 650 of them are actually certified by Access Health CT, so that they

Nancy Barrow:

Access Health's mission, which I loved on your really know not only other insurance plans to offer you, website, is reducing the uninsured rate and eliminating but the 22 different health plans right on on our exchange health disparities. Let's talk about first, reducing the this year, as well as the six dental plans. So 650 of them. There is not a shortage at all. They are ready to work with you. uninsured across Connecticut. How do you do that? And why is there such a problem with people finding insurance?

Caroline Ruwet:

It's, you know, finding a health insurance plan is, is really complicated. I think a lot of us that even are employed and get the two or three, you know, plan options every single year to look at during your open enrollment period. Sometimes you're just looking through, you know, charts and graphs of, you know, all the different things that would be covered and at what expense, and is there a co insurance or CO payments? There's a lot of jargon and a lot of words that are specific to the industry that are just so hard to navigate. And so ultimately, you know, it's just really important to be able to provide that opportunity to people to get insured. It's just really, really confusing. So that's one of the reasons why we were started. And then also for what we talked about earlier, right? What do you do if you don't have health insurance, available job? And so that's the big problem. Is that, you know, sometimes people don't have full time employment. They might be working two jobs. Maybe they're only working part time. Maybe you got laid off, or maybe you had to involuntarily take some time off. Maybe you took FMLA for a while to care for somebody who was on hospice. And maybe the best estimate at the time was they were going to be, you know, only there for about four weeks, but, you know, maybe that person had a really remarkable recovery, and they're there for longer, and you need to leave right the workforce, even if it's temporarily. What are you going to do for health insurance? Because that's tied to your job. The fact that health insurance is tied to eight employment is really the thing that it makes it hard to keep people insured and keep that uninsured rate at zero. That's pretty much impossible, because there's always going to be some flux right in the workforce when insurance is tied to people's jobs. So that's the big challenge. But in Connecticut, you mentioned, you know, since our existence, we brought the uninsured rate from over 9% down to just over 5% which is extraordinary. There's a lot of other states in the country where the uninsured rate is actually pushing about 17 to 20% in some cases, so we're doing a really good job here in Connecticut, and I'm really proud of that and the team that we work with in order to get things done. And I think a big part of it is just making people aware of it and having opportunities like this to connect with with folks and let them know where they can go to find the coverage options. And really, that's what it is. It's complicated and time consuming at times, and so folks sometimes just don't make it a priority. But we're here to say, hey, we're making it easier for you. We can partner you up with free in person help to get it done. So let's do that.

Nancy Barrow:

And let's talk about the health equity in Connecticut, and how do you help with this?

Caroline Ruwet:

Yeah, so what's really interesting is we commissioned a study, actually two one was on the uninsured rate, and we really studied that, and then a year later, we commissioned a study on health disparities. And so there's a lot more data that we have to work with now than we did when we originally launched. And what we're finding is that even though Connecticut has a fairly low uninsured rate, there's actually quite a bit of health disparities going on here that we need to address, and so that very often times is related to the social determinants of health, right? Which is a whole thought process, and there's several of them, and I'll give a couple examples here. One is transportation. If you don't have access to transportation, even if you have insurance or coverage, it's really hard to use it, right, right? It's hard to get to a doctor's appointment. Another one is language. If you can't find somebody that helps speak your language to even get insured, that's a barrier. And then even if you cross that finding a provider that speaks your language, right? That's an issue too. So there's a whole host of social determinants of health, and we really struggle with those here in Connecticut, and so we have an entire department. It actually used to be part of marketing, which is the department I leave, I leave, but we actually, a couple years ago, broke out a whole new department. It's health equity and outreach, that's what we call it, and it's a lot of in person events, really what we call hand to hand combat, right? Getting in touch with people, having real conversations, and then also working with local nonprofits. There's over 2000 community partners that we have that help champion our message to people. So rather than us having go directly to everybody and foster those conversations. There's only so many of us. We're only about 100 people right total. We actually work with our network of community partners and nonprofits where folks already go, maybe for some other service. Maybe they need energy assistance. Maybe they just move to town and they just want to know what resources are available to them. And they're not necessarily in a financially poor, just poor place, whatever it is, they go to these nonprofits, these community resources, to find the things that they need that are going to make their lives better, and what they might come in for is something like transportation. And then we find out through a certain intake process at that at that community partner, that they also don't have insurance, and we can help them with that too, or they can help them with that too. And so it really is a whole village type of strategy that we have at Access Health dt, and we could not do that alone, and so it's a huge thanks to our community partners that help us get that done.

Nancy Barrow:

Yeah, I have seen you at a bunch of events that we do too, because our outreach is pretty much the same as yours, right? So we do a lot of health events and health fairs, so we do see you a lot, and we're happy that we've partnered with you and we work together to get our messages out there. I also read on your website that there's a disparity in life expectancy across Connecticut towns, and it was so interesting to read that in Westport, which is 91% white, the life expectancy is 89.1 years, and in a neighborhood at Northeast Hartford, where 94% of the people are black and Hispanic, the life expectancy is just 68.9 years, and that has to do with healthcare, right? It

Caroline Ruwet:

Absolutely does, yeah, and access to it, sure, right? Times throughout your life is incredibly. Important, and I'll give you just one, one example of that, if you're not going to get your preventative health screenings, small issues can turn into large issues, and those large issues can be as dramatic as shortening your life expectancy, for example, if you do develop diabetes, right? And we know that black and brown communities, for example, are disproportionately affected by diabetes, meaning they get diabetes more than their white counterparts do. If you're not going in for your preventative care and getting your blood work done to be monitoring something like that. We might not know about it until you're older and it's more severe, and at that point in time, maybe you're looking at something like amputations. Right circulation isn't so great. And then there's, you know, comorbidities or different other types of health risks that come with not being able to take advantage of preventive care and getting that under control earlier. There's just a lot more that can go wrong, and that's what's contributing to that vast difference in life expectancy, which is just one metric, right when you're looking at health disparities,.

Nancy Barrow:

And it's great, because I think I saw that you partner too with community health centers, which are really important for those communities, you know?

Caroline Ruwet:

Yeah and so that's a big part of our strategy. We look at this data that we got from the uninsured as well as the health disparities, and we're able to find a certain pocket, pockets in the state of Connecticut, at a zip code level, that are more impacted than others, and that's where we do more of our in person events. When I put my marketing strategy together, that's where I get more billboards. And if there's not a billboard to purchase, we get a mobile billboard, which is like a truck. Can we drive it through major cities and streets and we park it in major shopping centers in those areas to try and get the word out more. So that is a big reason why we did lower and we're able to lower the uninsured rate from nine to 5% but we can do better. We want to get that as close to zero as possible. And we also want to be addressing these health disparities, because just having access or an insurance card isn't going to get the job done. People have to be able to go and book an appointment, get to their appointment, get their prescription drugs and maintenance drugs. If they need those things, there's a whole host of things that have to happen along this process in the continuum of care in order to make sure that health disparities are a thing of the past. And that's really what we're working toward.

Nancy Barrow:

Connecticut Paid Leave does as well. Yeah, it's wonderful that we

Caroline Ruwet:

A lot of shared values between our organizations, which is why I'm so happy to be here and talking with your listeners. It's really great work that we can do alongside each other.

Nancy Barrow:

And also mental health services that you include these in your plans, which I think is so vitally important, and I'm thankful that you guys do that.

Caroline Ruwet:

Yeah, it's really interesting. You know, when the Affordable Care Act, or the ACA was passed more than a decade ago, at this point in time, which is, which is how we exist. And the reason for us, there were 10 essential health benefits that were determined that needed to be covered under every single health plan offered on any exchange, any state based exchange, the Federal model here in Connecticut, right we're Access Health CT. So there's 10 essential health benefits that have to be covered on every single plan that we offer. Mental health is one of those. And prior to the Affordable Care Act, mental health was something that was not covered on a lot of insurance plans. So we're really happy to say that any plan on Access Health CT that you purchase, or even if you're covered on Medicaid, mental health is covered. And that's that's so incredibly important. And then one other thing that I'd like to call out that that really changed the game is the fact that pre existing conditions don't exist now as a result of the Affordable Care Act. So before the ACA was passed, say you had a diagnosis of cancer or diabetes or something like that, when you went to re up your insurance, they might decide that they didn't want to cover you because it was expensive for them, because you had that condition that was called a pre existing condition. You had it before you went to enroll in health insurance. Now that's not a thing. Insurance companies can't say we don't want to cover you because you have this condition and you knew about it prior to being enrolled. So that's another thing that's really helping a lot of people, you know, stay covered, getting the health care that they need, and so things don't get to be in a really bad situation. And thinking about the fact that mental health care could have been a pre existing condition, and some reason why, you know, somebody didn't want to, you know, cover you that's really terrifying, right? People really need to be covered for these important issues. So really happy that that's a part of all of our plans.

Nancy Barrow:

Yeah and Connecticut paid leave also covers mental health and addiction treatments as well, and and it's pretty flexible, which I really love about our program, because you can use the 12 weeks of income replacement in a block and take them all together or intermittent or reduce schedule leave. So I really appreciate that we can work in connection with your plans as well.

Caroline Ruwet:

Agreed, you know, agreed.

Nancy Barrow:

It's really wonderful. Let's talk about the enrollment fairs. What's your strategy in holding these seminars and where you decide to hold the enrollment seminars?

Caroline Ruwet:

Yeah, that's a really great question. So going back to the data, right? I talked about the two reports that we commissioned, one on the. Insured rate, and one on health disparities. And by the way, the US Census also releases data on these topics as well, and we look at that data too. So there's a lot of different data resources. We have to figure out where in Connecticut are more people uninsured? Where do people need that help? And fairs are a really good example of how we do this. So we look at the data for the highest indexing zip codes of the uninsured, and we host our events there. And so enrollment fairs are one day. Pop up events during open enrollment. They usually take place on nights or weekends. We usually run out of place in like a church or the Fw, you know, Senior Community Center, libraries, yes, we'll run out some space in a public area and invite you to come. And there we have brokers. We have application counselors that can help you through that process so that you can enroll in a plan. And even if you didn't bring all the documents and things that you needed with us, you can come get help at a lot of the other events too. And speaking of that, outside of our enrollment fairs, those kind of one day pop up events, we also have places called enrollment locations. These locations are available Monday through Friday all year long, because sometimes you might find yourself without insurance, maybe you lost your job, voluntarily or involuntarily, right? That opens up what's called a special enrollment period, and so you would have time to enroll outside of the typical open enrollment period, right? What do you do then? So you can go to these static locations. They're available Monday through Friday during normal business hours. And you can find all of them on our website, at Access Health, ct.com click, get help. And you'll find all of our fairs, and you'll have find all of our enrollment locations where you can go so you can find help really, you know, during your business, Business Week, right during normal business hours, whether you need help at night or on a weekend or, you know, all throughout the year, there's a lot of resources available for folks. And I think a lot of people think that they have to do it alone, and that's why they don't do it. Or maybe they choose a plan, and it doesn't really work out very well for them. So I highly encourage you to take advantage of these free help opportunities, whether it's a fair or a location, and find someone to help you through the process. You don't have to do it alone.

Nancy Barrow:

And how do you help small businesses with their health insurance plans? That's interesting, that you help.

Caroline Ruwet:

Yeah. So we also have the small business side. So rather than individuals, you know, small businesses really suffer too. It can be really hard to to, you know, keep employees enrolled and be competitive when there's so many other things vying for your time as a small business owner. And so we have what's called our shop program, and and they really help enroll people in different small business opportunities as well. So that's available year round. A lot of different, you know, employers have open enrollment periods throughout the year, so those folks are not subject to the open enrollment period. We are working on, you know, an innovative solution that we look forward to making an announcement on in the coming months. So stay tuned. I'm just not ready yet. Oh yeah!

Unknown:

And that was going to be my next question in this holiday season and going into the new year. What are you looking to do differently?

Caroline Ruwet:

Yeah so we're really looking at finding more competitive ways to help the small business community. You know, rates increase every single year for health insurance, and the small business community has just been really hammered throughout the last couple of years. In particular, I do want to mention that access health, CT, has nothing to do with the rates, right? Those are set by the Connecticut insurance department, and they work with the different carriers. We have zero influence on that. And so we're frustrated too, to see, to see that kind of community, you know, suffer as much with it, with the increased rates. And so we're really looking at an innovative alternative that hopefully should bring costs down for employers and employees, and we really look forward to sharing more about that.

Nancy Barrow:

So exciting. Can't wait for that. Yeah, in 2025 What would you like people listening to take away from the podcast today?

Caroline Ruwet:

Yeah. So chances are you know, if you're listening, you may have health insurance coverage through an employer, and if you're on leave and you're going back right, you're you're going to get those benefits back again, but chances are, there's going to be some point in your life where that's not the case. And so I really want people to just remember the brand that they can go to access, lct.com, if they find themselves in a place where they don't have health insurance. And then you know some things that that are related to that, right? If you lose a job, sometimes you think Cobra is your only option. And so what Cobra is, is a temporary extension of your employer's health care coverage plan. So it's what you are enrolled in. Can get extended. That said, usually an employer pays a portion of that monthly premium, right? And they wouldn't be doing that anymore under COVID, or, excuse me, under COBRA, yeah, and so you would be responsible for paying the entire amount. That's usually pretty expensive, and folks don't know that they can come to access LCT as an alternative. So. You can do that at two different points. One, when you lose that coverage, and then you go, and then you're offered Cobra, you can immediately come to access health dt, and you can figure out if there's a better option for you financially with good coverage here, or after your Cobra ends, you can then come to access health CT as well. So both of those points are considered loss of coverage, which opens up a special enrollment period. So those are the things that I really want your listeners to understand. And if you find yourself without health insurance right now, please come to access health dt.com, to shop, compare and enroll, because we are in our open enrollment period. And I'll leave you with two important deadlines. Should you be in this case, you need to enroll by December 15 in order to have coverage starting on January 1, open enrollment ends on January 15. But if you enroll on December 16 through January 15, your coverage would not start until February 1. So you could find yourself with a month gap there unless you enroll. So truly, if you need health insurance coverage come in on or before December 15 to make sure that your coverage starts on January 1, and we will help you through that process. And then lastly, you know, maybe you can't come to an in person event, but you don't want to do this alone. We do have a call center, and that phone number is 1-855-805-4325, and there is call center representatives that can help you in more than 100 languages. So lots of help available there too.

Nancy Barrow:

Any last thoughts for you about how Connecticut paid leave really helps in the healthcare world like you do?

Caroline Ruwet:

Yeah. So going back to that kind of point that you know, here in the United States and in Connecticut included, our health insurance is largely tied to our employment, and so if you need to leave that for portion of time, oftentimes that meant risking your health insurance altogether. And oftentimes people couldn't flat out afford even just a couple of weeks, right? If they needed to take care of someone for just a couple of weeks on hospice. How would they pay their bills? How would they keep their insurance? And so they just flat out, we're not able to, and I think that Connecticut paid leave and access LCT, working together provides the assurance for people to be able to do those things that they need to, because at the end of the day, we're people, we're not just employees, we're not robots. We have aging parents, we have children, we have our own health needs, and so being able to take a little time off and be able to pay our bills, and then also make sure that our healthcare is covered ourselves and be able to afford that too, is all really important to being productive members of society and honestly, a part of the workforce long term. So I truly believe that what we're doing together to help kind of solve all the problems that kind of are associated with being able to be in the workforce long term, is helpful, not only for the people who need the resources, but it's also really beneficial to the workforce. In the long run, there's so much legacy knowledge that goes away with people if they're just not able to be there, even because it's just a portion of time that they need to, you know, take off, because we're able to provide that in terms of time and money and health insurance, people are now able to do what they need to do for themselves, and then ultimately, they can be more productive at work as well. So I think at the end of the day, it's really beneficial for the people who need the resources, but also the workforce and the greater community as well.

Unknown:

We really value your partnership, you know? We really, we really do.

Caroline Ruwet:

The feeling is mutual!

Nancy Barrow:

Yes, it's wonderful that we have this relationship. Caroline Ruwet is the Director of Marketing at Access Health. Thank you so much for being on the paid leave podcast.

Caroline Ruwet:

Thank you. We really appreciate the opportunity to connect with you and your listeners.

Nancy Barrow:

For information about enrollment fairs or questions you can go to access health, ct.com and for information or to apply for benefits, go to ctpaidleave.org This has been another edition of The Paid Leave Podcast. Please like and subscribe so you'll be notified about new podcasts that become available Connecticut Paid Leave is a public act with a personal purpose. I'm Nancy Barrow and thanks for listening.

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