30,000 under Covered California experience delays, dropped coverage

LOS ANGELES — Covered California acknowledged problems with enrollment delays and dropped health plan coverage for nearly 30,000 consumers over the weekend. The health insurance exchange is working to fix the issue before the next sign-up period this fall.

According to officials, the health plan provider failed to promptly send insurance applications for 20,000 people, which caused confusion and delays over coverage. Up to 10,000 had their Covered California insurance prematurely canceled because they were deemed eligible for Medi-Cal, the California Medicaid welfare program for low-income residents, based on an income check.

Covered California said that the private insurance should remain in place until Medi-Cal coverage takes over.

“There have been some cases of individuals where the wires got crossed and people were removed from Covered California before Medi-Cal was live,” said executive director Peter Lee. “It’s been a limited number of cases, but it’s still a concern.”

He added that the exchange is “working to improve” notices to consumers who were affected from the switch.

So far, Covered California has been contacting over 50,000 households in risk of losing health coverage without proof of citizenship or legal residency. About half have been cleared, but thousands of households must still provide verification. Under the Affordable Care Act, their insurance will be canceled by October 31st if they fail to provide proper documents.

Many customers have had problems reaching the state’s customer service, with less than one percent of callers reaching the exchange within 30 seconds, and 64 percent abandoning the call entirely. Call-center workers, according to Lee, have not been all that receptive nor consistent.

“We have taken a lot of people off the phone in the past month,” Lee said. “Unfortunately, we haven’t been answering the phone as quickly as we would like.”

Board member Robert Ross suggested a plan to reduce wait times for calls, particularly during open enrollment season beginning Nov. 15, and an extra call-center support will hopefully be on board to help during peak times. About 1.2 million enrollees will be looking to renew their coverage or shop for a new insurance policy before January.

Covered California plans to upgrade the state website to better assist consumers with their questions in order to reduce calls, as well as provide more efficient services; for example, being able to pay the initial premium online at sign-up rather than waiting for the bill.

On Thursday, the exchange board also voted to refrain from taking an official position on Proposition 45, which would give the California government restrictive authority over health insurance premium rates.

Previously, the exchange had called a formal statement against the new measure. Now they decline to comment.

“I think we have established a reputation of openness, evidence and consumer protection and for that reason I have been unwilling to further make this political by taking a formal board position,” said Diana Dooley, chair of the exchange board and secretary of the state Health and Human Services Agency.

Dooley also added, “I personally have some very serious concerns about the interaction of the plain language of this initiative and the work that we’ve invested in making the Affordable Care Act real in California.”

(With reports from LA Times and the California Healthline)

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