0

Washington state’s health plan exchange frustrating consumers and brokers alike

In a scene George Orwell might have concocted, Monica Kennard found more than she bargained for with the state’s healthplan finder to obtain health insurance.

With help from a Yakima County insurance broker, Barbara Bloomfield, Kennard completed the insurance application with Washington Healthplan Finder a month ago.

It’s been frustration after frustration since, as the program took five monthly insurance premiums out of her bank account – at a cost of more than $2,000 - even though she was only eligible for coverage starting this month.

To add insult to injury, Kennard has since found out that her chosen provider, Lifewise, doesn’t even list her as a plan subscriber.

“I’m responsible for all doctor bills,” Kennard said in exasperation. “How is that possible after I’ve already paid over $2,000? That’s crazy!”

She learned about the lack of coverage after visiting a doctor this month only to be told she did not have insurance and, further, Lifewise had not received any money.

Bloomfield says she called the state’s insurance commissioner’s office and was told the agency is aware of the problem, but that she would need to turn to officials with WA Healthplan Finder to resolve the issue.

That was also the message from Stephanie Marquis with the insurance commissioner’s office.

“We have heard anecdotally of money taken out, or that the insurance company doesn’t have them enrolled as a subscriber,” says Marquis. “You would need to talk to the exchange itself.”

Upon Marquis’ recommendation, the Daily Sun News called the exchange’s communications director, Michael Marchand.

Marchand did not respond to attempts to reach him at his office or cell phone. Instead, another spokesperson for the exchange, Bethany Frey, replied.

In repeated attempts to gain comment from the exchange, Frey did not confirm or deny the insurance payment issues. She did, however, pledge to forward the concerns for further investigation.

Exchange snafu impacts local broker

Here in Sunnyside, insurance broker Mark Van Hollenbeke shares Kennard’s frustrations.

That’s because he, too, has faced snafus with the insurance exchange.

“Last summer I got certified to be a broker with the exchange,” said Van Hollenbeke, who operates Vanmar Insurance. “But when I couldn’t pull up a customer to serve them I called the exchange’s direct line for brokers and was told I wasn’t in their system.”

According to the exchange website, Van Hollenbeke is indeed a registered broker.

He fears the hiccups experienced by brokers and consumers is just the tip of the iceberg for the Affordable Care Act.

Van Hollenbeke notes in December he helped 93 customers sign up with the health benefit exchange, and only two found less expensive premiums.

In his own situation, Van Hollenbeke says his monthly premiums doubled.

For those finding cheaper premiums due to subsidies, he’s concerned their monthly premiums will rise sharply in a year when it’s time for renewal.

“We fully expect we’ll see a 100 percent increase at the renewal,” he said, noting the program is intended to eventually be self-sustaining.

Sunnyside success stories

As for consumers like Kennard who don’t yet show up as an insurance subscriber, Van Hollenbeke notes to be fair that for many insurance plans it take a month or so for customers to be reflected in the system as enrolled clients.

Plus, here in Sunnyside there are success stories with the exchange.

“We have not experienced or heard that,” says Rhonda Hauff, Chief Operating Officer and Deputy CEO of Yakima Neighborhood Health.

The agency has been helping consumers in both Yakima and Sunnyside obtain health insurance through the exchange, and Hauff says there haven’t been issues with multiple payments deducted or consumers not listed as subscribers. “We have not heard those stories,” says Hauff.

She notes that about 80 to 85 percent of the people they assist qualify for the state’s Apple Health or Medicaid plan.

In 2013, Yakima Neighborhood Health doubled the size of its Sunnyside clinic with renovations funded by a $4.7 million grant through the Affordable Care Act.

“We don’t sleep well”

In an e-mail this morning, Thursday, Bloomfield says despite communicating with the governor’s office the issues of multiple payments and lack of coverage still have not been resolved.

She says state officials have told her that in order for five payments to have been deducted they must have been submitted five times.

“Passing the buck seems to be their game plan,” says Bloomfield. “It has been submitted more than once because the system gives an error code and the payment does not show up.”

She added the issue seems to be a lack of communication, both with the exchange and consumers and within the agency itself.

“They need to communicate within their varying departments to ensure this doesn’t happen,” she says.

And, ultimately, that’s why Kennard and Bloomfield want to get their situation told…to make sure it doesn’t happen to others.

“This is absolutely outrageous and unacceptable. My question is how many people would be bouncing checks by now, not paying other monthly bills and going without necessities as a result of this screw up?” says Bloomfield.

Kennard says the experience is upsetting for her family.

“It’s really stressing me. It’s just not right,” she said. “We’ve been coping with it the best we can. We don’t sleep well, we’re afraid they’ll take more money.”

Comments

Use the comment form below to begin a discussion about this content.

Sign in to comment