Amid confusion, some California health insurance deadlines are pushed back
01/15/2014 12:00 AM
01/15/2014 12:01 AM
Beset by processing delays and customer confusion, two providers operating in the state’s new health insurance exchange have pushed back their due dates for premium payments.
On Tuesday, officials with Anthem Blue Cross of California said the company was pushing back its payment deadline to Jan. 31. Kaiser Permanente set its new payment date for Jan. 22.
Meanwhile, the state exchange said its deadline would remain midnight tonight for those whose coverage with nine other participating insurers begins Jan. 1. Midnight tonight is also the deadline for customers to enroll in coverage that begins Feb. 1.
Deadlines for payment under the Covered California exchange have been a moving target as the state and insurers seek to enroll hundreds of thousands of people in the new system.
Some who signed up for health insurance through the exchange have been complaining about long delays in receiving invoices to pay their first monthly premium. Others who made their payments are awaiting confirmation. Covered California and several insurance companies have acknowledged the raft of delays, including exceedingly long wait times for telephone customer service inquiries.
Covered California had already extended its payment deadline from Jan. 6 to tonight, a decision that spokesman Roy Kennedy said “was agreed unanimously to by the 11 health providers.”
Kennedy said the exchange has processed and passed along to insurers all of the applications for coverage that began Jan. 1, including paper submissions. That hasn’t stopped customers from inundating the exchange with phone calls in recent weeks.
Average wait times increased to nearly 46 minutes in the first few days of January, an increase of more than 10 minutes over the first week of December and more than 20 minutes over the last week of November.
Calls into the exchange’s service centers warned of half-hour waits. Throughout Monday, callers were instructed to visit the exchange’s website before being told “goodbye.” The system can accommodate 1,288 simultaneous callers and up to another 550 in a holding queue.
Callers get a sped-up busy signal once the number of calls reaches 2,600, Kennedy said. The exchange is exploring the possibility of adding phone lines at its customer service centers in Rancho Cordova, Concord and Fresno, where it continues to hire more operators.
“The demand for coverage and information is there, and that’s why we are seeing so many people contacting us,” Kennedy said.
Customers also reported long wait times and problems trying to get through to their insurers.
James Thomas of Fair Oaks said his experience trying to obtain coverage through the state exchange was dismal. Three weeks after enrolling, Thomas still couldn’t pay his first premium because he had yet to receive an invoice from his provider, Anthem Blue Cross.
Thomas tried reaching out to the insurance company, Covered California and certified enrollment agents, but he kept getting busy signals and forced hang-ups.
When he could get through to a live person, they were of little help. Then, last weekend, he received a mailed invoice and was able to pay.
“It was very, very frustrating,” Thomas said. “And throughout it I didn’t believe that I could be the only one in such a position.”
The myriad delays have many customers “getting nervous and irate because they don’t know what is happening,” said Jeffrey Tompkins, an insurance agent.
More than 1 million calls came into Anthem Blue Cross companywide in the first two days of the month, surpassing its usual monthly total, spokesman Darrel Ng said. The company has made hundreds of new hires, repurposed other employees and extended service hours to handle the increased demand, he said.
Still, officials opted to move their payment deadline for customers with coverage that began this month to Jan. 31.
Chris Stenrud, a spokesman for Kaiser, said the insurer extended the payment deadline by one week to Jan. 22 for those affected by processing delays and to allow all members time to receive and pay their invoices. Kaiser also started an outbound call campaign to reach members proactively to help them make payments by phone or online, and to know how to get the care they need, Stenrud said.
He noted an “overwhelming majority” of those who enrolled in coverage that began this year have already received their invoices and paid for their plans.
“We will ensure that all members seeking medical care, including new members, are able to receive the care they need when they need it, even if they have not received their ID card yet,” he said.
Blue Shield of California decided against extending the payment deadline because the vast majority of enrollees in its exchange plans have already paid, spokesman Steve Shivinsky said.
California continues to lead the nation in health exchange enrollment. Through Dec. 28, nearly 500,000 people selected plans and another 460,000 were getting covered through the state program for low-income residents.
Editor's Choice Videos
Join the Discussion
The Sacramento Bee is pleased to provide this opportunity to share information, experiences and observations about what's in the news. Some of the comments may be reprinted elsewhere on the site or in the newspaper. We encourage lively, open debate on the issues of the day, and ask that you refrain from profanity, hate speech, personal comments and remarks that are off point. Thank you for taking the time to offer your thoughts.