California’s health insurance exchange is vowing to fix enrollment delays and dropped coverage for about 30,000 consumers before the next sign-up period this fall.
Covered California said it failed to promptly send insurance applications for 20,000 people to health plans recently, causing delays and confusion over their coverage.
Another group of up to 10,000 people have had their insurance coverage canceled prematurely because they were deemed eligible for Medi-Cal based on a check of their income, officials said.
The exchange said the private insurance should remain in place until coverage kicks in under Medi-Cal, the state’s Medicaid program for lower-income residents.
“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 Peter Lee, executive director of Covered California. “It’s been a limited number of cases, but it’s still a concern.”
At the same time, Covered California has been contacting nearly 100,000 households that risked losing coverage if they didn’t provide proof of citizenship or legal residency.
Covered California said it has cleared half of that list and about 50,000 households must still provide verification. Their coverage under the Affordable Care Act will be canceled Oct. 31 if they fail to provide the proper documentation.
That verification effort, in particular, has taken a toll on the state’s customer service, according to the exchange.
Less than 1% of callers reached the exchange within 30 seconds last month; the state’s goal is an 80% response rate in half a minute.
Sixty-four percent of people abandoned their call entirely.
Lee attributed the poor performance to shifting call-center workers to citizenship and residency issues.
“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.”
Robert Ross, a Covered California board member, asked at last week’s board meeting whether there was a plan to reduce wait times before calls ramp up when open enrollment begins Nov. 15.
Also, about 1.2 million enrollees will be looking to renew their coverage or shop for a new policy prior to January.
Lee said the exchange is close to hiring an outside vendor to supply extra call-center support during peak times.
He also noted that upgrades to the state website should decrease the number of consumer questions and calls.
For instance, applicants will be able to pay their initial premium online at sign-up rather than wait for their insurer to bill them. That two-step process confused many consumers who were unsure about the status of their coverage, and it triggered a high volume of calls.