Can Marketplace Health Insurance Terminate for Not Sending In Documents?

[Yagents]

The young man gets a letter on insurance company's letterhead threatening to turn over the 'past due' premium to a collection agency. The insurance company states that the threatening collection letter is marketplace generated.

I also started hearing this from past Cigna clients. Are you or anyone else seeing it from other carriers?? How can they do that? If they don't pay, terminating the policy is the only recourse.

Also, I had 4 clients, count them......1......2.......3.......4, all within 1 hour forward me the following email from the marketplace, after uploading their documents over past few weeks.

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Subject: Help with Marketplace health costs may end soon

We recently sent you an important notice about your Marketplace coverage. As of March 22, 2015, our records show that we still haven’t received the documents we need from one or more people in your household as proof of their expected yearly income, if they have income. If we don’t have the needed documents, we may end or adjust the financial help you are getting to pay for your Marketplace health plan on May 1, 2015 for you and/or someone on your application.

What to do next

Immediately send any documents the Marketplace still needs.
Check your mail or HealthCare.gov online account for the official Marketplace notice ending coverage.
Read all notices carefully to understand who is affected and what will change.
If your assistance is adjusted and you think we made a mistake and financial help shouldn't end for you or the person(s) named in the notice, follow the directions in the notices to appeal this decision.

If you need help

You can find local help or call the Marketplace Call Center at 1-800-318-2596 and tell them the Marketplace is ending coverage for someone on your application. TTY users should call 1-855-889-4325.

Your health coverage is important to you and your family. It’s important to us too. We’re here to help you stay covered.

 

[AllenChicago]

That wouldn't be legal. It was "The Law" until they rule otherwise. What you're describing is called "Ex post de facto" and that is against the law in this country.

Thanks for that correction and clarification, HouCoogster! Government agencies like the IRS and the Veterans Admin often arrive at a decision and make it retroactive. I was thinking that the Supreme Court could/would do that too.

 

[MaryDallas]

I also started hearing this from past Cigna clients. Are you or anyone else seeing it from other carriers?? How can they do that? If they don't pay, terminating the policy is the only recourse.

Also, I had 4 clients, count them......1......2.......3.......4, all within 1 hour forward me the following email from the marketplace, after uploading their documents over past few weeks.

----------
Subject: Help with Marketplace health costs may end soon

We recently sent you an important notice about your Marketplace coverage. As of March 22, 2015, our records show that we still haven’t received the documents we need from one or more people in your household as proof of their expected yearly income, if they have income. If we don’t have the needed documents, we may end or adjust the financial help you are getting to pay for your Marketplace health plan on May 1, 2015 for you and/or someone on your application.

What to do next

Immediately send any documents the Marketplace still needs.
Check your mail or HealthCare.gov online account for the official Marketplace notice ending coverage.
Read all notices carefully to understand who is affected and what will change.
If your assistance is adjusted and you think we made a mistake and financial help shouldn't end for you or the person(s) named in the notice, follow the directions in the notices to appeal this decision.

If you need help

You can find local help or call the Marketplace Call Center at 1-800-318-2596 and tell them the Marketplace is ending coverage for someone on your application. TTY users should call 1-855-889-4325.

Your health coverage is important to you and your family. It’s important to us too. We’re here to help you stay covered.

Yes; Cigna clients.

 

[bluediamond]

It doesn't seem to matter if you get these documents in or not, I have had 3 that have sent docs several times and this past week lost their subsidy because they were told they never sent the docs. I have also had one who lost it because they said he had made too much money in 2014, HE HASN'T FILED IS TAXES YET FOR 2014. Then the clawback's.

 

[FLM2]

Every time I read these posts I come back to how this law is deliberately making everyone who receives a subsidy a potential tax evader.

I have no clue why the lawmakers who signed off on this atrocity aren't being strung up by their gonads when such a simple solution (base subsidies on last filed income taxes with an appeal process for those who will be making less in the subsidized year) was available.

This is stupidity of the highest order, the absolute worst legislation passed in my lifetime of over 60 years, period.

 

[bluediamond]

I agree with you FLM it appears in some cases the govt is actually giving a loan to purchase health insurance with expectation's they are going to get it back. I come in and read this everyday at least once and very seldom have anything to add to this because we are all (regardless of geography) experiencing the same scenario's. What a bunch of crap.

 

[TN_agent]

I was told last night when enrolling someone that now every document that is sent in must have the person's full name, SSN, birthdate, application number and state that coverage is in handwritten on the top of the document (even if most of that information is on the document itself). This includes ones that are uploaded online to a marketplace account. Otherwise they can't guarantee that they will be applied correctly. Another marketplace rep suggested a signed summary document/attestation. Would have been nice to have that information earlier.

 

[Yagents]

The morons checking this info must print off every document and share a printer amongst 100 other employees. Picture that!

And don't forget the bar code chit, I'm mean sheet

 

[MaryDallas]

Yes, what about that bar code? I tell every client to send in with the original letter with the bar code and to write their name, birth date, SS#, state on every page of every document. This is turning into quite the joke. So the 30% that gained insurance the first year will then lose it the second year. What is the point?

 

[FLM2]

Based on the documents that I am receiving from some of my clients it is very clear that most of the lower income subsidy recipients who enrolled directly through the Marketplace are going to lose their subsidies and maybe coverage because they have absolutely no clue as to what to send in.

When a client sends me their documents I will at least filter them for compliance to the original income estimate and let them know that the document won't work-they can then make changes (if they wish, I don't touch the documents) before submission. Anyone without a knowledgeable agent (probably 75% of the recipients) has a strong probability of just sending something in with no correlation to the subsidy.

This is just getting worse and worse, isn't it?