Post by Logan on May 9, 2016 7:28:29 GMT -6
When Covered California goes wrong, insureds get the runaround
When it comes to signing up customers, Covered California has been a success. But when it comes to serving customers, the independent public agency — now in its third year of helping individuals and small businesses get federally subsidized or free health insurance — still has growing pains.
While the insurance marketplace works for most enrollees, a single mistake can set off an avalanche of errors that blocks coverage or generates inaccurate tax forms. When customers try to get problems fixed, some say, they get bounced from Covered California to their health insurer and back again. Even when all three parties get on a call together and come up with a solution, the fix doesn’t get made — or doesn’t stay fixed.
The Chronicle has learned that Covered California will submit a budget proposal to its board on Monday that includes $2 million for a new ombudsman’s office. In April, The Chronicle reported that Covered California lacked an ombudsman or consumer advocate, unlike many other public agencies.
For Elin Larson of Redwood City, Covered California worked just fine in 2014, but when 2015 rolled around, she discovered that the subsidy she had been getting on her Kaiser Permanente policy had disappeared, even though her income and household size had not changed. “I was on the phone with Kaiser and Covered California for almost three hours every week. It was like a little part-time job,” Larson said. “I almost got to the end of my rope on a couple occasions. I was crying.”
Read more: www.sfchronicle.com/business/article/When-Covered-California-goes-wrong-insureds-get-7420793.php?t=b26983ef62
When it comes to signing up customers, Covered California has been a success. But when it comes to serving customers, the independent public agency — now in its third year of helping individuals and small businesses get federally subsidized or free health insurance — still has growing pains.
While the insurance marketplace works for most enrollees, a single mistake can set off an avalanche of errors that blocks coverage or generates inaccurate tax forms. When customers try to get problems fixed, some say, they get bounced from Covered California to their health insurer and back again. Even when all three parties get on a call together and come up with a solution, the fix doesn’t get made — or doesn’t stay fixed.
The Chronicle has learned that Covered California will submit a budget proposal to its board on Monday that includes $2 million for a new ombudsman’s office. In April, The Chronicle reported that Covered California lacked an ombudsman or consumer advocate, unlike many other public agencies.
For Elin Larson of Redwood City, Covered California worked just fine in 2014, but when 2015 rolled around, she discovered that the subsidy she had been getting on her Kaiser Permanente policy had disappeared, even though her income and household size had not changed. “I was on the phone with Kaiser and Covered California for almost three hours every week. It was like a little part-time job,” Larson said. “I almost got to the end of my rope on a couple occasions. I was crying.”
Read more: www.sfchronicle.com/business/article/When-Covered-California-goes-wrong-insureds-get-7420793.php?t=b26983ef62