Firm running call center an affiliate of insurer

Firm running RI health exchange call center an affiliate of insurer; state cites protections

Associated Press

PROVIDENCE, R.I. (AP) -- The company that won a $24 million contract to operate the Rhode Island health benefits exchange's customer service center is an affiliate of a company that is selling plans on the exchange, but state officials say there are built-in protections to prevent conflicts of interests.

Florida-based Connextions got an 18-month contract to manage a call center in Providence that will help individuals and small businesses shop for insurance on the new state-run exchange, a part of the federal health care overhaul. Connextions is a subsidiary of Optum, whose parent is UnitedHealth Group. Its UnitedHealthcare division is offering plans on the exchange.

Connextions provided the state with a plan for addressing potential conflicts, including "impaired objectivity," or the possibility that call center employees could steer consumers or companies to health plans offered by United. It also addressed its access to non-public customer information that could provide — or be seen as providing — United with an unfair advantage in competing for future contracts.

Christine Ferguson, director of the exchange, known as HealthSource RI, said earlier this week there are information barriers "all over the place" between Connextions and UnitedHealthcare. She also said the awarding of the call center contract to Connextions was not tied to United's agreement to participate in the exchange.

Exchange attorney Sam Salganik said Friday that Connextions has a strong business track record and that the state has protections built into the contract that allow it to take action against the company if it even perceives a conflict.

"We have a lot of checks and balances in place," Salganik said in an interview. "The key here is they are a professional company and their reputation is really important to them."

He added: "It's something we'll continue to monitor and make sure that we continue to be comfortable."

Connextions was selected to run the call center after a competitive bidding process. The other bidders were Dell, Faneuil, Inc., Maximus and Xerox, according to exchange spokesman Ian Lang. Connextions' proposal scored highest overall, and its cost was the lowest, Lang said.

In documentation provided to the state, which HealthSource RI has made public, Connextions said it would maintain a strict separation between its business and that of United. It said it would establish "information and security firewalls" to prevent customer data from getting to anyone at United. People working on the state contract will not be allowed to transfer to a position at United involving work related to Rhode Island's exchange.

Connextions also said it has policies in place to prevent bias. It said the state-provided tools and technology its specialists will use to help individuals and businesses find the best insurance coverage for their needs are based on objective measures. The company said its "exercise of judgment will be minimal in the handling of customer inquiries or the steering of consumers to specific products and services."

Connextions said it will have teams monitoring calls to make sure its employees aren't favoring specific plans or carriers. It also said its compensation is not tied to how many Rhode Islanders enroll in UnitedHealthcare plans and that customer service specialists have no financial incentive to direct consumers to those plans.

Salganik said the state will also have exchange staff working at the center and monitoring calls.

Connextions President Steve Auerbach said at a ribbon-cutting for the call center on Monday that the firm plans to hire between 50 and 75 people initially. It will eventually employee up to 100 people. Attempts to reach Auerbach on Friday were not immediately successful.

The call center is expected to open in September; the exchange opens for enrollment on Oct. 1. Most Americans will be required to have health insurance beginning in January.

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