ACA sign Up

[skyline]

Thought I'd share an update on my application (through CA's exchange). After successfully enrolling through the site and selecting a plan, I was told by the exchange to expect my first communication confirming the enrollment from the insurance company. Once the supplied date had passed, I called the insurance company and was then told to expect my first communication from the exchange - and that the insurance company won't have anything in their system until at least 10 days after I receive welcome letters from the exchange.

I called the exchange this morning to confirm that everything is fine, and that they still think I'm supposed to hear from the insurance company first (even after I told them that the insurance company told me the exact opposite earlier in the day).

Also, the exchange sent me a message telling me that I was temporarily approved to buy insurance for 90 days, and that I needed to send in verification docs to get the approval extended for the year - except I already sent in all the paperwork using the exact method requested in the message. Oh yeah, the message also asked me to pick a policy (it thought I hadn't yet). The rep at the exchange told me to ignore that message.

My point? I guess I'm just rambling - and hoping my experience will help someone who might be just getting started - expect lots of mis-communication and confusion. Hopefully it'll all work out in the end.

I did also have a question for anyone that might be further along in the process - has anyone in CA actually received enrollment/id cards from their selected insurance company? Care to describe how it all went down?

Cheers,

 

[John Galt III]

....

I can no longer start another application in healthcare.gov as it appears to recognize my name and stops stating only one approved application per individual is allowed.

I was wondering about this. I still haven't applied since I am waiting for the bugs to be fixed first, but am getting nervous since 12/15 is approaching. Can we still submit multiple applications, on the federal version?

 

[MRG]

I was wondering about this. I still haven't applied since I am waiting for the bugs to be fixed first, but am getting nervous since 12/15 is approaching. Can we still submit multiple applications, on the federal version?

I have 2 in processs on fed exchange. One started 10/20, the other 11/17. So yes you can, you'll need a different email address and go through the verification again.

I can't get any insurer to claim knowledge of 'cost sharing' our FPL is down to under 200% on the 11/17 application.

Spoke with one insurance rep yesterday, that company won't get my business. That guy had less of a clue about their provider network than me. Said straight out 'I've not heard of cost sharing'.

I spoke with a broker yesterday, she knew what it was and will be meeting this week with folks, she said she'd bring the topic up. How do I get it if healthcare.gov isn't showing any silver plans with cost sharing? Last I talked to healthcare.gov it was a glitch.

MRG

 

[John Galt III]

I have 2 in processs on fed exchange. One started 10/20, the other 11/17. So yes you can, you'll need a different email address and go through the verification again.

I can't get any insurer to claim knowledge of 'cost sharing' our FPL is down to under 200% on the 11/17 application.

Spoke with one insurance rep yesterday, that company won't get my business. That guy had less of a clue about their provider network than me. Said straight out 'I've not heard of cost sharing'.

I spoke with a broker yesterday, she knew what it was and will be meeting this week with folks, she said she'd bring the topic up. How do I get it if healthcare.gov isn't showing any silver plans with cost sharing? Last I talked to healthcare.gov it was a glitch.

MRG

MRG,

Thanks for your answer.

Your experience mirrors mine when it comes to getting information from the people who are supposed to know. I share your disgust.

I got lucky I guess when I called the Highmark Blue Shield 800 number. An affable woman answered and knew exactly what I was talking about regarding cost sharing subsidies, and walked me through the numbers pertaining to the plan I was interested in. She even knew what I would encounter when filling out the federal exchange application. They seem to actually want to enroll exchange plans. Their website even has an option to show you your exact deductibles, copays, coinsurance, and max oop associated with your "number" from the cost sharing formula. My number was 94%, since my low income would result in the plan having a 94% actuarial value regarding cost sharing. The next number down the tier is 87% AV, based on slightly higher magi income.

You say the federal exchange now has a glitch for silver plans that doesn't allow you to see your copays, deductibles, and coinsurance and oop max after you've gone to the trouble of filling everything out? Great! I suppose I could enroll anyway, and trust the insurance company's numbers to be accurate.

I found good, understandable data on healthinsurance.about.com regarding cost sharing and how much you get based on income.

I'm still debating how much income to list for 2014. I really don't know what it will be, so I'm tempted to report a low income, like $12,000, but that might trigger the system to require me to apply for medicaid, which would take who knows how long, just to get rejected for it. Time for another one hour chat session with HC.gov, I guess.

Good luck! There is hope, evidenced by the Highmark Blue Shield agent who was very helpful.

 

[Accidental Retiree]

Thought I'd share an update on my application (through CA's exchange). After successfully enrolling through the site and selecting a plan, I was told by the exchange to expect my first communication confirming the enrollment from the insurance company.

.......

Also, the exchange sent me a message telling me that I was temporarily approved to buy insurance for 90 days, and that I needed to send in verification docs to get the approval extended for the year - except I already sent in all the paperwork using the exact method requested in the message. Oh yeah, the message also asked me to pick a policy.


I did also have a question for anyone that might be further along in the process - has anyone in CA actually received enrollment/id cards from their selected insurance company? Care to describe how it all went down?

Cheers,

I have gone through just what you describe, except that to date, I haven't called the exchange -- and I ain't gonna. Not yet, anyway.

I got an online message about the 90-day approval. Just a few days later, I got the same message via regular mail.

I am thinking that the Covered CA exchange is finally going to tell the insurance company that I am provisionally approved and the insurance company may finally send me the stuff I was told, online, they would send, when I first chose our plan.

 

[MRG]

John Galt III,

Just talked to a supervisor at healthcare.gov. She was unaware of the issues with the 'cost sharing' but did put in an incident for the technical team to review. She validited 'yes you should get cost sharing'.

In the middle of our conversation my tax subsidy went away. She saw it disappear too, her response: 'We've been having issues today, try back tomorrow, sorry for the issues.'

She could also see all 3 applications I've submitted, said maybe start another one if this isn't fixed.

Thanks for your response, good luck,

MRG

 

[pb4uski]

It seems strange that they have all this verification stuff going on but there is no problem with a single household having registered numerous accounts to get around the inadequacies of the system. With our state's system, you can have multiple accounts as long as the username and email address are unique from other accounts. But for our 3 accounts we have the same insureds at this juncture. Odd.

 

[MRG]

It seems strange that they have all this verification stuff going on but there is no problem with a single household having registered numerous accounts to get around the inadequacies of the system. With our state's system, you can have multiple accounts as long as the username and email address are unique from other accounts. But for our 3 accounts we have the same insureds at this juncture. Odd.

I'm guessing that since you can't edit your application after its submitted, that's the work around. It would have been easy to put constraints/referential integrity in to prevent this on day zero. Not so easy now.

MRG

 

[Free To Canoe]

I made it through the sign up. Very happy with the resulting subsidy. There were problems but it turned out to be not too bad.

I had the idea that the subsidy delivered in 2014 was based on 2013 MAGI. The web site leads me to believe that it is based on 2014 actuals which you estimate from 2013 info. I don't think they considered my "one time" Tira to Roth conversion in the calculation. Maybe I will find out the calc details after the dust settles in a couple of months.

 

[meierlde]

I made it through the sign up. Very happy with the resulting subsidy. There were problems but it turned out to be not too bad.

I had the idea that the subsidy delivered in 2014 was based on 2013 MAGI. The web site leads me to believe that it is based on 2014 actuals which you estimate from 2013 info. I don't think they considered my "one time" Tira to Roth conversion in the calculation. Maybe I will find out the calc details after the dust settles in a couple of months.

Recall that they will true up the subsidies after the 2014 tax returns are in (we don't know how but I suspect there will be a couple of more lines on the tax forms, and a table in the instructions. All the more reason to file taxes using a program)

 

[MRG]

Recall that they will true up the subsidies after the 2014 tax returns are in (we don't know how but I suspect there will be a couple of more lines on the tax forms, and a table in the instructions. All the more reason to file taxes using a program)

That makes sense for the tax subsidy. It could be trued up later. Are they going to compensate us for cost-sharing benights that we didn't receive?

I don't think that will happen, can't see who would pay who. Maybe my lack of understanding.

MRG

 

[kmt1972]

Hi. I do have a question on how the healthcare.gov works.

Once one finds the right plan, is the transaction "complete" only after one sends the info to the insurance company for the insurance company to validate the data. Or does that take place in Jan when one pays? In other words, when is point where the insurance company has your info to validate it. Now or in Jan when you pay.

 

[reubenray]

While reviewing possible plans I have two questions.

1) We travel a lot out of state (4 to 5 months a year-2 or 3 weeks at a time). Will we need a "Multi-State" plan?

2) We both are on blood pressure medication, but it is under control. Will we need this "High blood pressure & cholesterol program available"?

 

[MichaelB]

That makes sense for the tax subsidy. It could be trued up later. Are they going to compensate us for cost-sharing benights that we didn't receive?

I don't think that will happen, can't see who would pay who. Maybe my lack of understanding.

MRG

Cost sharing is not reconciled after the year end, only premium assistance / tax credits.

Hi. I do have a question on how the healthcare.gov works.

Once one finds the right plan, is the transaction "complete" only after one sends the info to the insurance company for the insurance company to validate the data. Or does that take place in Jan when one pays? In other words, when is point where the insurance company has your info to validate it. Now or in Jan when you pay.

Your enrollment is final once you pay the first month, at the latest by Dec 15.

1) We travel a lot out of state (4 to 5 months a year-2 or 3 weeks at a time). Will we need a "Multi-State" plan?

You need to check the provider network of the plan to make sure it covers the geographic area you intend to visit.

 

[jflynn4]

Recall that they will true up the subsidies after the 2014 tax returns are in (we don't know how but I suspect there will be a couple of more lines on the tax forms, and a table in the instructions. All the more reason to file taxes using a program)

What's interesting to me is that, since people won't file their 2014 taxes until well into 2015, (March/April), the subsidy amounts for BOTH 2014 and 2015 could be very skewed. And I'm wondering if someone, for example, ends up being over subsidized for 2014 and, say, gets a tax bill for $5,000 for their 2014 return, will the government then adjust their 2015 subsidy down mid-year? And what if that person is unable to repay (in April of 2015) their over-subsidy for 2014 and are continuing to receive a subsidy into 2015? Does that fact enter into the process at all? Will the government continue to subsidize premiums for those who've been oversubsidized in the past and already owe significant amounts because of that?

What of the couple who, individually, are both receiving subsidies, getting married in December and whose joint income now puts them into a non-subsidy position. Simple math will show that couple could end up being over subsidized by $8000-$10000.

I'd be thoroughly surprised if many people will report income changes thru the year to the exchange, or do the math necessary to look into what is going to happen in the future, voluntarily decreasing their subsidies. This is not going to be uncommon on either side of the equation as people get married, divorced, change jobs, retire, etc.

It would seem that the confusion we are seeing now could be relatively minor compared to the outcries we are likely to see in early 2015 as people who have been used to seeing $1000 or $2000 tax refunds are instead getting tax bills for $3000 or $4000 (or more).

 

[audreyh1]

Your enrollment is final once you pay the first month, at the latest by Dec 15.

Right - you must have paid the first month by Dec 15. That is the true deadline. And the proof enrollment is complete.

 

[kmt1972]

Right - you must have paid the first month by Dec 15. That is the true deadline. And the proof enrollment is complete.

Yes. But don't you need to apply to the insurance company ahead of that deadline for them to approve the policy and check for data problems. I agree the policy is not final until 12/15 when you pay. But I would think the insurance company need to vet the data well before 12/15.

 

[Rpharmer]

Yes. But don't you need to apply to the insurance company ahead of that deadline for them to approve the policy and check for data problems. I agree the policy is not final until 12/15 when you pay. But I would think the insurance company need to vet the data well before 12/15.

I think that avoiding the week of 12/15 might be a good idea, if possible. It took my insurer about a week to call me to verify a few details about my enrollment (like, what the website showed my premium and subsidy to be.) Then about a week to mail out the new insurance cards. So there's some phone tag and snail mail involved, which is fine with me (kind of reassuring, in fact.) If enrollment is starting to increase now as 12/15 approaches, some backlog seems inevitable, but avoidable, if you've made your choice.

I'll feel officially enrolled when I can log in on the insurer's website and see my name next to the new premium, deductible, etc. -- and when I can see and download the Summary of Benefits there, not "just" via Healthcare.gov. (Granted, it's a link between the two sites for now, but still.)

 

[ziggy29]

I'll feel officially enrolled when I can log in on the insurer's website and see my name next to the new premium, deductible, etc. -- and when I can see and download the Summary of Benefits there, not "just" via Healthcare.gov. (Granted, it's a link between the two sites for now, but still.)

I already have all that. I'll feel officially enrolled when I receive the specific materials (and bill) in the mail and they have cashed my check for the first month's premium.

 

[rbmrtn]

I already have all that. I'll feel officially enrolled when I receive the specific materials (and bill) in the mail and they have cashed my check for the first month's premium.

And even then, you really never know if have insurance till you try to file a claim and they actually pay it.

 

[audreyh1]

Yes. But don't you need to apply to the insurance company ahead of that deadline for them to approve the policy and check for data problems. I agree the policy is not final until 12/15 when you pay. But I would think the insurance company need to vet the data well before 12/15.

BCBS told me they could actually do it pretty much same day with bank draft (or maybe day before) but I wouldn't try to cut it so close.

They also said they won't actually do the draft or whatever until Dec 15.

 

[audreyh1]

And even then, you really never know if have insurance till you try to file a claim and they actually pay it.

It's not quite that bleak, although there may be certain things not covered. ACA compliance takes care of many of the old gotcha's.

 

[John Galt III]

Applied successfully today! The eligibility notice stated I "can choose a health plan with lower copayments, coinsurance, and deductibles(06)". I think the "(06)" is a reference number for how much cost sharing I can have.

 

[bamsphd]

I finally got around to comparing a "Family" plan for myself and DW with two "Individual" plans. To my surprise the sum of the two individual premiums was exactly the same to the penny as the family plan. The deductibles and most importantly OOP Max for the family plan were also just the sum of the individual plans. So if both individuals spent nothing, or both exceeded their OOP max both cases were the same. However, if only one person needed health care, the lower individual limits would make having two plans a win.

Unfortunately, it looks like that is not allowed. I could not find any documentation, so I used chat on healthcare.gov and asked:

Can a married couple apply for two individual policies instead of one family policy without changing their combined premium subsidy?

The answer was:

A married couple would have to apply as a family.

If anyone has firm information to the contrary, please let me know. Though I think I'm kind of relieved that we won't have to successfully sign up twice with healthcare.gov. I would certainly need health insurance if my insurance went through, but DW's hit a snag!

 

[bamsphd]

Looks like I misunderstood the original healthcare.gov chat answer. The relevant part of my latest chat confirms ziggy29's answer that you must apply together, but can have separate plans.

For more details see the thread: ACA: "Recommended Health Plan Groups" (Family versus 2 Individual Policies)