Charter Oak: Health Insurance or Social Program?

Last week the state’s health care advocate wrote to Gov. M. Jodi Rell’s administration to stop it from referring to her Charter Oak health plan as “insurance”, saying the word is “false and misleading.”

Charter Oak is the state-subsidized plan to provide affordable health care to uninsured and underinsured adults ages 19 through 64. It was launched on July 1 and since then more than 1,300 individuals have been enrolled in the plan.

In a Sept. 30 letter to Insurance Commissioner Thomas Sullivan, State Health Care Advocate Kevin Lembo wrote, “There is no question that the application form and Charter Oak website are misleading where they repeatedly refer to the Charter Oak Health Program as insurance.”

About a year ago, Sullivan referred to the Charter Oak health plan as a “social program,” which would not be regulated by his department.

“As you are aware, ‘insurance’ is a word that has legal meaning in our state,” Lembo wrote Sept. 30. “It is inappropriate for state officials to misrepresent the protections and rights that flow to consumers.”

Lembo pointed to the numerous radio and print advertisements Rell has used to market the health plan with the use of the word insurance.

“For the first time in my life I have health insurance, thanks to the Charter Oak Health Plan,” reads a voiceover in a radio ad.

In response to Lembo’s letter, Sullivan wrote on Oct. 3, “We don’t find that the Charter Oak Health Plan misrepresents or misleads the consumer.”

“The Charter Oak materials are clear in describing the applicable co-pays and coinsurance levels, as well as clearly indicating annual and lifetime maximum benefits,” Sullivan wrote in his Oct. 3 response to Lembo.

In this letterback to Lembo, Sullivan wrote, “There are many forms of public or social insurance which are not subject to the Department’s regulation, including, but not limited to, Medicare, HUSKY, Social Security, unemployment insurance, and the Charter Oak Health Plan.”

“Generally these public or social insurance programs are regulated elsewhere, some by the federal government and some by other state agencies such as the Connecticut Department of Social Services (DSS),” Sullivan wrote.

David Dearborn, spokesman for the Department of Social Services, said in an emailed statement Tuesday, “It’s safe to say that the nearly 1,300 Connecticut residents now enrolled in the Charter Oak Health Plan—and the additional 1,200 applicants now eligible to enroll—are not overly concerned about what it’s called.”

“The important thing is that they’re no longer worrying about how to pay for doctor visits, prescriptions, medical emergencies and other health care needs,” he said.

Today in a phone interview, Lembo called Sullivan’s response “inadequate.” He said this is about consumer protection.

However, Lembo said his office is still reviewing it and will soon determine whether or not to ask Attorney General Richard Blumenthal for his opinion.