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California officials gearing up for Obamacare open enrollment

BusinessHealthcare Policies and LawsInsuranceTelevision IndustryAffordable Care Act (Obamacare)
Covered California and health insurers want to simplify the task of Obamacare policy renewal
Nearly 90% of Covered California's enrollees received federal money to lower their insurance bill
Covered California and health insurers vow to fix customer service problems during enrollment

Looking to avoid the pitfalls and confusion that surrounded the launch of Obamacare, California is gearing up to get 1.2 million people to renew their health policies for next year.

The Covered California insurance exchange easily outpaced its expected enrollment during the rollout of the Affordable Care Act. Now it faces the challenge of getting those people to stay on board for a second year once open enrollment begins Nov. 15.

The state-run marketplace and its 10 participating insurers want to simplify the task of renewal and save consumers from applying all over again. For instance, people will be automatically renewed into their existing policy by Dec. 15 unless they want to change. That's similar to how it is for employees covered through work.

But a cumbersome two-track process outlined by California officials could complicate matters, some consumer advocates warn. Policyholders will have to sort through separate notices from the state and their health plan in the weeks ahead.

One crucial detail — a person's government subsidy amount for 2015 — may not arrive until late in the year. Nearly 90% of Covered California's enrollees received federal money to lower their insurance bills.

Meanwhile, Covered California and health insurers have vowed to fix their dismal customer service that sparked numerous complaints during initial enrollment.

"This is our first-ever renewal period, and the first time for anything may be bumpy," said Anthony Wright, executive director of Health Access, a consumer advocacy group. "We don't want people knocked off their coverage."

Covered California will start promoting enrollment and renewals next week with new TV ads, part of a $74-million marketing campaign that runs through the end of open enrollment in mid-February.

The first enrollment window for Obamacare coverage lasted more than six months, from October 2013 to April. The next round lasts only three months, and Covered California is aiming to grow enrollment to 1.7 million people by early next year.

Health plans are eager to hold on to their existing customers and protect the market share they have already established. But consumer advocates are encouraging people to shop around because their current policy may not be the best deal anymore. Before the health law, changing plans was often difficult because insurers could deny applicants for preexisting conditions.

Statewide, the average rate increase next year is 4.2%. But some insurers, such as Anthem Blue Cross, are raising premiums more than 10% in some markets, while HMO giant Kaiser Permanente cut its rates in several areas to be more competitive. There can also be changes in a health plan's network of doctors and hospitals.

Consumers can check their health plan options and proposed rates for 2015 at Covered California's online calculator. Regulators are expected to finalize these rates by Sept. 30.

"We want to encourage people to shop first and not just default into a plan," said Betsy Imholz, special projects director at Consumers Union, the publisher of Consumer Reports.

Insurers are slated to send renewal notices from mid-October to Nov. 1. Those mailings should show the person's 2014 premium, his or her current federal subsidy and next year's rate for the same plan.

But it won't include the person's 2015 subsidy, and that may lead some consumers to mistakenly think that they're facing a huge rate hike because the full premium will be shown on the form.

Covered California said it would send updated subsidy information sometime between Oct. 10 and Dec. 15. The exchange said consumers are more familiar with how the health law works compared with a year ago and any confusion should be limited.

"Those people already enrolled in Covered California over the past year have gotten an education in all this," said Dana Howard, an agency spokesman. "I think going forward people will understand."

Health plans say they will do their part by reminding people to update their income and other personal information on the state website so the 2015 subsidy calculation is as accurate as possible.

"Health plans are working with Covered California to streamline renewals so we don't lose ground with the 1.2 million people who enrolled this year," said Patrick Johnston, president of the California Assn. of Health Plans, an industry trade group.

At times, the exchange itself has created headaches for consumers. Covered California apologized in December for sending flawed eligibility notices to nearly 114,000 households.

Those types of gaffes have exacerbated long wait times at the state's call center. In its most recent report for July, Covered California said 38% of calls were answered within 30 seconds, far short of the state's 80% goal. Nearly a third of callers abandoned their calls, according to exchange data.

"For many consumers now, we are doing reputation recovery," said Peter Lee, Covered California's executive director. "We know we have some work to do."

chad.terhune@latimes.com

Twitter: @chadterhune

Copyright © 2014, Los Angeles Times
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BusinessHealthcare Policies and LawsInsuranceTelevision IndustryAffordable Care Act (Obamacare)
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