A Look at the Tar Heel State’s Approach to Driving Enrollment in the Pre-Existing Condition Insurance Plan (PCIP)

By Arie Stock

When it comes to enrolling people in the Pre-Existing Condition Insurance Plan (PCIP), North Carolina’s Inclusive Health is not letting the tar on its heels slow it down. Inclusive Health is the state’s insurance program for people with pre-existing health care conditions. It has both a state high-risk pool and a federal option, which is one of the nation’s 27 state-administered PCIPs. North Carolina’s PCIP has the fourth highest enrollment in the country, with more enrollees than many plans in states with bigger populations. Let’s take a closer look at what the state has done to encourage enrollment in its PCIP.

  • Coordinated Application Process

Inclusive Health makes it easy for a consumer to start and finish the application. Inclusive Health’s web portal features two short questions that help guide the consumer to the right program, so they know whether to apply for the state program or the PCIP. Consumers only need to answer whether or not they have insurance, and if not, how long they have been uninsured. If their answers suggest that they qualify for the federal PCIP option, they will be automatically directed to the plan’s website where they can fill out the online application for coverage.

  • A “Saveable” Online Application

If consumers don’t have all the information they need to complete the application in one sitting, the system allows them to save their progress and come back later when they’re ready to finish applying. A paper application that can be submitted by mail is also available.

  • Minimal Documentation Burden on Applicants

If consumers have one of over 100 conditions that are on Inclusive Health’s presumptive conditions list for the PCIP, all they need to do is provide a doctor’s note to verify that illness.

  • Help Is Available

For those who need help applying, Inclusive Health offers plenty of assistance. A hotline is available (866-665-2117) where callers can reach representatives who are trained in both plans, and consumers can also ask a question online and have an agent contact them directly.

  • Outreach

Inclusive Health uses a variety of avenues to reach eligible consumers. A key component to Inclusive Health’s outreach is advertising. It has done two rounds of television ads so far, and a third wave will be launched soon.

Another outreach strategy with which Inclusive Health has found success is holding enrollment events. These events often take place at community locations, such as libraries and hospitals, where trained brokers and agents help consumers navigate health plans and fill out applications. To give brokers extra incentive to make sure that individuals successfully enroll in the plan, Inclusive Health increases payments to brokers after four successful referrals.

Additionally, Inclusive Health makes regular appearances at health-related community events, where it disseminates information on its state and federal options. For example, Inclusive Health recently sponsored Bike MS: Tour to Tanglewood, where an agent manned a booth next to Krispy Kreme. Inclusive Health also made appearances at the Alzheimer’s Memory Walk, the 2011 Annual Lupus Summit, and the MS Society Annual Meeting, and the MS Society, American Cancer Society, and AARP all sent emails and mailings to their members to spread the word.

With more than 2,500 individuals enrolled in Inclusive Health – Federal Option as of October, other states may want to take a close look at North Carolina’s strategies for driving enrollment in its PCIP.

Thank you to Michael Keough, Executive Director of Inclusive Health, for his assistance with this blog.


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