UHC Terming for Non Payment on Jan 8th

Jan 5, 2016

  1. saintstigers
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    saintstigers Guru

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    A UHC broker services rep told me that the company will be terming all Jan 1, 2016 on-exchange policies if the first month's premium is not received by January 8th. Including those members that had a 2015 policy and renewed onto a new 2016 policy.

    I thought carriers were required by law to give members 30 days to pay their first month's premium???
     
  2. STIBROKER
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    STIBROKER Like My post and enter the DRAWING,,,, Moderator

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    actually its 3 months........

    Under the Affordable Care Act (ACA), if a patient who receives an advance premium tax credit does not pay his or her health insurance premiums in full, he or she enters a 90-day "grace period." During the first month of the grace period, the patient continues to have health insurance coverage, and the patient's health insurer will pay claims for health care services provided to the patient during that time. However, if the patient enters the second or third month of the grace period, the health insurer may pend claims for services provided to the patient during that time.

    Affordable Care Act "grace period"
     
  3. AllenChicago
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    it looks like this is applicable to even the first month's premium if the applicant is subsidized?
     
  4. Tkruger
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    It applies to On X plans only. Off X you have a 30 grace period.
     
    Tkruger, Jan 5, 2016
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  5. Ann H
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    The 90 day grace period that is allowed for subsidized business is not applicable to the initial premium. The policy is not activated unless the first premium is paid. Technically, there is no grace period for the first premium, although most carriers are allowing it.
     
    Ann H, Jan 5, 2016
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  6. MBSC
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    Reference: Health Reform FAQs | The Henry J. Kaiser Family Foundation

    Reference: https://www.law.cornell.edu/cfr/text/45/156.270
     
    MBSC, Jan 5, 2016
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  7. WiscBroker
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    How about this one- client paid for Jan. back in November, UHC admits it see the payment, but their system shows the policy, which is new and effective 1/1, has a paid through date of 1/1. So, the client's policy is not activated, cannot access benefits, cannot get online, no cards, no nothing from UHC. She calls UHC and is told she is 'ineligible' for coverage. I call broker support and they say, 'oh there has been a pause in the system and the payment is not being applied, we need to have someone figure out why it is not being appied.'

    I can totally see this policy getting termed for nonpayment on Jan 8 even though the client has indeed paid and the insurance company says they see the payment but for some stupid reason doesn't know how to apply the payment.
     
  8. saintstigers
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    saintstigers Guru

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    UHC is totally screwy with their billing and enrollment this year. Not sure if intentional or incompetence.
     
  9. AllenChicago
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    Your key words are "this year". They didn't have these issues in 2015, which points to "intentional", vs "incompetence". Especially in light of the "We Screwed Up!" statements from United Healthcare leadership, removal of plans from UHOne.com, Reduction in Commissions, and administrative snafus that are keeping 2016 UHC applicants from becoming 2016 UHC customers.
     
  10. WiscBroker
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    Intentional would be considered illegal, would it not? If so, will we see a class action lawsuit?
     
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