On Tuesday and Wednesday, the government sent information to insurers
listing everyone who had enrolled in a plan through the federal
marketplace. Insurers are supposed to compare the information with their
own records and with the daily reports they received from the
government over the last 10 weeks.
Insurers said that they had found many discrepancies and errors and that the government was overstating the improvements in HealthCare.gov.
In some instances, they said, the federal government reported that the
home address for a new policyholder was outside an insurer’s service
area. In other cases, a child was listed as the main subscriber — the
person responsible for paying premiums — and parents were listed as
dependents.
In some cases, children were enrolled in a policy by the federal
government and parents were left off, or vice versa. In other cases, the
government mixed up the members of a family: A child or spouse was
listed two or three times in the same application in late November. Such
errors can have financial implications, increasing the amount of
premiums that a family is required to pay.
While some of the problems were discovered in the last few days,
insurers said that they had previously reported many of the errors to
the “help desk” at the Centers for Medicare and Medicaid Services, and
that the problems remained unresolved.
Federal officials, insurers and health care providers said they were
concerned about confusion and possible chaos in the early days of
January, when people try to use the new insurance coverage they believe
they have.
The government’s overriding message to insurers is: Do whatever you have
to do to maximize enrollment and to provide coverage by Jan. 1 to
anyone who wants it. Federal health officials have told insurers that
they can sort out the details and work out financial arrangements with
the government later. (Full Story)
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