Hiccups persist in California health insurance exchange
Paperwork and computer glitches are still tripping up some eager consumers who are seeking coverage through California’s insurance exchange and its 11 health plans.
On Monday, the Covered California exchange said that all the applications it received online for coverage starting Jan. 1 have been sent to participating insurers, but that it is still sorting through an unspecified number of paper applications for that time period. In light of that delay, last weekend the state exchange extended the payment deadline for January premiums by nine days to Jan. 15.
A week into the new year, some people are still waiting to get an invoice or confirmation of coverage. Other enrollees have run into problems trying to pay online and long hold times when calling to get answers from their insurer or the exchange.
A surge of applicants in late December has created bottlenecks at government-run exchanges and insurers nationwide trying to implement the Affordable Care Act.
Overall, more than 400,000 Californians have signed up for private health plans so far through the state exchange. About 100,000 of those people enrolled in the final four days before the Dec. 23 deadline to have coverage in effect Jan. 1.
“We did receive a flood of applications before the deadline, so we are working at top speed to process all those and get them through the pipeline,” exchange spokeswoman Anne Gonzales said. “We understand people are waiting, and we are going as quickly as possible on our end.”
She said the exchange had to follow up with some applicants to get additional documentation before sending those files to insurers. Gonzales said she didn’t have a figure for how many applications for Jan. 1 coverage are still pending.
Insurers said some problems are inevitable because enrollment deadlines were repeatedly extended to help more people sign up in time for Jan. 1 coverage. The original deadline was Dec. 15, and Covered California was letting people finish applications as late as Dec. 27 after several extensions.
Insurers “are making every effort to ensure people are enrolled if they have made a good-faith effort,” said Nicole Evans, a spokeswoman for the California Assn. of Health Plans. “This kind of volume at one time in the individual insurance market is unprecedented.”
Open enrollment continues through March 31 under the healthcare law.
San Francisco resident Marin Perez, 29, tried for days to pay his $211 monthly premium to Anthem Blue Cross, a unit of industry giant WellPoint Inc.
He and other consumers have said the company’s online payment system wasn’t working in recent days. So, Perez said, he called the company, waiting on hold twice Friday for more than two hours apiece with no success.
“It was a complete nightmare,” said Perez, content manager for a technology start-up. He hasn’t had health insurance since leaving his previous job about three months ago.
“It seems the private sector should be a little more savvy about managing this,” Perez said. “I thought many times, just forget it, I’m going to take my chances” without insurance.
Perez said he was able to pay Monday only after contacting an Anthem official directly.
An Anthem spokesman said the company’s online payment system has gone down “intermittently” and the company “continues to increase its stability.”
Los Angeles resident Sandy Ragan, 60, was able to pay her premium for a Bronze plan with L.A. Care Health Plan on Dec. 9. But she’s frustrated because she hasn’t received a membership card or any other information from her insurer. She said she has asthma and high cholesterol and would like to see a doctor using her new benefits.
“The whole process has been so frustrating,” Ragan said.
A spokeswoman for L.A. Care said it takes consumer complaints seriously and it is always looking to improve its service.
Healthcare giant Kaiser Permanente said exchange enrollees can make medical appointments and get care even if they haven’t yet received an invoice or paid their first premium. Anthem Blue Cross said its enrollees needing care can file a claim and get reimbursed later, subject to the terms of their policy.
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