Health & Medicine

California pilot program seeks to close the deal with health insurance shoppers

Robert Blatt started an application but abandoned the effort before selecting a plan through the state’s health insurance marketplace.

But soon after, Blatt was contacted by a certified insurance agent for Covered California stating he was eligible for coverage.

“I look forward to assisting you!” the agent, Stephanie Berger, wrote in an email to Blatt, a consultant from Moorpark in Ventura County.

Blatt, 60, is one of tens of thousands of prospective customers who began their application but has yet to select a specific plan. This week, Covered California quietly unveiled a pilot program meant to close the deal with customers by Dec. 23 for their coverage to start Jan. 1.

The program involves the state exchange providing customers’ names and contact information to firms working with Covered California, which then turn it over to their certified licensed insurance agents.

Blatt, who didn’t end up seeking coverage because his current plan was extended, was not pleased to learn his information had been shared. He remains convinced the state lacks the authority to do so.

“That’s a violation of so many rules,” he told The Sacramento Bee. “I don’t even know where to begin.”

“People need to know that the state government is releasing personal information to sales agents without their approval.”

Anne Gonzales, a spokeswoman for Covered California, said the exchange is within its rights to release names and contact information for enrollment purposes, and is not providing medical or financial information. Agents are certified by the exchange, and those participating in the program are given additional training.

Participating agents also receive prepared scripts to work from and must check with the customer to ensure they are not working with another agent. (The individual who contacted Blatt did just that.)

Berger said she received her initial batch of customer leads on Wednesday, and most of the people she hears back from are happy to receive the assistance.

“These are people who are welcoming the help because they are confused,” Berger said.

The exchange opened enrollment on Oct. 1, and completed applications have increased steadily.

As predicted by exchange officials, the agency has been hit with a crush of applications in recent weeks and at times has struggled to keep up with the demand as customers try to get in under the deadline to begin receiving coverage in the new year.

On Wednesday, the state marketplace received about 17,000 calls into its service centers in one 50-minute period, surpassing what it was getting each day in the weeks prior. On Nov. 30, officials said the number of calls was nearly 90 percent higher than the previous Saturday.

Meanwhile, the agency is rushing to process more than 21,000 paper applications to meet the deadline. Officials said they are bringing on more staff and pushed back the first payment deadline to Jan. 5.

The goal of the pilot program is to ensure the thousands of “in-play applications,” are completed and that people who need additional help see their needs met.

“For all we know, they may think they are finished,” Gonzales said.

“We have to reach out to them,” she added. “We don’t want to lose them if they are interested in getting a plan.”

Commissions for agents in the individual exchange market are 10 percent in 2014. Exchange officials said the program has long been contemplated but acknowledged some residents could be surprised about being contacted.

In the email chain he shared with The Bee, Blatt made it clear he no longer required coverage and then began peppering the agent with questions about how she got his information and the extent of the personal data she was provided.

“Please provide specifics,” he wrote.

The agent stated it came from the state exchange before issuing a final promise: “I’m not going to solicit to you in the future.”

Related stories from Sacramento Bee