In mid-August, Patty Fontneau, the chief executive officer ofConnect for Health Colorado, left her post to take a job withCigna. ¶ It was the latest controversy in a far-from-perfect yearfor Colorado's state exchange and Fontneau both: there was a greatdeal of criticism surrounding the compensation plans for Fontneauand other executives; and in March, a mid-level manager for theexchange, Christa Ann McClure, was forced to resign afterallegations of theft and fraud surfaced—allegations made by aprevious employer in Montana.

“We set three models—one at 75,000, one at 136,000, and ourhigh-level model is 200,000 people enrolled,” Davis notes. “We hitour mid-level model in late June, so we're really proud ofthat.

“Our state exchange is not like the exchanges in most states,”he continues, “because ours is a stand-alone nonprofitorganization. We're working in partnership with the state to refercitizens for Medicaid, and as of April, 178,000 Coloradans havequalified for Medicaid since we opened our doors. So that'sessentially 315,000 Coloradans who have received health insuranceas of late June, if you include the public options. So,big-picture, we've had a pretty sincere and large impact ofColorado's health care outlook.”

Matt Case, vice president of strategy and development at AccessHealth Colorado, a carrier participating in the Connect for HealthColorado exchange, says the biggest challenge for Access HealthColorado has involved issues with enrollment.

“Going into the launch of the exchange, we believed consumerswould have a single-eligibility, single-enrollment process,” heexplains, “processing Medicaid eligibility at the same time as thetax subsidies. But that didn't happen, so we had people stuck in aprocess where they were waiting to hear about eligibility beforethey could move any further.”

Although that was problematic, Case adds that the perception ofproblems with the online exchanges added to those burdens.

“Just the perception of the cluster kept people out,” he notes.“They thought, 'I'm going to wait until this is all figured out.'We definitely saw that at a federal level, and in our state, wesuffered even though we didn't have anything to do with the federalexchange.”

Access Health Colorado sold products through the healthmarketplace in 2014, and Case says brokers will be key to theirstrategy for 2015, in addition to selling products directly to thepublic; the exchange has given Access Health Colorado a platformfor a unique product that they developed to fill a gap in thehealth marketplace.

“There are a lot of very complex conditions that require caremanagement plans and a focus on integrated care between physicaland behavioral health,” Case explains. “One of the things that canbe most disruptive to a person's care is having to move to a wholenew system and start over—that's a big problem in all of our healthcare delivery systems. So we made a conscious decision to create anoption for people in the marketplace who needed that community. Werestructured our entire company to develop a commercial healthplan, and we deliberately went out to the market in a veryconservative way. We wanted to observe and learn and apply ourlessons to a really solid strategy in 2015. And that's wherebrokers come in for us, because we know they will be critical toour success moving forward.

“We're a little bit different, and most brokers have not seencarriers like us before, and they probably aren't used to a verycommunity-oriented, locally based health plan that's also stillmission-oriented,” he concludes. “But for brokers who have clientswho are buying local—and there are more and more people buyinglocal—we think we have a really good chance to expand our clientbase in this next year.”

Davis says that future areas of focus for Colorado's exchangeinclude streamlining the application process and working withinsurance companies to improve the variety and price of planoptions.

“We want to see the small-business options improved,” Davisadds. “They're not what we hoped they would be, and that's probablyone of the most challenging areas that we've worked in. And we'removing toward a single, streamlined application, which will be mucheasier for consumers to use.”

“In general, folks are very happy with the quality of the planswe're offering and the diversity that we have, as well as thepricing. Our biggest challenge in Colorado, which we have nocontrol over, has been the pricing, but the insurance companies areworking on it, and we're hoping that they can come up with asolution.”