The Small Business Health Options Program (SHOP) from Covered California has unfortunately proved itself to be just as inept at processing enrollments as the individual and family plan side. What promised to be a stream lined and easy process for small employer groups to offer health insurance to employees through Covered California is beset with a dysfunctional enrollment website and poorly trained support staff. They make Anthem Blue Cross’ decision not to offer plans through SHOP absolutely prophetic.
Small groups left hanging by poorly built SHOP website
In early January I got a call from a small business owner hopelessly stymied by the Covered California SHOP enrollment website that wouldn’t let him either move forward or backward. Fairly savvy with computers, the owner started the online SHOP application in early December thinking that he would have health insurance in place for his employees on January 1st. As the weeks wore on and no one from Covered California would help him move his application along he called me.
SHOP knew their website was faulty
Upon reviewing the application I saw what looked like the fatal error – the state employment identification number was properly entered into the correct field. Now, you wouldn’t think that correctly entering the information that you’re asked to enter would cause the application to lock-up, but it does with the SHOP. The dirty little secret is that SHOP told were agents NOT to enter the State Employer Identification Number (SEIN) because it would corrupt the enrollment. But small business owners were never notified of this when they attempted to enroll. (See: Covered California releases online small business enrollment)
Humans work no better than SHOP website
While Covered California announced that through the end of December they had a whopping 279 small businesses enroll in SHOP, they didn’t say how many successfully enrolled online and how many were paper applications. With my small business owner’s application locked in digital irons, we rushed to submit a paper application before January 15th for a February 1st effective date. The paper application sent over in PDF form seemed to fair no better than the web based enrollment.
Covered California confusion continues
The only correspondence I received was a confusing quote from Covered California that didn’t even list all the health plan options for the employees. Just days before February 1st effective date I received a call that SHOP needed a Secretary of State document to complete the application. It isn’t uncommon in the underwriting process for the carrier to request different supporting documents to verify the company. We emailed the requested documented and waited for the invoice to arrive.
The bills in the mail…not
On February 3rd I received a call from SHOP saying that an invoice was being prepared and would be mailed to the company that day. As the days went by and the owner didn’t receive either a paper or emailed invoice I started calling SHOP only to leave voice mail after voice mail after voice mail and receiving no response. On February 11th, a week into when the new small group plan should have started, I received a message from Covered California SHOP that yet more documents were needed to enroll the group.
SHOP cabin is not ready business
It is clear from the feeble customer support and worthless website that the SHOP program is not ready to serve small businesses in California. But as I was writing this post I received the following email.
Covered California Suspends Small-Business Online Enrollment to Implement Improvements
Paper Applications Remain the Conventional Enrollment
Vehicle During the SHOP Portal’s Redesign
SACRAMENTO, Calif. — In response to requests for modifications and enhancements to the Small Business Health Options Program (SHOP) portal, Covered California™ announced today that it is suspending this component of SHOP to implement a series of redesigns. Meanwhile, enrollment in SHOP will continue via the industry standard process of using paper applications.
“The SHOP portal was not meeting the needs of agents or small employers and needed improvements,” said Covered California Executive Director Peter V. Lee. “Taking the portal offline will not affect the paper application process, which has been the preferred enrollment method traditionally used by insurance agents in the small-group market.”
The online portal for SHOP enrollment will go offline today, Feb. 12 and is projected to be back online in the fall of 2014. Small-business owners can continue enrolling in SHOP by calling the SHOP Service Center or working with a Certified Insurance Agent.
Representatives of the SHOP Service Center are available 8 a.m. to 6 p.m. Monday through Friday at (877) 453-9198. The Service Center can assist both small-business owners and Certified Insurance Agents with paper application enrollments, along with answering questions about existing applications. To date, the vast majority of SHOP enrollments have been submitted using paper applications.
“Certified Insurance Agents are critical partners in SHOP, and we want to be responsive to their input about improvements to the program, including their feedback that retooling is needed in the SHOP portal,” said Lee. “We are committed to ensuring the smoothest possible enrollment experience, and we believe the new version of the online portal will significantly enhance the enrollment process.”
The new version of the SHOP portal is expected to increase the efficiency of service and allow better management of applications, including determination of eligibility, implementing group changes and issuing invoices.
As of Jan. 31, 2014, 571 groups were enrolled in Covered California’s SHOP, representing 4,490 individuals. SHOP is currently processing an additional 200 group applications, representing 1,200 individuals. Small businesses can enroll in SHOP plans year round.
For more information, please check out our FAQ “What Does Removing the Online SHOP Portal Mean to Agents?” which will be available on CoveredCA.com tomorrow.
SHOP needs rebuilding
The SHOP enrollment website should never have gone live in the first place. Covered California’s long over-due removal of the website underscores how Peter Lee and the SHOP management are incapable of handling the roll-out of the small group health plans. Covered California, despite spending millions of dollars on the enrollment website, can not deliver on their promise for an online enrollment portal for small groups and the handling of paper applications is no better.
Efficiency lost to poor design
I was an early supporter of Covered California and SHOP as I saw the great efficiency to having all my clients, individuals, families and small groups all in one convenient web portal. Any efficiency gained has been scuttled by the time spent by consumers, business owners, and agents trying to fix the problems caused by the untested software programs. Covered California has built a leaky drafty cabin for their health plans and new members. Hopefully, a skilled builder will come in and fix that problem, but the craftsman is not the Executive Director Peter Lee.