Obamacare coverage starts, but some CT customers are still waiting

More than 34,000 state residents were slated to begin new private insurance plans Wednesday as part of the federal health law. But as the new year began, many people who bought policies through the state’s health insurance exchange still hadn’t received their first premium bills, which must be paid by Jan. 10 to get coverage this month.

John Calkins, a Watertown insurance agent, is among those getting calls from clients who are “panicking a little bit.” He’s trying to calm them down. Calkins said it’s typical for there to be problems at the start of the year, when many plans start up, and insurance carriers are scrambling to get everything in order.

“The first 10 days of January are notorious for this kind of issue,” said Calkins, president of Bozzuto Associates. “These are not out of the ordinary in some regards. It’s just even more exacerbated because of the volume.”

Tim Tracy, a Fairfield insurance broker and president of the Connecticut Chapter of the National Association of Health Underwriters, said the current situation is worse than in previous years. While in the past brokers could easily reach people at insurance companies to work out problems, it can now take an hour of waiting on hold to reach someone, he said. Consumers are also having trouble getting through to representatives at the insurance companies, he added.

Kevin Counihan, CEO of Access Health CT, the state’s health insurance exchange, said he’s had discussions with insurers about contingency plans in case some people don’t receive bills by Jan. 10, the payment deadline. But he said that hadn’t yet produced anything to announce.

“There’s a lot of obvious concern,” Counihan said, noting that people have been calling Access Health’s call center because they haven’t gotten their bills yet. “Everybody’s trying to make sure they get the premium in on time.”

Counihan’s advice for people who still haven’t received a bill: “What I would do is I’d be on the phone to that health plan right away and I’d be saying, ‘What’s the fastest way for me to get into your eligibility system? Do I give you a credit card? … You tell me the fastest way that I can assure that I’ll be covered.’”

Three insurers are offering plans through Access Health’s individual exchange market: Anthem Blue Cross and Blue Shield, ConnectiCare Benefits, and HealthyCT.

Anthem spokeswoman Sarah Yeager said Thursday that all of the company’s bills for exchange customers had gone out. Anthem has the largest share of exchange customers.

ConnectiCare Benefits has already billed more than 99 percent of its approximately 8,100 exchange customers, Michelle Zettergren, the company’s senior vice president and chief sales and marketing officer, said Thursday. Those who have not received a bill will get one in the next day or so, she added.

HealthyCT, a new nonprofit insurer, said earlier this week that it had been regularly sending bills to people who signed up through the exchange. The company also sent reminder letters last week to people who had signed up with the company by Dec. 23 but had not paid their bills yet. Those who pay their bills after Jan. 10 will get coverage that takes effect Feb. 1. About a third of customers paid their bills by Jan. 1.

Bills paid, waiting for ID cards

What about people who paid their bills but haven’t yet gotten an insurance ID card?

Counihan said people can ask their insurer for a temporary ID card or identification number to use when getting prescriptions filled or getting care.

Each company has a different way of handling ID cards.

Anthem sends out insurance cards after it receives a member’s premium. If members go to the doctor before getting an ID card, the provider can call Anthem to verify coverage, which will be in effect as long as the premium has been paid. Members can also download temporary ID cards through the Anthem website.

ConnectiCare sends ID cards to people who are in its system, but the cards are not valid until payment is received.

HealthyCT allows people who have paid their bills to print temporary ID cards through its website.

Because there can be delays in getting insurance cards, Calkins said he always advises his clients that if they need a prescription filled or a doctor’s appointment just after the start of a new year, they should be prepared to pay out-of-pocket and get reimbursed later.

“I could’ve told you back in September that the first 10 days of January are going to be horrendous, because it’s the nature of the beast,” he said. “If we didn’t have this federal program, I would still have these same issues.”

Calkins said he suspects insurers will be flexible with customers whose bills don’t arrive promptly, knowing they will likely face criticism — even if it’s unwarranted — from politicians if things don’t go smoothly. But he noted that backdating coverage for people could be a major administrative challenge for the carriers.

Who to call

Access Health is advising people who signed up for coverage but haven’t received a bill, or who have other questions about the health plan, to call their insurance company.

Anthem Blue Cross and Blue Shield customers who have not received a bill can call 1-855-738-6644.

ConnectiCare Benefits customers who have not received a bill should call 860-674-5757 or 1-800-251-7722 (TDD/TYY Services 1-800-842-9710).

HealthyCT customers who have not received a bill should call 855-458-4928.

Deadlines

People who signed up for insurance through Access Health by Dec. 23 can get coverage effective Jan. 1 if they pay their first premium bill by Jan. 10. Access Health’s open enrollment period for private insurance runs through March 31, and people who qualify for Medicaid can sign up at any time during the year.

Although most people are now required to have health insurance as part of the health law commonly known as Obamacare, those who are uninsured for fewer than three months will not face a penalty. That means that people who have not signed up for coverage yet still have time to get insurance and avoid the fine.

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