Applications submitted to Covered California in October and November are missing agent designations and have corrupted household information when received by one of the insurance companies. It is hard to know if these data corruptions are an aberration or if the problem may be more widespread in the Covered California system. The bottom line is that these individuals have received no billing information from the carrier and the agent is not the broker of record.
Consumers are growing frustrated as they find their current doctors aren’t included in new Covered California individual and family plan (IFP) health insurance networks. There is also widespread uncertainty about the rules of in-network providers with the new Exclusive Provider Organizations (EPOs) and California’s new 19 pricing regions. When California consumers are craving information the doctors have been silent and the insurance companies along with Covered California are providing scant information.
Covered California had high expectations for 21st century e-commerce technology but agents and consumers have resort to 19th century pen and paper. There has been an avalanche of paper applications into Covered California significantly slowing down the verification and enrollment process. The sluggish processing of applications means that some families may not have insurance coverage on January 1, 2014 as promised.
Covered California announced a marketing campaign aimed at the Lesbian, Gay, Bisexual and Transgender communities to encourage them to enroll in new ACA health plans through the exchange. The print media and billboard advertising is in addition to grants to LGBT organizations to provide outreach and education.
The California Assembly Republican Caucus has declared that people with pre-existing conditions are the root cause of escalating health care costs. From their statements on their website Covering Health Care: A California Resource Guide, one can only come to the conclusion that California Republicans feel that sick people should be denied guarantee issue health insurance so premiums of healthy people won’t be adversely affected.
The time spent hiking up to the Sutro Tower was far better spent than the energy wasted on the Hockney exhibit. On any day I’m in the City I tell myself I want to climb the hill the three legged TV antenna rests upon. With a trip to the De Young museum to see a David Hockney exhibition, the weather, time and energy level to hike up a hill all aligned for us to find a way to climb up to the Sutro Tower.
Covered California has estimated that nearly 100,000 households have started an application but have not selected a health plan. To help “Jump Start” these stalled applications Covered California will be distributing the contact information of these stalled applications to Certified Agents to call the applicants and offer assistance to help them make a health plan selection for an effective date of January 1, 2014.
Health Net and several other administrators of Medicare Advantage plans were issued fines from the Center for Medicare and Medicaid Services (CMS) for errors in their updates to people enrolled in the MA-PD plans. The penalties, issued in October 2013, were for incorrectly stating plan information in annual notices to Medicare beneficiaries enrolled in the Advantage plans and ranged from $23,410 up to $86,530.
Compared to existing small group quoting and enrollment systems from the insurers and the Cal Choice private exchange, the Covered California SHOP program seems a little clunky and unfinished. If an employer wants to realize the tax credits for contributing to employee health insurance premiums they have to have a small group plan through Covered California. Except for the option to purchase pediatric dental plans for dependent children, SHOP offers no adult dental or vision insurance.
One of the secondary benefits of the Affordable Care Act is the new plan offerings in the individual market. Both VSP and Blue Shield of California have introduced individual and family vision insurance plans (IFP) with benefits rivaling group plans. Just as we have seen the medical benefits for IFP become equivalent to small group plans, the insurers are reworking their dental and vision insurance products to be more comprehensive as well.