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Agent Alert: Covered California drops health application data

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 CalHEERS 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. Without the broker of record designation, the agent can’t assist the client with health insurance issues at the carrier level.

Apps pushed to carriers stripped of agent data

The applications with the missing and corrupted data were all created online with the families starting with a Covered California account for the household and enrolling in a health plan during the first six weeks of online open enrollment. I was alerted to the problems when the clients had not received any invoice for their first premium payment. My investigation was further complicated by the fact that I was not designated as the agent of record. These individual accounts show up on my Covered California agent dashboard as the clients had sent me an agent designation and I accepted it.

Household information dropped from application

One family did receive a notice from Covered California requesting verification of the each family member’s Social Security number. When I called the carrier there was only one person listed on the application and that person’s social security number was actually for the spouse. Neither the spouse nor the dependent were on the application. The Covered California online application shows they are eligible for premium assistance and they have chosen a health plan.

Is this the tip of iceberg of lost data?

It is uncertain if the same or similar issues are happening with applications submitted to Covered California when initiated by the agent through the agent dashboard. I can confirm that only applications that receive no premium assistance are being shown as enrollments on my agent page. Applications submitted that have chosen a health plan are not being included if the enrollment was initiated with an individual account.

Call your carriers to confirm broker of record

Even though I have numerous individuals listed in my agent portal, many of whom have enrolled in a health plan, I am assuming that my agent information is not being transmitted to the carrier.  If your clients have not received any request for payment from the health plans they have enrolled in, and the enrollment was several weeks ago, I would consider that a red flag that there is a problem. In conclusion, if individuals are showing up as “Active” in your agent dashboard and they have enrolled in a health plan, but the enrollment is not reflected in the number of Platinum, Gold, Silver or Bronze health plans you have assisted with, you are probably not listed as the broker or agent of record.

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