Covered California turns to local agents to deal with deluge of applications

jlavelle@thetribunenews.comDecember 9, 2013 

Covered California has turned to local insurance agents for help as it struggles to process a backlog of 25,000 paper applications for individual health insurance.

Last week, state officials asked insurance agents who had already mailed or faxed applications to go back and upload the information directly onto the health exchange website.

“We have reached out to ask insurance agents to help us with the backlog,” said Larry Hicks, a spokesman for Covered California. “It’s sort of an all-hands-on-deck situation.”

The exchange has also reassigned some employees to help process the deluge of paperwork sent in directly from consumers. Many of the paper applications were sent during the first weeks after the Covered California website debuted Oct. 1 with glitches that now are mostly resolved, Hicks said.

While consumers can apply for individual health insurance plans directly on the Covered California website, they also can go to an insurance agent certified by Covered California to help them file an application.

There are more than 8,000 certified Covered California agents statewide, including more than 100 in San Luis Obispo County.

In Paso Robles, Dee Hinds, chief financial officer for HFG Coastal Insurance Services, said his company has filed 55 Covered California applications.

“They asked us to resubmit 40 of them online,” he said. “This is very stressful. The applications have to be processed through Covered California, which sends them to the insurance companies so a policy can be issued. The system is swamped.”

The deadline for people to apply for insurance that will start on Jan. 1 is rapidly approaching. Applications must be filed by Dec. 23 and the first premium paid by Jan. 5.

In San Luis Obispo, insurance agent Michael Framberger said he, too, has been working overtime to resubmit applications he originally sent to Covered California by mail or fax.

“I’m re-entering everything we sent in from the beginning to make sure they’re in the system,” he said. “My biggest fear is that (statewide) we’re not going to be able to get this done in time. I’m spending 25 minutes to an hour to file an application online. You can only do a handful of these per day with everything else we have to do.”

Framberger said that as the Dec. 23 deadline approaches, he expects Covered California to be overwhelmed.

“People are coming out of the woodwork now to sign up,” he said. “I don’t see any way at this point that they’ll have everyone enrolled and billed (by insurance companies) by Jan. 1. So, we’ll just have to see what happens.”

Hicks said that Covered California is up-to-date with online applications.

“We are sending those applications to insurers on a daily basis electronically and they will send an invoice to the consumer,” he said. “As of Friday we are up to date in transmitting the forms from people who have submitted applications electronically.”

Paso Robles resident RoseAnn Keating has spent a nerve-wracking two months trying to make sure she’ll have insurance on Jan. 1. She’s filed applications both by mail and online.

Keating went to the Covered California website after Aetna notified her that her policy would be cancelled Jan. 1.

She chose an Anthem Blue Cross plan and mailed in an application on Oct. 4, after a Covered California helpline employee said it would be forwarded to Anthem in a week or two.

On Nov. 15, Blue Cross said they hadn’t received her application from Covered California, so she immediately filed a new one, this time online. Last week, Anthem Blue Cross told her they still hadn’t received it.

Keating tries to keep her sense of humor, figuring that eventually things will work out.

“It’s a good thing the Affordable Care Act requires psychiatric coverage because this whole thing is driving me crazy,” she jokes.

On Monday, she was rewarded by reassurance from another Covered California helpline employee that she was in the system.

“She also said that I would be covered effective Jan. 1, 2014 even if I do not hear from Anthem by then. Phew!”

As of mid-November, Covered California had enrolled nearly 80,000 people in health plans. Those numbers don’t reflect the 25,000 unprocessed paper applications.

 

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