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

[cadylou]

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..

In the cases I described I did terminate the 2015 coverage--one by one--so that apparently isn't enough in some cases. In the case of the Coventry client situation, after they received the 215 termination, the "accidentally" terminated the new 2016 enrollment. Not sure how I can possibly protect my client when nothing is consistent and all are unknowns until you resolve them case by case . . . Depressing!

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In the cases I described I did terminate the 2015 coverage--one by one--so that apparently isn't enough in some cases. In the case of the Coventry client situation, after they received the 215 termination, the "accidentally" terminated the new 2016 enrollment. Not sure how I can possibly protect my client when nothing is consistent and all are unknowns until you resolve them case by case . . . Depressing!

PS --I had also deleted the auto renew for 2016 where possible . . . Nothing seems to guarantee anything will work properly.

 

[AllenChicago]

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.

One of my clients had that problem yesterday. The BCBS customer portal wouldn't let him make a payment for January.. "No policy exists by that number". He called in and the client services rep told him the same thing, even though I could see the new plan in the BCBS agent portal...complete with policy number.

Also found out today that insurance company customer service reps hate calling the FFM as much as everyone else. Especially this Open Enrollment, due to a huge increase in data arriving from the Marketplace with errors. Wrong plans accidentally cancelled... 2016 plans being cancelled even though the 2015 plan was supposed to be the one cancelled...on and on and on.

After telling one customer service rep that the Marketplace cancelled a dental plan when it wasn't supposed to, she raised her voice in resignation, saying, "You know I'll have to call the Marketplace about this issue don't you!?!? Hold on...this make take some time." After 10 minutes, she disconnected us. This erroneous cancellation was eventually straightened out yesterday, but only after I let the client know that she'd have to call the Federal Marketplace to take care of it herself. You feel bad and diminished when you have to tell clients this.

 

[cadylou]

One of my clients had that problem yesterday. The BCBS customer portal wouldn't let him make a payment for January.. "No policy exists by that number". He called in and the client services rep told him the same thing, even though I could see the new plan in the BCBS agent portal...complete with policy number. Also found out today that insurance company customer service reps hate calling the FFM as much as everyone else. Especially this Open Enrollment, due to a huge increase in data arriving from the Marketplace with errors. Wrong plans accidentally cancelled... 2016 plans being cancelled even though the 2015 plan was supposed to be the one cancelled...on and on and on. After telling one customer service rep that the Marketplace cancelled a dental plan when it wasn't supposed to, she raised her voice in resignation, saying, "You know I'll have to call the Marketplace about this issue don't you!?!? Hold on...this make take some time." After 10 minutes, she disconnected us. This erroneous cancellation was eventually straightened out yesterday, but only after I let the client know that she'd have to call the Federal Marketplace to take care of it herself. You feel bad and diminished when you have to tell clients this.

Its horrible--we have been rendered ineffective. Thst was their intent all along, but unfortunately the client is the one who suffers. . .

 

[Sherota1]

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.

Mwoodbird I hope deleting the application does not cause problems for you. I had a case last year where a CSR deleted an application on a clients account. The application that they (The Marketplace) had already been submitted. My client simply called them to ask a question and they signed him up on one of the duplicate applications. We corrected it and resubmitted him through my web broker portal.

The company had both applications in the system. Since the company no longer has the authority to cancel a plan they were demanding payment for the plan submitted in error and would not issue the newly submitted plan. The Marketplace said that they could not correct the issue without having proof that the deleted account ever existed. They accused me and my client of deleting the account and claimed that THEY NEVER delete applications. I always send my clients a screen shot receipt of their plan summary from Healthcare.gov. After fighting with them for over 3 months one of them finally gave me an address where I sent proof that the account did exist. Finally by June it was fully resolved.

If the information has not already been transmitted to the carrier you should be okay but if it was done after December 15th you may have problems. The Marketplace says that they cannot cancel a plan on an application that has been deleted because they need the application to be present in order to effect the termination electronically. I think they should let the company cancel the plans at the request of the consumer and put the burden on the company to report it to the Marketplace. Since they claim that it takes 90 days to stop the subsidy payments they should require each company to setup an account to deposit subsidy funds for cancelled policies that they need to return to the government.

I also want to mention that there are problems with consumers getting double billed for January whether you used the double redirect method or not. I had several people who switched to a new plan this year that clearly shows up in their account get bill from the new company and from the old company. I called the Marketplace and got two answers. One was that it takes up to 14 days to notify the carrier of changes to enrollments which I told them does not explain why a plan that was changed on November 3rd did not cancel out when the new plan was selected. Explanation number two all accounts with an auto generated 2016 renewal application was set for auto renewal on December 15. Any changes made to the account would not be submitted to the previous carrier until that date (December 15th). I could take up to 14 days for the carrier to receive notice of the change. Evidently the Marketplace doesn’t know the carriers can’t wait until the 15th to send out invoices for January 1st. So either way your clients will get double billed. I just told them to ignore the bill form the previous company and warned them that they may receive an invoice from them for up to three months since the Marketplace is insufficient with cancelling policies and subsidy payments.

So instead of deleting the duplicate application see if you can terminate the plan which will send the termination electronically to the company. Keep the plan under the application ID that you created.

I have a duplicate application on a consumer account that a CSR created on an MIA (Missing account). I told her how to find the MIA account. She did not listen. I asked her if she was using the auto generated account to do the updates. I knew she did not when she asked my client for her name, address, email and phone number. Saw the duplicate on healthcare.gov. I’m going to go in on January 4th and see if I can terminate the old account since the terminate button seems to be disabled.

 

[mwoodbrid]

Mwoodbird I hope deleting the application does not cause problems for you. I had a case last year where a CSR deleted an application on a clients account. The application that they (The Marketplace) had already been submitted. My client simply called them to ask a question and they signed him up on one of the duplicate applications. We corrected it and resubmitted him through my web broker portal.

The company had both applications in the system. Since the company no longer has the authority to cancel a plan they were demanding payment for the plan submitted in error and would not issue the newly submitted plan. The Marketplace said that they could not correct the issue without having proof that the deleted account ever existed. They accused me and my client of deleting the account and claimed that THEY NEVER delete applications. I always send my clients a screen shot receipt of their plan summary from Healthcare.gov. After fighting with them for over 3 months one of them finally gave me an address where I sent proof that the account did exist. Finally by June it was fully resolved.

If the information has not already been transmitted to the carrier you should be okay but if it was done after December 15th you may have problems. The Marketplace says that they cannot cancel a plan on an application that has been deleted because they need the application to be present in order to effect the termination electronically. I think they should let the company cancel the plans at the request of the consumer and put the burden on the company to report it to the Marketplace. Since they claim that it takes 90 days to stop the subsidy payments they should require each company to setup an account to deposit subsidy funds for cancelled policies that they need to return to the government.

I also want to mention that there are problems with consumers getting double billed for January whether you used the double redirect method or not. I had several people who switched to a new plan this year that clearly shows up in their account get bill from the new company and from the old company. I called the Marketplace and got two answers. One was that it takes up to 14 days to notify the carrier of changes to enrollments which I told them does not explain why a plan that was changed on November 3rd did not cancel out when the new plan was selected. Explanation number two all accounts with an auto generated 2016 renewal application was set for auto renewal on December 15. Any changes made to the account would not be submitted to the previous carrier until that date (December 15th). I could take up to 14 days for the carrier to receive notice of the change. Evidently the Marketplace doesn’t know the carriers can’t wait until the 15th to send out invoices for January 1st. So either way your clients will get double billed. I just told them to ignore the bill form the previous company and warned them that they may receive an invoice from them for up to three months since the Marketplace is insufficient with cancelling policies and subsidy payments.

So instead of deleting the duplicate application see if you can terminate the plan which will send the termination electronically to the company. Keep the plan under the application ID that you created.

I have a duplicate application on a consumer account that a CSR created on an MIA (Missing account). I told her how to find the MIA account. She did not listen. I asked her if she was using the auto generated account to do the updates. I knew she did not when she asked my client for her name, address, email and phone number. Saw the duplicate on healthcare.gov. I’m going to go in on January 4th and see if I can terminate the old account since the terminate button seems to be disabled.

No issues so far, aside from prior carriers taking forever and a day to complete terminations in their systems. But that's an easy fix, directing clients to ignore billing from prior carriers.

 

[Sherota1]

I'm doing the same thing here.

 

[healther]

Thankfully a large majority of our switchovers were from plans that will not be offered in 2016, no auto enroll... however, I have seen at least two auto enrollments that were not caught during enrollment that appear to have died on their own... FWIW.