Exchange CEO: Anthem acknowledges billing, payment problems

The head of Connecticut’s health insurance exchange said Friday that officials at Anthem Blue Cross and Blue Shield have acknowledged “administrative challenges” in setting up coverage for people who signed up for plans that were supposed to begin Jan. 1.

As of last Friday, only 8 percent of customers slated to have coverage effective Jan. 1 had been recorded in Anthem’s system as having paid their premiums, said Kevin Counihan, CEO of Access Health CT, the state’s health exchange. That figure includes people who bought plans through the exchange and those who purchased them outside the exchange.

By contrast, about half of ConnectiCare Benefits’ exchange customers already paid their January premiums, a company official said earlier this week. And about a third of people signed up with HealthyCT, a new insurer, had paid their bills by Jan. 1.

Some Anthem customers who signed up through the exchange have said they tried to pay their bills multiple times over several weeks, but have not had their checks cashed or credit cards charged. The Mirror has asked Anthem about potential payment processing issues but has not received an answer. Members have until Wednesday, Jan. 15, to pay their January bills to receive coverage retroactive to Jan. 1.

Counihan said officials had acknowledged challenges with processing applications, getting bills out, processing credit card payments and cashing checks. But he referred questions about the details to the carrier. Anthem spokeswoman Sarah Yeager did not provide details when asked for them immediately after Counihan’s remarks.

“We believe that they’re working hard to solve their administrative issues and get these folks enrolled and into the system,” Counihan said during a conference call with reporters.

About 25,000 people who signed up for private insurance through Access Health picked plans sold by Anthem, the state’s largest insurer. That represents about two-thirds of the exchange’s private insurance enrollees so far, and includes people whose coverage will take effect next month because they did not meet the Dec. 23 deadline for Jan. 1 coverage.

Many people who signed up for Anthem plans through the exchange have reported problems getting their coverage set up, even if they signed up well in advance of the Dec. 23 deadline. Some said they have not received bills, which must be paid for coverage to take effect. Although people who have paid can print temporary insurance ID cards from Anthem’s website, people who haven’t received bills or whose payments were not processed don’t have that option.

People have also complained about long waits at the company’s call center. Callers who applied for coverage but didn’t have an ID number and called one Anthem phone number, 1-888-556-9929, received a message Friday that said, “Due to heavy call volumes associated with the Affordable Care Act, we are unable to connect you to a representative at this time.” It asked people to try calling again later.

The Connecticut Insurance Department’s consumer affairs division has been getting more calls than usual, as has the state Office of the Healthcare Advocate. Healthcare Advocate Victoria Veltri said her office has gotten involved in the cases of people who need immediate medical services, such as an imminent scheduled surgery or ongoing cancer treatment.

Yeager said Thursday that the company had been dealing with “overwhelming and unanticipated call volume.”

Anthem is part of Wellpoint, a national company that runs health plans in 14 states. During a two-day period last week, it got more than 1 million calls across the 14 states, with members calling frequently to check on enrollment status, receipt of payment, ID cards and other matters, Yeager said.

“This is an unprecedented time, and we appreciate our members’ dedication to following through and ensuring that they have secured health insurance with us for 2014,” she said.

Yeager said the company had hired more than 1,000 people to help members during the open enrollment process. It is also adding workers to its call centers by reassigning personnel and extending call center hours through Saturdays and holidays.

Counihan said exchange officials have volunteered to make robocalls and send email blasts to Anthem enrollees, letting them know that the fastest way to get their insurance ID card is to pay their January premium bill online with a credit card. The messages can’t go out until the Connecticut Insurance Department approves the wording.

“This is something that we’re very anxious to do,” Counihan said. “It’s done very specifically because our number one focus is to cover our members, make sure they’re in the system and that people can get needed care.”

Counihan said Anthem officials had indicated that after premium payments are recorded into the company’s system, there’s a three business-day delay before the member can print a temporary insurance ID card from the company’s website. Plastic ID cards are mailed after the payment is recorded.

Overall, about 76,500 people have signed up for coverage through the exchange so far. About 48 percent will receive Medicaid. Counihan said just over a third of the enrollees are under age 35.

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