Marketplace Stupidity

[Sherota1]

What's the most ridiculous thing you were told by the Marketplace or a Carrier while you were enrolling someone through exchange and what would be your simple solution to the problem.
A carrier told me they could not cancel a insurance plan that my client no longer wanted although it was terminated by the Marketplace. They said that the only way they could cancel the plan is if the Marketplace authorized it. So the Marketplace started one of their Escalation Frustration Situations inflicting 30 days of pain which usually results in no solution. This was repeated twice. The company never got the cancellation memo. Client charged for two months of insurance that they did not want.
My solution is for CMS or HHS to send a clear message to the carrier that they can cancel an insurance plan at the clients request and make it their responsibility to report the cancellation to the Marketplace and let them deal with stopping the subsidy payment to the carrier. Stop making the client suffer.

 

[MaryDallas]

And now those 'terminated' on the marketplace that were not terminated are getting collection letters as if it is from the insurance carrier. I found out it is from the marketplace because the marketplace continues to pay the Tax Credit money. The insurance companies need to refund that money back to the marketplace so the client is not responsible. Marketplace is taking too long to terminate. Many times they continue to pay tax credit money for months.

 

[Sherota1]

IIIIII HHHHAAAAAATE TTHEE MARKETPLACE!!!!!! NO TIME TO ELABORATE. MUST GO.

This is a rant. Read it if you want.
Today was one of the worse days I had dealing with the Maryland Exchange. To me they are all one in the same. A client who I submitted an application for back in November called me and said that he had not received a bill. I called the carrier UHC who confirmed there was no record of him anywhere in the system then they started the game of ping pong. They sent me to the Marketplace. They confirmed that the applications had been submitted and claimed that there was no reason why the carrier should not have received the applications so they sent me back to the carrier. For some reason not to waste my time while I was on the phone with UHC I decided to check the status of the other cases I submitted before December 10. None of them had reached the carrier. All of my submissions submitted after that date are showing up as received or active. I was not too concerned before that date as I was told it could take several weeks for the new clients to show on my portal. I became more concerned when the later submissions were showing up within a few days after submission but none of the earlier ones were showing up. Around the same time I got the first call from a client inquiring about how to make his first payment. That's when I discovered problem.
Today when checked the carriers again after the escalation. Still nothing is showing up at the carrier. The Marketplace explanation is that they cannot confirm the status of the case but they put it on the tracker and gave me the date and time they did it. So virtually all of my cases before December 10th except 1 Kaiser case which miraculously broke it's way through and got issued and paid all others are MIA (missing in action) Lost in the Marketplace Black Hole. Their stupid solution tell everyone to call the carrier and submit their first payment so once they solve the problem the carrier will have the payment. If you quit trying to do my job you would know the carrier cannot accept payment nor generate a bill for someone who does not exist in their system.
My other concern is with UHC. After all of this time that I spent trying to fix this since the Marketplace is dragging their feet on this is that I will not get paid on any of the cases because there is no possible way for it to reach the carrier by 01-01-16. I'm going to screenshot everything to show proof of submission. I feel robbed. First pickpocketed by UHC who cut compensation and the had my head cut off today because of an error beyond my control.
I've been ranting inside today about a need to totally change my business. I feel we are being asked to do things that's just not our job without any compensation. Dealing with documents, fixing issues with a government entity who has no respect for us and what we do, spending hours on hold trying to get a simple answer.
Starting January 1st I will no longer deal with clients who do not follow my rules for document submission. Mail a copy certified not regular mail to the Marketplace and mail one to me which I will upload to their account. I started this last year and it resolves the cases almost 95% of the time.
If they do not follow the two step mail and upload process I will not assist them if they are cancelled due to not sending in their documents. If they do not care to follow instructions I do not care about helping you. If you can't spend $5.75 to keep an $800 dollar subsidy for your family and stick a stamp on an envelope to send a copy to me deal with it yourself.

I will be fair to the client and let them choose the best option for them using the exchange screener. I will let them know if they choose companies that do not compensate me for my work they need to submit their application through the Marketplace and have them to help them with any issues they have with the carrier.

If my current clients get stolen from me due to the Marketplace error I will direct them where to go to get assistance but I cannot work for free.

I've decided I will work with the clients I currently have. Any new clients will not get the same attention that my long term clients have received and even the long term clients will receive less help with things that I just feel is not my job. They will receive even less help if they do not follow my rules.

For the ones who have not submitted payment by January 1st. Kaiser plus UHC Mid-Atlantic have stated twice that if they do not receive payment by 11:59PM December 31st they will be cancelled. No 30 day grace period as in years past. I will resubmit them for a February 1st start date but I will not track their case to see if it reached the carrier nor help them make their first payment. I will let them know what documents they need to submit but they will be on their own to submit them and track them with the
Marketplace. Slackers will receive zero assistance from me with this. If it goes through successfully through the web broker I get paid for the application submission. I think that's fair.

There is only one company in the Mid-Atlantic region that I feel compensates agents and broker fairly and that's Kaiser the pay a straight $200 per member per year then nothing else even if they cancel after the first few payments. The others are mediocre. The Aetna based companies are either $8, $16 or a whopping $0 depending on the your level of production, UHC is $20 per member per month now $0 per member per month if you are foolish enough to write business for them after January 1st and the absolute worse is Carefirst at $15.75 per month per contract. A family of 5 yields $15.75. They also axed their broker services line and has a recording telling you to contact your GA for further assistance. Really I don't think so. So I've been using member services

I feel if the Marketplace is going to do our job they should get it right or be held accountable for their mistakes except they are part of the entity that makes the rules that do not apply to them.

If you have cases that have not showed up especially UHC cases for 01-01-2016 you should check on them today especially if you do business in Maryland. If you get you get the ball rolling by 12-30-2015 and get it escalated you may have a chance at getting compensated. Call and send an email to producer services for a paper trail that dates before 01-01-2016 just calling the Marketplace may not be enough.

This was just a rant. I'll stop now. Just needed to get it out of my system. Just one of those days with the urge to speed down the road and scream as loud as possible.

I remember the days when I longed for a client to call now I almost dread it. It's no longer simple questions nor simple solutions. Time to change my answering machine. "If you need help resolving an insurance issue leave a message and I'll contact you as soon as possible after January 4th" No message no return call. I need a break. It's already tomorrow. Need to sleep before the sun comes up. Ridiculous.

I was once told people only treat you the way you let them treat you, Now time for new rules.