<p>Of course the demand is unprecedented. Duh. That they are swamped and overwhelmed implies that they were unprepared.</p>
<p>Duh…</p>
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<p>Well, what do you make of our case then? DH didn’t apply for a subsidy (so there was no verification process at all), AND he enrolled through the exchange. Application submitted through the exchange on 12/21. Anthem acknowledges that they had the full, complete application on 12/21. This should have been the simplest application they had – one enrollee, straightforward data entry – and yet it took 3 weeks to process. Responsibility for that delay lies 100% at Anthem’s doorstep. </p>
<p>I agree with you – why on God’s green earth the insurers didn’t anticipate a deluge of applications is beyond me – unless enrollments are far beyond anyone’s predictions. That seems the most likely explanation to me, although we don’t know how many apps are currently languishing in the pipeline like ours did. But we shall see.</p>
<p>I wonder what the insurance companies predicted as far as total enrollments, and how many people are signing up off the exchanges. Maybe the insurance companies are just incompetent, and didn’t staff up adequately to meet their own predictions. But it sure looks like they are getting more enrollees than they thought they would.</p>
<p>It was also the holidays, don’t forget. I don’t know how much that impacts an employer’s ability to keep employees at their desks, even when there is a need.</p>
<p>The insurance companies are still way behind. First of all, it can’t have been any surprise to any insurance company that Christmas and New Years fall at the end of the year, and secondly, New Years Day was two weeks ago.</p>
<p>Since 80% of people applying are getting subsidies, more is involved on the back end.</p>
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<p>This is incorrect, and it’s almost certainly far from the truth. Of the people signing up on the exchanges, 80% are getting subsidies. Of the people signing up off the exchanges, 0% are getting subsidies. </p>
<p>We don’t know how many people are signing up off the exchanges. We do know that it’s not zero people.</p>
<p>Bay, all of the verification stuff takes place before the insurance company ever receives the information - the only thing that is different for the insurance company from applications in the past is the need to account for the subsidy, which is simply an amount they are given. In California the payment date was extended to Jan 15 and I have received an email from Covered California saying that insurance companies are extending it out even further – but the information has already been transmitted from exchange to insurer – it is the insurance companies who seem to be having difficulty getting the bills out – and anecdotally, Anthem seems to be the one with the major issues (though Anthem is also probably the company with the largest number of new subscribers). (I’ve got Blue Shield and they seem to be doing a better job of keeping up with the demand – I’ve got my insurance card in hand. The only problem I’ve encountered is that the computer interface doesn’t seem ready to deal with my month #2 (February) payment - I’d like to set it up for auto-billing to my credit card, but maybe I need to wait until the Feb. invoice is generated). </p>
<p>I don’t really know why the insurance companies are having a problem with the simple tasks of managing phone lines & billing. Yes they have a flood of new applicants, but most of the process could or should be automated.</p>
<p>“Who’s Buying Obamacare, in Three Charts”</p>
<p>[Who’s</a> Buying Obamacare, in Three Charts - Businessweek](<a href=“Bloomberg - Are you a robot?”>Bloomberg - Are you a robot?)</p>
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<p>If by “back end” you mean the insurers, no, that is incorrect. The only additional task for the insurers on a subsidized enrollment is the need to input ONE additional number. They don’t even have to calculate that number; it is given to them by the exchange.</p>
<p>If you mean the exchanges, it’s correct that they need to do more, but they are handling it. Once they turn an application over the insurers is when it seems to go into a black hole.</p>
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<p>A more accurate headline would be: “Who’s Bought Obamacare During the First Half of the Enrollment Period.” It’s highly doubtful that the same mix of people will be buying it in January, February and March.</p>
<p>And I know you didn’t write the headline, but for the record, there’s no such thing as “buying Obamacare.”</p>
<p>"The insurance companies say their was “unprecedented demand”. “Swamped”. They were “overwhelmed”.</p>
<p>Yup. So, let me see. Not enough people are signing up, yadda, yadda, yadda. ObamaCare has failed - dum-de-dum-dah-dah. But the insurance companies can’t manage a system to rake in all their new dollars quickly enough.</p>
<p>What’s wrong with this picture?</p>
<p>For absolutely no logical reason I can think of, I would’ve thought the % buying on the exchange without a subsidy would’ve been much lower. </p>
<p>If it was an issue with the exchange not getting the numbers to the insurance company, there wouldn’t be cases like mine that have nothing to do with the exchange having major billing issues.</p>
<p>You’ve got to figure that some people who bought on the exchange are like Calmom; they didn’t ask for advance subsidies, but they are preserving their right to get a refund on their taxes if they turn out not to earn as much as they hope.</p>
<p>Good point- CF! I didn’t think about that population.</p>
<p>"A more accurate headline would be: "</p>
<p>Take it up with business week. I don’t really care what it needs to be.</p>
<p>I do suggest you tone down these lectures.</p>
<p>Calmom, the exchange fed my info to the insurer and I got my insurance cards before the verification of my income projection was complete. </p>
<p>My thought would be: if they are signing up masses, we don’t know how and when an exchange ships client data to the insurers. What if it’s batched, not one by one or even a daily download? Some, in some check process, could miss the next batch no? What if the insurers enter, process and QC a full parcel on their own batch schedule? So there is an ebb and flow.</p>
<p>We can say they should have capacity-- but we can also ask just how much $ investment is feasible for this initial phase, to reach some target of processing within x days. Just how much of a real daily or weekly work increase is this? Beyond that, dunno. Some of this needs to be separated, in looking at it-- what is a royal screw up versus what will just come out right on the far end, somehow, no?</p>
<p>Lookingforward, it is going to work out in the end. The next cycle will go smoother.</p>
<p>I was told that the insurance companies do not get the info from the exchanges on the day people sign up.</p>
<p>texaspg, sorry for the lecturing tone if that that’s how it comes across. And again, I do understand you didn’t write the headline.</p>
<p>I guess I’m just frustrated that some seem so ready to pounce on the statistics of the initial enrollments, when the game is only halfway over. But I will shut up about that particular topic for now. :)</p>
<p>Lookingforward, I believe that Covered California does batch the data, but I also believed that the January signups would have been transmitted to the insurers within days of the final day for enrollment. </p>
<p>There is a 2-step income verification process, at least in California. There is a preliminary verification that essentially gives people a pass to get a subsidy based on the information they have provided, and then some people are being told that more information is needed and they generally have 90 days to provide it. So the insurance companies are given enough info to write the premiums and collect payments at the outset, but they may get revised data on some of their customers down the line.</p>
<p>But this is no different for the insurance company than someone whose income changes during the course of the year. It’s just that at some point down the line a change in the payment allocation would be pushed through. </p>
<p>Remember: we subsidized insurance buyers will ultimately settle up with IRS in the end. So if hypothetically someone is supposed to pay $175/month for their premium – and then that figure is revised to $225 in, say, April – then the insurance company will just be notified to bill the customer a higher amount. </p>
<p>I can see the logistics being rather messy in the first few months while kinks are being worked out, but health insurance companies are in the business of handling and changing numbers. The premium calculation is pretty simple math compared to the typical process a hospital bill goes through on the way to payment.</p>