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My dead beat dad: Covered California SHOP

Covered California SHOP reminds me of my dead beat dad; I don't hear from them and they owe me money.

Covered California SHOP reminds me of my dead beat dad; I don’t hear from them and they owe me money.

It’s been over seven months since I heard anything from Covered California’s SHOP program and the commissions they owe me from the small group I helped enroll in their small business health options program. The lack of communication from SHOP is a flash back to over forty years ago when I wouldn’t hear from my dad for months and my mom received no help from him to pay the bills. Covered California is my new dead beat dad.

SHOP is like a dead beat dad

On numerous occasions I’ve listen to Kirk Whelan, Covered California Director of Sales , report on the progress SHOP has made paying agents their due commissions. In that overly optimistic salesman tone, Mr. Whelan would proclaim they were on track to pay all those back commissions. Of course, the multiple promises of getting the SHOP agent commissions current and paid-in-full are reminiscent of the broken promises I heard as a child. I hope Mr. Whelan is as embarrassed by Covered California’s performance as I am angry over not being paid.

Covered California employees get monthly paychecks

I am sure that Mr. Whelan has been paid his monthly salary. I am sure the Covered California regional sales directors throughout California have been paid their salaries. I am sure that Pinnacle Management, the company contracted by Covered California to run the SHOP program, has received all their renewed contract payments. I am positive that I have NOT received a commission payment since my last check from SHOP in June of 2014.

SHOP, dysfunctional by any measurement

From the lowly position of an independent insurance agent, my perception of SHOP is that it is a thoroughly dysfunctional organization. My measuring stick of how well an organization functions is based on the several insurance companies that I am appointed with and who compete against SHOP for small group business. They all pay their commissions in a timely fashion, generate a statement for the agent, provide an online portal for the agent to make changes to the small group’s employee enrollments, and provide online tools to quote new business

SHOP has been broken for over a year

A year after SHOP was launched they don’t even come close to a professional looking small group exchange such as California Choice. SHOP has virtually none of the tools afforded to agents by other insurance organizations, including timely commission payments. A simple call in early February to inquire about when I might be paid stretched to over fifteen minutes as the customer service representative researched my account. The update was that SHOP was still working on paying commissions from September 2014. This raises the ugly question about the condition of SHOP’s bookkeeping and accounting systems. Truly, SHOP needs to be audited by the state controller.

The health insurance works

From all indications, the SHOP health plans are performing as they should for employees and owners enrolled in the Covered California SHOP plans. But unlike the individual and family side of Covered California where the health plans and insurance companies pay commissions directly to the agents, SHOP is supposed to issue commission payments to agents for their small group enrollments. The fact that SHOP can’t pay commissions to agents raises serious questions about their credibility and viability as a state run exchange for small groups.

I can’t quote SHOP

Eventually my father did his best to make amends for the years that he was AWOL. There was no animosity in my heart as I sat next to him while he was dying in his bed. It’s just life and you have to move forward. I suppose Covered California’s SHOP will eventually get their double-wide trailer in order and get current with all the commissions they owe to various agents. However, I can’t in good conscience present the SHOP plans to any small groups. It’s one thing for SHOP to stiff me my commission payments for months, but I don’t want to put my clients into a situation where a dysfunctional organization is administering their health benefits.

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