As of Friday, August 8, 2014
Some families who’ve purchased, and paid for, insurance plans through Washington Healthplanfinder are receiving notices that their payments are overdue.
Certain issues, say state officials, have prevented payments from being correctly applied to customer accounts or distributed to insurance companies.
State officials also warn these “issues” may continue to result in customer notices from Washington Healthplanfinder…notices that request payment, or notifications that insurance companies are unaware payments have been made.
According to the state, any consumer experiencing payment issues with their health care coverage through Washington Healthplanfinder has the option to pay their health insurer directly.
There are additional steps consumers should take, as well.
“We want consumers to know they have several options to pay their premiums and have the certainty they deserve that their coverage is current,” Gov. Jay Inslee said.
“I encourage anyone with payment questions to contact Washington Healthplanfinder. They can help,” Inslee added.
Richard Onizuka, CEO for the Washington Health Benefit Exchange, said his agency apologizes to all customers in this situation and realizes that behind every application is an individual or family who is seeking care.
“It is critical that we continue to deliver on our promise of providing the best marketplace experience as expected by our state and all its residents,” said Onizuka.
State officials say consumers who are currently experiencing payment problems may take the following steps:
…First, consumers can con-
tact the Washington Health-planfinder Customer Support Center at 1-855-923-4633 to ensure the center is aware of the consumer’s issues. The consumer should clearly communicate any medical emergencies or urgent prescription needs to the customer support rep.
Consumers who have called in previously should provide their issue “ticket number” to the representative.
…Next, consumers may submit their monthly premium directly to their health insurer.
If a person or family enrolled in a Qualified Health Plan after April 1, 2014, they’ll need to submit supporting documentation to prove they are eligible for a special enrollment period. Both enrollment information and monthly payments for these customers will not be sent to the insurance company until this information is received and reviewed by Exchange staff.
State officials say if a customer has enrolled and paid their premiums through Washington Healthplanfinder, the Exchange will work with their insurance company to ensure that their coverage start date as listed in Healthplanfinder is upheld.
Washington Healthplanfinder administrators explained that even if a customer’s premium payments have not been immediately sent over, their coverage will be effective from their start date and claims for services will be covered under their plan benefits.
Those having trouble using their coverage are asked to contact Washington Insurance Commissioner Mike Kreidler’s office at 1-800-562-6900.
Kreidler notified health insurers yesterday (Thursday) of their obligation under the federal Affordable Care Act to accept direct payments from consumers.
“We cannot stress enough that resolving these system defects is the top priority for the Washington Health Benefit Exchange and our Board,” said Onizuka.
“The Exchange has developed an aggressive action plan to address these issues as quickly as possible, including implementing emergency system updates, bringing on additional staff members and engaging in collaborative meetings with our IT integrator, Deloitte, and the insurance companies to identify technical issues and define a roadmap that will allow us to achieve significant progress by the end of August.”