How did a Reno collections agent end up in collections himself?
He bought coverage in 2014 through the state’s health insurance exchange.
Rick Furst is still ironing out wrinkles in a plan purchased in May through Nevada Health Link and its contractor, Xerox. His cascade of issues has included bad coverage dates, unpaid medical bills and an incorrect tax-credit form.
“My credit was excellent, and now my credit is shot,” he said.
Furst is one of many Nevadans still struggling with Nevada Health Link’s woes. It’s hard to know how many others have coverage or tax-credit hiccups because exchange officials say the way they track unresolved cases makes it difficult to put a number to the problem. Nor do they trust Xerox’s reports on how many unreconciled cases remain.
What’s clear is some fixes are moving at a glacial pace with a week left until Tax Day, and some consumers will run out of time.
Karen, a Southern Nevadan who asked that we use only her first name, said representatives in Xerox’s Henderson call center advised her to request an IRS filing extension after her premium tax-credit statement, or 1095-A form, showed mistakes. That’s a problem because she needs her $1,000 refund to “juggle bills and get caught up.”
FORM ERRORS
The glitches aren’t an issue for the 75,000 consumers who bought through Nevada Health Link starting in November because the marketplace switched to the federal government’s more effective healthcare.gov system after it fired Xerox in May.
Xerox agreed to stay on through April 15 to help with coverage issues and tax-credit forms, but not all of the 35,000 who signed up in 2013 and 2014 “have been made whole,” local insurance broker Dwight Mazzone said.
Added local broker Pat Casale: “The average person has to work so hard to undo mistakes made on their behalf.”
Consider Casale’s client Dave Benardino of Las Vegas, who made only two premium payments for coverage that essentially ran from April through June of 2014.
The 1095-A form the exchange sent him said he had insurance from April through December. It also stated that the federal government covered $3,700 in tax credits to help pay his premiums.
It’s not clear whether the exchange or the insurer ever received the $3,700, Casale said, but Benardino is now looking at a tax bill of $1,800.
“All of a sudden, they’re telling me I owe thousands of dollars in subsidies. I never got subsidies,” he said.
Casale said Benardino is “getting bills for services never rendered. How many people is this happening to?”
At one point last spring, there were about 10,000 problem cases with exchange-based coverage, Casale noted.
“Does that mean there are 10,000 1095 errors?” he asked.
Other states and the federal government had to reissue 10 percent to 12 percent of their customers’ 1095-A forms.
If that share holds in Nevada, which had more persistent technical glitches than many other exchanges, the exchange may have to correct roughly 3,000 forms.
Xerox representatives did not estimate on Tuesday how many forms they might need to patch before the company’s 30-person call center closes on April 16 and is replaced with the exchange’s 10-employee call center in Carson City. They also didn’t say how many corrected forms the company has sent.
But Xerox spokeswoman Jennifer Wasmer said the accuracy rate for 1095-A forms in Nevada “is significantly higher” than for the federal and other state exchanges.
“For the vast majority of errors that did occur in Nevada, our customer-service representatives already have resolved matters, and new forms have been mailed or are in process. The exchange is responsible for getting all carriers to participate fully in order to resolve all issues affecting any individual,” Wasmer said.
As of March 5 — the most recent numbers available — Xerox had sent out 209 corrected forms. In a March 12 schedule submitted to the exchange board, Xerox said it would make two more mailings, one around March 17 and one in April, to an “unknown” number of households.
SLOW RESPONSE
Wasmer said Xerox sent three mailings in March, with one expected this week.
Karen said that for her it’s been slow-going.
She took the 1095-A form she received in January to her tax-preparer on Feb. 7. The two determined the form quoted the wrong coverage dates. She made nearly a half-dozen calls to Xerox’s customer-service center in February. On March 5, call-center reps told her they had finally “gotten authorization to review” her problem.
“I was shocked, and said the problem has supposedly (been) getting worked on for weeks,” Karen said. “And now I’m told they didn’t even have authorization yet?”
She added that call-center employees told her they print corrected forms only every two weeks and send out mailings just once a month. They said her form would be mailed on March 20.
Wasmer said reprints of original forms are mailed daily on request, usually within one or two days.
As of Tuesday, Karen still had a bad form.
“I’ve asked (Nevada Health Link) several times if there is anywhere I can go to show my ID and pick up a copy of my corrected 1095, but the answer is always, ‘No,’ ” she said. “I don’t think customer service has ever been part of their plan.”
Wasmer said Xerox “is not making any of the policies” related to 1095-A forms.
“Rather, we are fulfilling those laid out by the exchange,” she said.
The exchange’s policies call for Xerox to send corrected forms “in a time-frame that allows for an extensive review and correction period” that can take a “number of days” to complete, agency spokesman Tyler Klimas said.
Klimas said the exchange is also advising consumers to visit licensed professionals for tax advice, and that Nevada Health Link is unable to provide walk-in service for 1095-A inquiries.
“The exchange is working closely with Xerox to ensure the proper resolution on all 1095-related issues,” he said. “We will continue to work together to solve these issues in the most effective and efficient manner possible.”
Furst, at least, received his corrected form on March 31.
Not all of the Reno man’s problems are fixed, though.
He paid his premium on May 23 for a July 1 policy start date. On July 3, excruciating abdominal pain sent him to an urgent-care center. But he never received member ID cards and couldn’t prove coverage. He paid $120 out-of-pocket for his care and a referral for diagnosis. On July 6, he entered a Reno-area hospital, where a test found stomach ulcers. Furst said he spent two days in the hospital on pain medicine. He couldn’t pay the $10,000 tab.
He’s personally out the $600 or so he could afford out of pocket. He’s in collections on much of the rest. He said he hopes the bills will be paid now that his 1095-A form reflects his actual July 1 start date.
What Furst won’t get is a do-over on the aggravation his experience put him through.
“I had a hole in my stomach,” he said. “I don’t need this frigging stress.”