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<p>From what I remember reading, it is due to the websites, again, that are causing problems communicating all the necessary information about enrollees to the insurers and thus holding up billing.</p>
<p>Except they are having trouble billing people who, they acknowledge, are their subscribers. We’ve heard multiple accounts of this.</p>
<p>My billing issues are NOT with a plan that I got through the exchange… fwiw.</p>
<p>Ok, but your (CF’s) question specifically asked about “new clients.” I have no idea what the problem is with “old” clients.</p>
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<p>Anthem had DH’s application on 12/21. They did not enroll him until 1/10. That’s not a faulty transmission by the exchange. That’s Anthem’s being unable to process the application for almost 3 weeks once they had it. </p>
<p>My agent told me that Anthem of California has been overwhelmed with a “tsunami” of applications. Her word.</p>
<p>Sorry, GP. ;)</p>
<p>From Blue Shield’s facebook page…</p>
<p>“We’re very sorry for any issues you’re experiencing when reaching out to our customer service center or visiting our website. It is every bit as unacceptable to us as it is to you. While we anticipated and planned for increased traffic, the sheer volume of enrollments has swamped all major health plans. We owe you a much better service experience and are working through this challenge as quickly as we can. Thanks for being patient.”</p>
<p><a href=“http://www.sacbee.com/2014/01/04/6046423/kaiser-permanente-extends-payment.html[/url]”>http://www.sacbee.com/2014/01/04/6046423/kaiser-permanente-extends-payment.html</a></p>
<p>“. In addition, Kaiser Permanente has begun calling new members to inform them about the deadline extension and about the alternative to pay their premium online.”</p>
<p>For the subsidized applicants (which constitute 80% so far), the insurers need to verify Social Security numbers, citizenship and household income, correct? That is a lot of additional work not normally associated with a standard, unsubsidized policy. Regardless, it is surprising that they would be so overwhelmed, especially when the total enrolled is less than projected (altho I don’t think we know the individual states’ projections for Dec 31). It is either shoddy planning on their part, or the logistics/technology for verifying the additional information is not efficient.</p>
<p>More deadline changes…</p>
<p>[Capitol</a> Alert: State keeps Wednesday, but insurers pushing payment deadlines | State News | FresnoBee.com](<a href=“http://www.fresnobee.com/2014/01/14/3713437/capitol-alert-state-keeps-wednesday.html]Capitol”>http://www.fresnobee.com/2014/01/14/3713437/capitol-alert-state-keeps-wednesday.html)</p>
<p>"“We have extended the payment deadline for Jan. 1 coverage to Jan. 22 for those affected by processing delays, to allow all of our members time to receive and pay their invoices,” Kaiser spokesman Chris Stenrud said.</p>
<p>“We have also started an outbound call campaign to reach members proactively to help them make payments on-line or by phone, and to know how to get needed care.”</p>
<p>Stenrud noted that the “overwhelming majority” of those who enrolled in coverage that began this year have already received their invoices and paid for their coverage."</p>
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<p>So according to Blue Shield, they have more signups than planned and so does everyone else. So either they didn’t believe the CMS estimates, or they are getting a lot of signups off the exchange.</p>
<p>That really makes me want to know the mystery number, how many people have signed up off the exchange.</p>
<p>Covered California projections about California seem to be lower than CBO projections. </p>
<p>California is doing very, very well.</p>
<p>[California</a> continues to lead U.S. in numbers of health insurance enrollments - San Jose Mercury News](<a href=“California continues to lead U.S. in numbers of health insurance enrollments – The Mercury News”>California continues to lead U.S. in numbers of health insurance enrollments – The Mercury News)</p>
<p>"California’s numbers continue to lead the nation; its exchange added 389,498 from late November through Dec. 28 to reach a total of 498,794. Another 460,000 are getting signed up for MediCal, the state’s health program for the low-income.</p>
<p>"We’re pleased with the response of Californians turning to the state exchange for competitively priced health care coverage,‘’ said Larry Hicks, a spokesman for Covered California.</p>
<p>Officials there had projected a minimum of 487,000 enrollees by March 31, when open enrollment for 2014 ends. They estimated up to 700,000 Californians could sign up by then.</p>
<p>The surge in December enrollments reflected the procrastination by many Americans who waited until the last minute to beat a deadline to receive coverage this year under the Affordable Care Act, also known as Obamacare. And those late enrollments often taxed the exchanges, which repeatedly pushed back deadlines and grace periods to handle the crush of business.</p>
<p>The delays continue. An “unprecedented demand’’ on its customer service desk last month has prompted Anthem Blue Cross on Monday to extend its payment deadline for those who enrolled in a plan last month. Payments that were due Wednesday can now be received as late as Jan. 31.”</p>
<p>I don’t understand the shock that the first group of enrollees includes more older people than hoped. This was perfectly predictable. </p>
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<p>But enrollment isn’t over yet. There will be 3 more waves of signups, starting tomorrow. IMO it’s nonsensical to assume that the enrollees between now and March 15 will mirror the December 15 wave. The people who desperately need insurance were, I predict, heavily overrepresented in the first wave. As to what happens between now and the end of open enrollment:</p>
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<p><a href=“http://www.nytimes.com/2014/01/14/us/health-care-plans-attracting-more-older-less-healthy-people.html?hpw&rref=us&_r=0[/url]”>http://www.nytimes.com/2014/01/14/us/health-care-plans-attracting-more-older-less-healthy-people.html?hpw&rref=us&_r=0</a></p>
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<p>Why would the insurance companies need to do any of that? That makes no sense to me at all. For sure the exchanges have to verify that people are eligible for subsidies, but they do that before they send the customer’s data to the insurer. When the exchange sends a customer to a health plan, the insurer needs to know what plan was selected, who selected it, probably their SSN but that was already verified by the exchange, and what the amount of the subsidy is if any.</p>
<p>I’ve not heard it was up to any insurance company to check citizenship, because it’s not up to the insurance company to decide whether someone is eligible for a subsidy. AFAIK, foreign nationals can buy insurance in the US if they want it.</p>
<p>You are correct, Fang. The exchanges are responsible for verification, not the insurers.</p>
<p>Yes, my bad, it is the “exchange” that must do the verifying. But that does not change the fact that there are additional steps that must be performed for the subsidized before one is cleared to be insured, and is actually worse, because another level of bureaucracy must clear 3 things with other levels of bureaucracy, before the insurer can send out the bill for the policy.</p>
<p>For some reason I envision the “exchange” as the website itself, and not as an autonomous organization with employees.</p>
<p>I’m not sure what extra steps and levels of bureaucracy you’re referring to, Bay. My understanding is that the insurer gets two things from the exchange: The application indicating who is to be enrolled and in what plan, and the subsidy amount. Seems to me that all the insurer must do is enter the information from the application (this step applies to all apps, not just subsidized ones), and then enter the subsidy amount for those who have been found eligible during the exchange’s verification. </p>
<p>The insurer doesn’t do any “clearing”. They have no discretion about who is allowed to be insured, or what plan they’re allowed to choose, or what price they pay – with or without subsidy. Boiled down, their only job (at the point of purchase) is data entry. The decisions are all made on the exchange, before the insurer ever gets the application.</p>
<p>Yes, that is what I said.</p>
<p>The extra steps and levels of bureaucracy that are different from a standard application for insurance, are that the process involves the exchange, which verifies Social Security, citizenship and household income.</p>
<p>But then how are you exculpating the insurers in any way, Bay? You wrote:</p>
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<p>That could only make sense if the insurers weren’t billing people because the insurers didn’t have the enrollee data. But the insurers themselves acknowledge that they DO have the data. Whatever extra steps had to be taken have already been taken by the time the insurers get the data, and yet, the insurers by their own admission are overwhelmed. The exchanges have had their own well-publicized problems, but the insurers are screwing up royally on their own merits.</p>
<p>And I find the insurance company screw-ups baffling. They knew what was going to happen. They aren’t doing anything new here-- they need to bill people for insurance that people have purchased. Why are the insurers doing such a bad job at it?</p>
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<p>From what I remember reading (and I’m sorry but I don’t want to search it out again and it might have even been from a post on this thread), much of the data being received by the insurance companies is incomplete, or problematic. I did not read anything that said all the data received by the insurance companies was perfect. If it is, then I agree with you, that there is no excuse for the delays. I’m not exculpating anyone. I think there is no excuse either way. lol</p>
<p>Some seem to be complaining that they signed up on X date, and 3 weeks later, they had not been billed, for example. If this is a subsidized applicant, then the hold up could be either due to the exchange or the insurer. I don’t know how anyone could know which was the cause. If you are unsubsidized, then the delay is certainly the insurer’s fault. Unless you signed up through the exchange. lol</p>
<p>Let’s see…</p>
<p>The insurance companies say their was “unprecedented demand”. “Swamped”. They were “overwhelmed”.</p>
<p>When you run a business…those are good terms. ;)</p>
<p>Anthem hired 1,000 people and they were getting 500,000 calls a day at the beginning of the year. </p>
<p>That is 500 calls per employee a day.
That is not going to work. ;)</p>