Kevin Knauss: Health, History, Travel, Insurance
Posts on the development and implementation of the California health insurance market place, application, account, enrollment, termination.
The Executive Director of Covered California, Peter Lee, insinuated that Californians are being lazy when it comes to paying for the first month’s premium of their new health plan. Lee’s statement, released in a press announcement on Friday, would be laughable if it wasn’t insanely out of touch with reality. Californians have been stymied from making their first month’s premium payment because of the failures at Covered California.
When Covered California decided to force health insurance companies to cancel their policies on December 31, 2013, they set in motion a cascading effect that have left many new plan members without access to prescription drug coverage. At least two pharmacies have recognized the problem and are offering help to cover vital prescription medications to new Affordable Care Act health plan members that have yet to received neither member ID numbers nor an invoice.
Families that didn’t have their insurance cancelled by the ill-fated Covered California forced policy cancellation of December 31 are now wrestling if they should make their current health plan premium for January. The utter lack of communication between Covered California and the health plans has left many families without knowing if they do or don’t have health insurance.
A pregnant Bay Area woman who applied for health insurance through Covered California in November and has yet to receive any notification from her selected health plan or Covered California must now consider cancelling her prenatal doctor visits for lack of insurance. When asked about the status of the woman’s application a Covered California call center staffer said that it can take weeks for the insurance companies to receive the application. Essentially, Covered California has decided to ignore the woman, her family and unborn baby.
The Affordable Care Act regulations preclude individuals and families from receiving tax credits to lower health insurance premiums bought through an exchange if they are offered employer sponsored health insurance that is deemed to be affordable and meets minimum value. This rule is actually denying some families access to affordable health insurance and is set to penalize other families with a huge IRS tax bill in 2015.
While a significant number of California residents have successfully applied, the Covered California website and enrollment systems presented significant challenges and failures not only for those applying but also insurance agents, enrollment Counselors and the health plans themselves. The management at Covered California has consistently ignored the failure of their design and process and sought only to promote their perceived successes.
If you missed completing your application online December 23rd because of the Covered California melt down you now have another opportunity to enroll. But instead of calling Covered California or faxing over your application you’ll have to find a Certified Insurance to enter you application into the CalHEERS program online for you. Insurance agents never charge clients for their services. They are always paid by the insurance company or health plan by either a one-time payment, fixed monthly monthly or a commission percentage.
With the CalHEERS enrollment website swamped with users as of December 23, 2013, users may have pages that time out or generate a system error. When this happens, refreshing the page, reloading the page or using the back browser buttons can be of no use. The only option is to close the page and re-open the website by typing www.coveredca.com. You might be surprised, as I was, to learn that you are automatically returned to your application with out having to enter a user name or pass word.
The Covered California CalHEERS online application and enrollment system is creating date of birth errors in the SubmittedApplicationPDF.pdf file. The month and the day are being switched. It is unknown if this is a simple reporting error or if the data is actually being submitted wrong to the carriers causing delays.
Covered California has finally admitted that their system has not been properly attributing agent designation by Certified Agent clients to insure the agent is listed as the Broker of Record with the insurance company for compensation. At the same time, the Covered California health plans continue to stonewall agents wanting to get appointed with them and one health plan is demanding agents work for free.
