Auto-renew Apps Aren't Dying on Their Own when a New App is Submitted

[mwoodbrid]

We've all been watching closely to see what would happen with duplicate apps, and I've had a chance to test the system now.

I had a couple of folks come to me this year who had an auto-renew app in the system, as well as a new 2016 app, so I used them as my canaries to test what would happen. I went back in to look at them today.

The result: FFM system completed the enrollment on the auto-renew app right alongside the new 2016 app & enrollment. Tax credits showing on both plans, and both showing 1/1/16 effective dates.

Mainly an "I wonder" test, and basically only confirms what we already knew - the FFM is erratic at best.

I cleared the incorrect enrollments and deleted the apps associated with them, leaving them with one enrollment for 2016.

 

[Duaine]

ACA Express Question:

Hello:

I’m having clients who I have submitted in Missouri who are receiving 2016 billings from BCBS or Coventry which reflect the pricing that they would pay without subsidies instead of the subsidies for which they are entitled according to the ACA express site.

It looks as though the auto-enrolled polices are being issued and not what we submitted.

If we go and pay the new polices through ACA’s backdoor to CMS will that kick the auto-enrollment out?

I had thought that you said that the new ACA app would be the issued app but this seems to be incorrect.

Thanks,
Duaine

 

[KennyWest]

ACA Express Question:

Hello:

I’m having clients who I have submitted in Missouri who are receiving 2016 billings from BCBS or Coventry which reflect the pricing that they would pay without subsidies instead of the subsidies for which they are entitled according to the ACA express site.

It looks as though the auto-enrolled polices are being issued and not what we submitted.

If we go and pay the new polices through ACA’s backdoor to CMS will that kick the auto-enrollment out?

I had thought that you said that the new ACA app would be the issued app but this seems to be incorrect.

Thanks,
Duaine

Got your email too Duaine.. Gotta give us a few to reply..

 

[insurance5511]

so lets say you take someone from pos humana plan in 2015 to hmo plan in 2016 since they cant afford it...what happens??.....

 

[AllenChicago]

Thank-you MWoodbrid for the independent investigation and confirmations. Do you think this affects millions of Americans who are already insured, and re-enrolling in other plans/companies across all these platforms, including healthcare.gov directly?

And what about the 2014 to 2015 transitions? Maybe the same thing happened behind the scenes then, but we didn't have access to see these multiple apps as easily as we do now.

All the more reason to not put Exchange people on Auto Premium Payment. Eventually it could cause a major financial mess at the beginning of a new year. I experienced this unpleasant situation with a few Auto-Payment clients during the 2013 to 2014 transition. Almost all are on manual payment methods now. I tell them that if they get two bills, just pay XYZ company. The other will go away on it's own.

 

[mwoodbrid]

Thank-you MWoodbrid for the independent investigation and confirmations. Do you think this affects millions of Americans who are already insured, and re-enrolling in other plans/companies across all these platforms, including healthcare.gov directly?

And what about the 2014 to 2015 transitions? Maybe the same thing happened behind the scenes then, but we didn't have access to see these multiple apps as easily as we do now.

All the more reason to not put Exchange people on Auto Premium Payment. Eventually it could cause a major financial mess at the beginning of a new year. I experienced this unpleasant situation with a few Auto-Payment clients during the 2013 to 2014 transition. Almost all are on manual payment methods now. I tell them that if they get two bills, just pay XYZ company. The other will go away on it's own.

I agree on the auto-pay issue. Too much risk when you're dealing with a system that can retroactively remove your subsidy for 5 months at a time.

I think the duplicate app issue is likely limited to situations where apps were created via different methods (consumer account, WBE, carrier portal) over two OE periods. 2015 app via WBE, and 2016 via a different method or WBE, for example. In particular, situations where an agent didn't look up the new year's app and "take over" the auto-renew app to use for the assisted enrollment.

With that said, a couple of carriers here in Oregon had renewal billing out to members with auto-renew apps in the system in the first week of December. Many of those members moved to other carriers for 2016 in the first half of December. I even had one who called to make his January payment to the carrier based on that billing, and was told that his plan was ending 12/31/15 and they wouldn't accept the payment because he wasn't in the system for January... despite the billing they sent him.

 

[mschlange]

It seems we need to go into each application and if we see multiple 2016 policies we need to cancel them and have just one policy showing in the system?
Do we leave the one with the FFM number listed on our enrollment? Sometimes it seems like that one shows pending
Need advice so I can get this corrected ASAP
Thanks
Mark

 

[mwoodbrid]

It seems we need to go into each application and if we see multiple 2016 policies we need to cancel them and have just one policy showing in the system?
Do we leave the one with the FFM number listed on our enrollment? Sometimes it seems like that one shows pending
Need advice so I can get this corrected ASAP
Thanks
Mark

If you've been using a double-redirect WBE (eBroker, Welltheos, etc) and the recommended method of searching for an existing 2016 app via the broker landing in the FFM, then using that app and reporting a life change to submit the 2016 enrollment, you should be fine.

Sherpa says their system does this system automagically, so in theory that should be fine also. I haven't used them this year, so can't independently confirm that.

I can't remember if ACA Express provided feedback on their backend process as far as this goes, so maybe Kenny can step in and let us know if we're good there too?

If you've been helping clients create accounts on HC.gov and running apps that way, you'd only have the risk of dupes if they used a WBE last year, created an account this year, and didn't use the "claim my app" function to pull in last year's application.

I tend to err on the side of caution, so I've scrubbed all of my cases so far this year to ensure no other dupes exist, and have removed the ones I've found. I'm at about 500 cases so far this year, and have found dupes on about 10%.

 

[cadylou]

If you've been using a double-redirect WBE (eBroker, Welltheos, etc) and the recommended method of searching for an existing 2016 app via the broker landing in the FFM, then using that app and reporting a life change to submit the 2016 enrollment, you should be fine.

Sherpa says their system does this system automagically, so in theory that should be fine also. I haven't used them this year, so can't independently confirm that.

I can't remember if ACA Express provided feedback on their backend process as far as this goes, so maybe Kenny can step in and let us know if we're good there too?

If you've been helping clients create accounts on HC.gov and running apps that way, you'd only have the risk of dupes if they used a WBE last year, created an account this year, and didn't use the "claim my app" function to pull in last year's application.

I tend to err on the side of caution, so I've scrubbed all of my cases so far this year to ensure no other dupes exist, and have removed the ones I've found. I'm at about 500 cases so far this year, and have found dupes on about 10%.

I'm finding all sorts of inconsistencies. I had termed 2015 plans for people, attempted to get rid of duplicate 2016 IDs in the system & be sure that they at least showed no programs associated, trying to only leave the one we had in play.

Now that people are attempting to make 1st payment we're running into issues. I had one gal who had Coventry last year, had to re-do Marketplace app due to change in income & get subsidy re-determination. When we chose a plan, it was a Coventry plan for 2016. Couldn't pay bill through Marketplace - I had her call. Coventry had received the 2015 termination, and then "accidentally" termed the 2016 enrollment when it came through. . . .this one is not resolved.

I had a Blue Cross client, who got a bill for her "auto-renewed" policy before we could even get in to do the subsidy redetermination. Her subsidy for the renewal was only $6. The new subsidy is $118. No button in the system for "pay your premium" - I had her call & BCBS is saying they see the old plan info only, and that it's taking 10 days to get the feed and have information in system. It's been since 12/12 when we did the enrollment. I have a paper trail with eligibility letter - programs & plans page from system, etc.

I'm sure there are more messes to come. The only ones I've had no problems with are the ones that were terminating completely because Coventry was pulling out of the marketplace in KS . . . .

Doesn't seem to matter whether it was Health Sherpa or ACA - had a few on both that had issues, but mainly problems with new enrollments with the same company.

If they can't figure out how to automatically disenroll someone from a previous plan, the way they do with Part D programs in the Medicare space, then they should just go ahead & term all plans on 12/31 each year. As it is - they are forcing everyone to shop every year anyway, only this way they get to live with a lot of anxiety and fear of losing their coverage right through the New Year. I think it's criminal. . . . .

 

[Duaine]

This in from ACA Express:


Simply processing a new enrollment for the consumer is not enough to kick anything out. There have been some companies claiming such action will work but when dealing with CMS we’ve learned that isn’t the case. All enrollments are independent of themselves. If the consumer does not want the “auto-enrolled” plan then you or the consumer must make sure that it is terminated. Otherwise, what you’ve seen will likely happen. There will be confusion because the consumer will get information for more than one plan in the email.

The “marketplace access” feature is great for cases like this where you need to terminate coverage.

This is a FREAKING MESS.....now I'm not sure if anything processed correctly..