A major software upgrade to the Covered California online enrollment website has suspended the ability to add a new baby or household member to a family plan until November 4th. This black out period for babies or adoptions applies to current consumers in a Covered California health. The ability to add new household members will return, they hope, after a November 3rd upgrade. Update: as of November 12th, the Report a Change function was operational and new family members could be added.
Baby blackout period
Correspondence from Covered California to agents.
Important Notice: Report a Change for 2014 Coverage from October 13th Through November 3rd Only
Covered California will start to send notices this week to all households with at least one member enrolled, or pending enrollment, in a Covered California Health Plan informing them of the Renewal process beginning in mid-October. However, between Covered California Online Application Release 8 .0 (10/13/14) and Release 9.0 (scheduled tentatively for 11/3/14), the Report a Change functionality for benefit year 2014 will not be available in the online application. Covered California is providing this alternate procedure as a temporary process to assist consumers who need to report changes on their account for the 2014 coverage year. You are to use this process from October 13 – November 3, 2014 only. –Download the instructions at the end of the post.
Will babies really be added to the health plans?
Additional instructions for Certified Insurance Agents informed us that in order to add a new born or adopted child we would have to call the service center and have the child added. From reading through the escalation procedures outlined by Covered California, it doesn’t sound as if the child will actually be added to the health plan. All the phone call does is put Covered California on notice that we alerted them within a specified time period. From the instructions on escalation and notification to the consumer –
When adding a newborn baby or an adopted child to the coverage, please note the added baby’s or child’s coverage will not begin immediately but may be retroactively applied. Therefore, the consumer may be required to pay for the baby’s or child’s medical bills out of pocket and request a reimbursement from the health plan after the coverage begins.
Special Enrollment Period limited time
Parents of new babies or adopted children need to notify Covered California within thirty days of the birth or formal adoption under the qualifying event rules for a Special Enrollment Period to add a household member. If the family’s thirty-day period ends between October 14th and November 3rd, during the blackout period, then the child can’t get health insurance. Covered California seems to be saying that if you at least tell them of the baby, when they finally fix the software, they will add the family member to the health plan. In the mean time, you have no insurance and you have to pay out-of-pocket and then fight with the insurance company for reimbursement. Wow…thanks Covered California.
Covered California is the gate keeper to health plans
Remember, all changes to private health plans, if purchased through Covered California, must be routed through Covered California. No one can call their health insurance carrier and add a baby or even change their telephone number unless it is first changed in the Covered California account and it is sent over to the carrier by Covered California. From the memos I’ve read, it doesn’t sound like Covered California will be sending any new baby family additions to any of the health plans during the blackout period.
Only current consumers are being punished
Consumers and agents can still start new applications for enrollment or work with an account that had the participation terminated. The baby blackout only pertains to current Covered California consumers who are pending for renewal. No changes can be made to these accounts during this period. The webpage does allow the consent for income verification to be updated. The only problem is that the consumer or agent can’t check the transaction summary page of the account to make sure the update was properly accepted. Essentially, for current Covered California consumers their accounts are inaccessible until November 4th.
What did they know and when did they know it?
The baby blackout period was not unknown to Covered California. In a presentation on the renewal process to agents the Covered California host alluded to certain challenges during the October 13th upgrade. She failed to mention the extent of those challenges and that the system would essentially go dark for current consumer. But Covered California has been consistent in never revealing or preparing their partners for the magnitude of operational or software problems they are entirely familiar with. The letter alerting agents that the Report a Change function was dead is dated October 14th. They knew weeks earlier that this would be an issue but chose not to inform their partners until after the fact.
Greeting page failure
A tip off that the website had gone funky on us happened when I opened the account of a female client on Monday, Oct. 13th, and the page greeting included my name. I’m the agent, not the health plan member. So if the website can’t display the correct name of the account holder, how do I know that the updated consent was properly accepted or that the renewal would be correct? As a pure precaution, I won’t do any renewals for clients until after November 4th at the earliest.
Call center full employment act
As is typical of Covered California, they can’t even put a notification on the webpage explaining the Report a Change function is dead until November 4th. The Covered California call center will be kept busy answering phone calls from consumers and agents that need to update their accounts. I really think the software engineers at Covered California have a secondary mission to keep the call center fully employed with people to handle questions that could be easily answered with a two sentence explanation on the website.
Report a change_renewal_function escalation.pdf
Instructions for alerting Covered California that a family has a new member such as birth or adoption during the renewal software update period (10/13 - 11/4) when children can't be added to active account.
|Date:||October 15, 2014|