- 1,304
Timeline:
January 2K14
Established contact with consumer frustrated with not being able to get enrolled for a plan thru HC.gov. Consumer attempted twice to get through the HC.gov system each time encoutering some sort of issue, site crash, site slow and so on.
Agent began with enrollment issues via HC.gov (Go figure) Site crashes caused an additonal 3 app ID's so in all client has 5 app id's out there floating in HC.gov land.
Feb 3
Client still hasn't received information for plan supposed to be effective Feb 1 Contact carrier who states HC.gov hasn't passed the complete information over. Contact HC.gov and requested them to push the complete information over to the carrier...result first escalation. Told to check back in 14 days.
Feb 20
Call carrier to see if client information has been received and still nothing in the carriers system. Told by carrier that it's a HC.gov issue and to contact them. Contacted HC.gov second escallation. Again, told to check back in 14 days.
Mar 5
Client calls in to see what the status of things are with the plan. Still no card, still no information showing in Carriers side again told to call HC.gov...escalation number three. Another 14 days.
Mar 25
Seeing how traditionally 14 days wasn't working for us I waited 20 to call and check status. This time carrier sees partial information in system but not a complete application. Did 3 way convo with HC.gov and carrier to see if we can fially get a reselution to the issue. Ended up each side blaming the other and no solution. Escalated again this time told 30 days.
April 25
This time called HC.gov first, they said all good. Called carrier with client on 3 way to pay first premium to be told again that it's still not showing Feb 1 start date in the system. Called HC.gov back and was told that there were 5 app ids in the system from diffrent time periods. Explained the issue to rep who got me to a supervisor that told me that sometimes it takes a while for the system to transfer the data for the Feb 1 start date!?!?!?! Advised supervisor that other clients who I've enrolled for Feb 1 dates haven't been an issue and have began as scheduled. Super told me all they could do is escallate this yet again. Call back in 30 days.
By this point my client is Pi$$ed and rightfully so. I do my best to keep the situation calm and advise client that I will check back in 30 days as advised.
May 26
Called Carrier, still not in the system. Called HC.gov and got a rep who used the erronouse enrollemnt to get an SEP for June 1. It was looking like this was finally being resolved.
June 1
Consumer calls me to tell me that she has been able to make her first payment and things are looking good.
Now this brings us to July 29th. I get a call from consumer stating that she received letter from carrier stating that they were cancelling her policy due to non payment of her Feb 1 plan effective May 31. Consumer goes on to tell me that she has made June and July's payment. I confirm this with carrier. Carrier goes on to tell me that the plan effective Feb 1 had the payments applied to that plan because carrier was owed money for that plan.
I go into explaining that client never received documentation, cards or anything and there is a history of call ins to check on the status of this with the carrier, each time carrier telling me and client that they are not showing policy in the system. Now you're telling us that a plan that never went into effect has had the premiums that have been paid in applied to a plan that never existed and client didn't have use of and you can't find her June first start date app....
Anyone else out there having similar issues or have a solution?
Challenge is that consumer while they were under the impression they were covered ended up in ICU with a hefty bill between June and the call earlier in the week. So, SEP and switching carriers while on a move forward would be fine....going back to get the coverage for the ICU...well not so much.
Again, suggestions / solutions are appreciated.
January 2K14
Established contact with consumer frustrated with not being able to get enrolled for a plan thru HC.gov. Consumer attempted twice to get through the HC.gov system each time encoutering some sort of issue, site crash, site slow and so on.
Agent began with enrollment issues via HC.gov (Go figure) Site crashes caused an additonal 3 app ID's so in all client has 5 app id's out there floating in HC.gov land.
Feb 3
Client still hasn't received information for plan supposed to be effective Feb 1 Contact carrier who states HC.gov hasn't passed the complete information over. Contact HC.gov and requested them to push the complete information over to the carrier...result first escalation. Told to check back in 14 days.
Feb 20
Call carrier to see if client information has been received and still nothing in the carriers system. Told by carrier that it's a HC.gov issue and to contact them. Contacted HC.gov second escallation. Again, told to check back in 14 days.
Mar 5
Client calls in to see what the status of things are with the plan. Still no card, still no information showing in Carriers side again told to call HC.gov...escalation number three. Another 14 days.
Mar 25
Seeing how traditionally 14 days wasn't working for us I waited 20 to call and check status. This time carrier sees partial information in system but not a complete application. Did 3 way convo with HC.gov and carrier to see if we can fially get a reselution to the issue. Ended up each side blaming the other and no solution. Escalated again this time told 30 days.
April 25
This time called HC.gov first, they said all good. Called carrier with client on 3 way to pay first premium to be told again that it's still not showing Feb 1 start date in the system. Called HC.gov back and was told that there were 5 app ids in the system from diffrent time periods. Explained the issue to rep who got me to a supervisor that told me that sometimes it takes a while for the system to transfer the data for the Feb 1 start date!?!?!?! Advised supervisor that other clients who I've enrolled for Feb 1 dates haven't been an issue and have began as scheduled. Super told me all they could do is escallate this yet again. Call back in 30 days.
By this point my client is Pi$$ed and rightfully so. I do my best to keep the situation calm and advise client that I will check back in 30 days as advised.
May 26
Called Carrier, still not in the system. Called HC.gov and got a rep who used the erronouse enrollemnt to get an SEP for June 1. It was looking like this was finally being resolved.
June 1
Consumer calls me to tell me that she has been able to make her first payment and things are looking good.
Now this brings us to July 29th. I get a call from consumer stating that she received letter from carrier stating that they were cancelling her policy due to non payment of her Feb 1 plan effective May 31. Consumer goes on to tell me that she has made June and July's payment. I confirm this with carrier. Carrier goes on to tell me that the plan effective Feb 1 had the payments applied to that plan because carrier was owed money for that plan.
I go into explaining that client never received documentation, cards or anything and there is a history of call ins to check on the status of this with the carrier, each time carrier telling me and client that they are not showing policy in the system. Now you're telling us that a plan that never went into effect has had the premiums that have been paid in applied to a plan that never existed and client didn't have use of and you can't find her June first start date app....
Anyone else out there having similar issues or have a solution?
Challenge is that consumer while they were under the impression they were covered ended up in ICU with a hefty bill between June and the call earlier in the week. So, SEP and switching carriers while on a move forward would be fine....going back to get the coverage for the ICU...well not so much.
Again, suggestions / solutions are appreciated.
