Colorado health-insurance exchange gets mixed reviews in audit

Colorado’s marketplace for individual and small-group health insurance has improved its finances enough to be self-sustaining for at least the next three years, but it still spends millions of dollars out of compliance with its own policies, according to an audit released Tuesday.

The exchange, known as Connect for Health Colorado, has cut about $18 million in costs since the start of 2015 by renegotiating contracts and reducing administrative expenses, noted the Colorado Office of the State Auditor, which performed the examination of the state-chartered health-insurance exchange at the request of members of the Legislature.

That is key because the exchange, like other state insurance marketplaces established under the federal Affordable Care Act, lost federal funding at the end of 2014 and now must subsist only on fees it brings in from policies sold on the exchange.

However, the often-criticized exchange, which survived a legislative attempt earlier this year to shut it down, still needs more guardrails on its contracts and other payments, auditor’s office representatives told the Legislative Audit Committee.

One contractor, for example, was paid more than the contracted amount, while other contracts had not been signed before grantees began to perform work.

Also, the audit gave mixed reviews to Connect for Health’s customer-service functions.

Exchange workers reduced wait times through its call center from 11 minutes in 2014 to less than three minutes in 2016, the audit found. But one-third of the appeals of decisions made by exchange leaders were not resolved within a 90-day timeline stipulated by the federal government.

About 178,000 Colorado residents purchased insurance last year through Connect for Health.

[Source:-.bizjournals]