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California Health Insurance Exchange Confronted With a Backlog of 25,000 Paper Applications

by Vanessa Jones on December 10, 2013 at 1:15 PM
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 California Health Insurance Exchange Confronted With a Backlog of 25,000 Paper Applications

Those people who filled out the paper work for health covers on their own or through insurance agents or with the help of an enrollment counselor might miss the deadline. The California's online exchange faces a backlog of more than 25,000 paper applications that have to be re-submitted online.

The Covered California officials feel that this could be done in a week's time, though critics feel that it will result in many people without insurance before the deadline. Now the question is whether Covered California can finalize the huge number of last minute applications before the 1st of January when coverage will begin.

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"They're not prepared,'' said Oly Storz, owner of Storz Insurance Services in Los Gatos."People have been given false expectations.'' He found that brokers from his company had waited for 3 months to be certified to be able to sell plans on the exchange. "It's an avalanche now,'' said Storz of Covered California."They say they're adding resources but they can't just hire new people who don't know what they're doing. It's just mind-boggling.'' Larry Hicks, a spokesman for Covered California, said the exchange has "adequate personnel and adequate computer capacity to handle the workload that is to come.'' Hicks pointed out that those buying insurance on the exchange have "a lot of different paths to enrollment,'' including 7,700 insurance agents, 2,047 enrollment counselors and 10,725 county eligibility workers.

The paper applications backlog was discovered only last week. "You've got 25,000 applicants that have not been processed yet and those 25,000 are expecting coverage on Jan. 1,'' said Neil Crosby, spokesman for the California Association of Health Underwriters. "But since they're not yet in the system, the insurers don't even know they exist,'' said Crosby. Hicks agreed that it would be tough and the staff would deal with this issue first, he said, "It's an avalanche now,'' said Storz of Covered California."They say they're adding resources but they can't just hire new people who don't know what they're doing. It's just mind-boggling.'' When the web site failed to work properly - certified insurance agents printed out the 32 page form and their clients filled it and mailed it to the exchange's office.
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The forms have to be entered online for the insurers to send the client a notice of premium payments due, which have to be paid by December 31st for coverage to begin by January 1st. When Covered California realized it could not process all 25,000 applications, the exchange approached the California Association of Health Underwriters for help with the backlog. Covered California is entering basic information from each application and any more information needed is added by agents or Certified Enrollment counselors, Hicks said. "All we are asking agents to do is finish the enrollment process as it was intended -- online -- and for which they are compensated by insurers,'' said Hicks. Consumers cannot assume that by filling out their paper work their application was accepted and that their coverage would begin.

References:

Hannah Punitha (IRDA Licence Number: 2710062)

Tracy Seipel, December 2013

Source: Medindia
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