The Covered California website internally known as CalHEERS (California Healthcare Eligibility and Retention System) while not as much of a mess as the Healthcare.gov website, has provided its own level of frustration and failure for consumers, health plans and agents. From problems with logging in, bad and missing information to the virtually inoperable agent dashboard, the Covered California web portal to enroll in new ACA health plans has serious issues that no one at the California Health Benefits Exchange wants to address openly.
Filling in fields
When you fill in fields on the online application use no parentheses (), decimal point ., dashes -, or dollar signs $. You will invariably get an error message. If the page does refresh with an error message and you correct it, re-check the drop down menus. On some pages, and maybe it’s the browser, the drop down menus will reset to “Select” or the wrong selection such as “Single” when the member is married.
Mysterious Login screen
On numerous occasions I or a client have attempted to login only for the page to be refreshed with empty fields for the user name and password. After a couple of more attempts with being returned to the same blank fields, the user gets completely flummoxed. There is no explanation as to why the login failed. Did we put in the wrong user name or password? Is the system down? Does the system not like the wi-fi were using? See also Covered California internet security issue
What did we do wrong?
The system gives no explanation as to why login failed, like every other application will do for the user. Perhaps we have the wrong password. Click on “forgot password” link and you are directed to call Covered California. Why can’t they email the password like every other credible web site will do? Why in the heck did the user answer all those goofy security question like “What was the name of your first cat?” if they aren’t going to use them to help the user recover the forgotten password?
Confusing Summary of Benefits
The great aspect of the Covered California website is to compare health plans side by side. This is done by using a drop down table typically known as the Summary of Benefits. At the very least the verbiage they use is confusing and it seems like some of the information is also wrong. How can the bronze plan have a $5,000 deductible and the Silver plan (not an enhanced Silver) show no deductible. But the $2,000 Silver plan deductible shows up down the page in another row labeled Medical deductible?
Not Applicable isn’t an explanation
I completely understand why the numbers were placed where they were. The Bronze plan deductible includes the pharmacy deductible while the Silver plan has a separate Rx deductible. But consumers don’t understand that reasoning when Covered California fills in most of the cells with “Not Applicable”. The Bronze plan does have a pharmacy deductible, it’s $5000, which is also the medical deductible.
Covered California immune from regulations
All health plans must create a Summary of Benefits for each plan according to a design established in the Affordable Care Act. The whole point of making them uniform was so people could more easily compare benefits. There are fines for misleading summaries. Obviously, Covered California is immune from having to create a uniform summary of benefits for consumers to compare plans with.
At first the doctor search function was up on the Covered California website and then it was taken down, now its back up. The problems still exist. There are doctors that show up as not being Board Certified and speaking languages like Arabic, which according to one client I spoke with is a total error. Some of the carriers are just now releasing their provider networks. Anthem Blue Cross put out PDFs of their provider networks because they are still loading all the information into their online database. How can Covered California have good information when the health plans were still confirming their provider networks?
Where are the children’s dental plans?
To all those Californians who have enrolled their families in Covered California health plans, you’ll be getting another email from Covered California shortly about additional costs for pediatric dental. The dental plans for children aren’t on the website. (Where are the children’s dental plans?) Families must choose a stand alone dental plan for dependents 18 and under. And yes, there will be an additional premium per child for the pediatric dental.
If you can, select a dentist for your child or children under 18 years old. The selection seems to ensure that the “Enroll in a Dental Plan” option will be offered after you select your health plan. In some instances, the dental plan selection is not offered until a dentist is selected.
Total loss of words
When I recently enrolled a family with a child, the CalHEERS website allowed them to select a health plan with no mention of having to select a pediatric dental plan for their son. I thought I had screwed up until I called Covered California and they told me the dental plans hadn’t been released in the system yet. I am at a loss for words on the scope of failure this represents. Covered California couldn’t even build in a little pop-up window into the system notifying families that an ESSENTIAL HEALTH BENEFIT required by the ACA wasn’t ready?
We don’t need no stinking agents
The part of the website that truly is not ready for prime time is the agent dashboard. This part of the website is supposed to allow agents to receive individual and employer designation requests to represent the client. The requests are not showing up. Agents have no clue if the help and service they provided to the client will have any commission attached to it in the future. (Covered California Peter Lee gives pep talk to agents)
Requests lost in the ether
When a request does make it through the glitched filled website, clicking on that client only yields html code signifying yet another failure in the system. The whole point of the agent designation was so that agents could change information on behalf of the client so they family or employer didn’t have to bother with it. The nature of the changes might be adding a new born baby to the policy, change of address or adjustment of income that affects the premium. This is all still a dream and Covered California has given no indication when the agent dashboard will be fixed or the other functionality added.
Zero information on Medi-Cal
Half the people enrolling in Covered California are being channeled into Medi-Cal. The people I have worked with would like some sort of idea of what the Medi-Cal plans cover and how they work. Can Covered California give any information about those health plans? No. That would be too easy. They would rather pass the buck to Medi-Cal or the respective counties. Here is the deal; If Covered California is going to market itself as the one stop shop, no wrong door approach, for health insurance and half their clients are going into plans that Covered California has no information on…that is a failure. (Medi-Cal Plans by County in California)
There is no Medicare plans on Covered California
And for good measure, would someone at Covered California please add to their home page that they don’t sell Medicare Advantage or Part D Prescription Drug plans. Covered California has done such a great job branding itself as the health insurance market place that seniors are trying to purchase Medicare Advantage, Supplement and Part D plans on the site because this is also Medicare Annual Election Period, October 15 – December 7.
How much longer?
They have had a month to fix the mess and it seems no better. The website seems worse since none of my web browser “work around solutions” I figured out seem to gain me access to the site anymore. So they have tightened up the website at my expense of actually using it.
One man’s exit
To be honest, I was a little sad and a little mad when Michael Lujan, the previous Director of Sales and Marketing, left Covered California rather abruptly back in September right before the announcement of the small business SHOP plans. Now I understand. Mr. Lujan has a wealth of experience in the health insurance business and has seen carriers successfully develop e-commerce sites for consumers that integrate agent assistance. One man can’t make a difference in a bureaucracy hell bent on doing it “their way”. I would have probably left also. Industry experience is what is lacking at Covered California. The ability to give straight answers, or any answers, as to how they are tackling and fixing the problems is also lacking.
Primary Care Physician Failure
Every person who selects a Health Maintenance Organization or HMO plans must select a primary care physician (PCP). That’s how a HMO works, you have a PCP who refers you to other specialist. No where on either the on-line application or the paper application is there a space to type or write in the name of your PCP selection on the Covered California website. This means that all the HMO plans will have to incur the added expense of mailing and calling new members to try and track down their selection or the members will be automatically assigned a physician.
Sorry Covered California, this is a real rookie mistake. Any one with any experience enrolling individuals, employees or Medicare beneficiaries into an HMO plan knows they have to select a PCP and write the doctors ID number on the application. Covered California has devoted a whole page in the paper application to asking folks how they heard about the exchange and advertising other public assistance programs like CalFresh and CalWorks. But what they can’t do is design an application form to meet their most important mission: enroll people in new ACA health plans.
Carrier Pigeons might be faster
As I followed up with various carriers about folks I had enrolled through Covered California, none of the carriers I had talked to had received any applications from the state exchange. Consequently, I have no way to check on any application. The agent dashboard doesn’t work and Covered California has sent an unknown number of enrollments over to the health plans. No one seems to know if this is a system problem, a communication problem or if the carrier pigeons have died. The old underwriting procedure where clients had to fill out five pages of health questions, have it reviewed and finally be interviewed by a third party nurse, was a shorter time frame for approval or denial than what is happening at Covered California right now.
Where does the electronic buck stop?
The mess at Covered California is not the fault of President Obama, the congress or even Ted Cruz. This is total failure on the part of Peter Lee the Executive Director of Covered California and his assembled staff and the contractors Accenture and Getinsured. I know the health plans will be ready to service their members on January 1, 2014. The health plans, under great pressure to meet numerous regulatory deadlines, have shown they will be ready. It is just sad that Covered California hasn’t exhibited the same fortitude with the creation of the health insurance market place in California.
I know Covered California wants us to use health insurance market place to describe what they do. At the moment, I like the term “exchange” because it is synonymous with how I feel, “I would like to exchange them for a website that works.”