24 April 2014

Connect For Health Colorado Finally Delivers (Sort Of)

To recap the saga:

In late October of 2013, my wife set up an account at Connect For Health Colorado including a lengthy and intrusive application for Medicaid, even though we knew that we didn't qualify for it.  Sometime after Thanksgiving, after many catastrophic system failures at Connect For Health, we finally get our Medicaid application rejection and are allowed to access the part of the website that allows you to compare and contrast health insurance plans.

There are lots of plans and lots of details involved, but eventually, we pick a no deductible "gold plan" with CIGNA that will be hundreds of dollars cheaper than the health insurance that I have from Anthem (Blue Cross-Blue Shield) through the Colorado Bar Association (after Obamacare subsidies) has a $5,000 deductible for in network services, per person, and will no longer be available starting May 1, 2014 since it doesn't comply with Obamacare requirements.  We submit our plan on the December 23, 2013 deadline to choose plans effective January 1, 2014.

A day or two before January 29, 2014, we finally get an invoice from CIGNA for the health insurance we were unable to utilize from January 1, 2014 through January 31, 2014, because we had no health insurance cards and no one at CIGNA could confirm that we had health insurance from them.  Some of the delay was due to Connect for Health not being able to get our information to CIGNA in a timely fashion, and some of the delay was due to CIGNA's failure to process the information in a timely fashion once it was received from Connect for Health.

In order to try to avoid this kind of overlap of coverage, on January 29, 2014, we make a simple request that is supposed to take two weeks to fulfill.  We change our start date from January 1, 2014 to March 1, 2014, allowing an ample thirty days for the change to be processed, so that we can pay our premium and have health insurance cards in hand when our new CIGNA coverage begins.  Silly us.

Earlier this week (i.e. April 23), about twelve weeks after our requested change in start date and four months after we chose our health insurance plan, we finally are given the opportunity to pay our March premium for CIGNA and get into their system, and have been promised that we will received temporary health insurance cards tomorrow.

In the intervening twelve weeks, we had dozens of phone conversations with almost as many Connect For Health and CIGNA representatives (several times on conference calls involving representatives of both), about half of them managers and devoted probably thirty hours to the problem - hold times of half an hour to an hour were common.  Sometimes they would talk to me about the health insurance application submitted by my wife for our family without question, other times, they refused to talk to me citing confidentiality requirements.  We were told that there are hundreds of similarly situated people in the Connect For Health system and that there is no process for escalation of problem cases like ours to higher levels.  Connect For Health representatives swore that they'd sent information to CIGNA that was actually never sent several times.  We were promised calls back from Connect For Health representatives about ten or twelve times, and only received return calls two or three times.  One of the two times we were given a direct line for a particular person, Connect for Health refused to connect us to that person when we called back.  Threats of lawsuits and legislative intervention were to no avail.  I was promised a response from someone outside the call center, but got no response, although I did get a name and address.

Connect for Health mostly refuses to do business by mail, by e-mail, or in person, despite being supposedly a Colorado specific operation and their call centers are all across the United States.

Eventually, my wife's dire and disgruntled posts all over the Connect for Health website got us a call from someone in the Connect for Health organization with a direct line, e-mail and apparently, the ability to finally get the job done in just a few days.

One can get health insurance directly from a health insurance company, but doing so means that you forfeit the Obamacare premium subsidy, which Connect for Health has a monopoly upon.  But, in the end, we will have ended up paying for my old health insurance from January through April, coming within a week of having no health insurance at all, and also paying for the new health insurance for March and April despite the fact that we won't have any opportunity to use until the last week of April.

We were given an opportunity to move back the start date to May, and just like the first time we did it, we were told that it would just take two weeks.  But, that would leave us uninsured for the first week of May and the last time we were told it would just take two weeks it actually took twelve, so we declined that opportunity.

Connect for Health tells you that you can take a screen shot of your Connect for Health application and get health care from medical providers, but this is just a plain and simple lie, and one that health insurers are ill advised to participate in because, a screen shot is too early in the process to guarantee that a health insurance policy will actually be generated.  A process that routinely encourages people to pay for health insurance that they didn't receive is fundamentally fraudulent.

Connect for Health's insanely incompetent bumbling has cost my family about $2,500-$3,000 that we wouldn't have paid if they'd been doing their job, which eats up almost all of the economic benefits we would have received from Obamacare in the first year.  All told, the process has taken about 70 hours of our time, more than half of which was due to various screw ups by Connect for Health, and I fully anticipate that we will have about 15 hours or more dealing with the health care billing screwups caused by having two health insurance policies in place for the same time for March and April.

Assuming that our experience is typical of the hundreds of majorly screwed up cases in the system, Connect for Health has caused several hundreds of thousands of dollars to a million dollars of direct economic harm to people trying to sign up for health insurance, and thousands of hours of time for people trying to deal with their screw ups.  Worse still, some of those people were probably denied necessary health care as a result of their bumbling and suffered much more serious harm as a result.

I am currently exploring filing a class action lawsuit against Connect for Health seeking money damages for the class of people harmed by their failure to live up to their promises upon which people have relied and their contacts with health insurers and governments, as well as seeking injunctive relief to address the problems causing the damages.

The irony of it is that I am a big supporter of Obamacare as public policy.  Expanded Medicaid coverage, subsidized mandatory individual coverage for the more affluent uninsured in a well regulated market, and a largely unchanged situation for Medicare and group health care, may be an ugly kludge, but it dramatically reduces the ranks of the uninsured, substantively hurts almost no one, and meaningfully dents health care costs for those who pay most dearly for it under the old system, like self-employed people.  But, the implementation of health insurance exchanges like Connect for Health has been so abysmally incompetent, that this little detail has tarnished the entire program.  It is a problem that can and should be fixed.  Nothing that Connect for Health is charged with doing is very difficult.  But, because they have utterly fucked up this task, the promise of Obamacare has not been fully realized yet and immense problems have been created.

1 comment:

andrew said...

Or Not. After receiving our payment on what was actually April 22, 2014, we still aren't in CIGNA's system and still don't have even temporarily health insurance cards as of April 28, 2014.