Dollars & Sense

New customers must pay to start coverage, Blue Cross of KC says

Updated: 2013-12-12T04:26:45Z

By DIANE STAFFORD

The Kansas City Star

Some Kansas City area consumers who have signed up for policies through the federal Health Insurance Marketplace could be left without coverage in January if they’re waiting to pay until they get a bill in the mail.

An enrollment verification page from Blue Cross and Blue Shield of Kansas City has been telling its federal marketplace customers that their first bill will come in the mail. It may not be clear to some buyers that their first monthly payment is due by Dec. 31.

Ordinarily, waiting for a bill might not be an issue, but payment deadlines have been tightened because computer problems with the Affordable Care Act website prevented most attempts to buy policies until the last few days.

The Affordable Care Act requires individuals who aren’t covered by employment-related or government plans to buy health insurance effective in 2014. The government extended until Dec. 23 the final date for consumers to sign up for Obamacare policies that would be effective beginning in January, with the first month’s payment due by Dec. 31.

“We’ve seen an uptake in the number of people signing up, but a very low number of people are actually paying for their plans,” said Priya Nibert, a spokeswoman for Blue Cross and Blue Shield of Kansas City. “Many people don’t seem to know their payments have to be in before coverage is effective.”

The company is spreading word that marketplace policy buyers will have to start over and re-enroll online if they don’t pay their January premium by the end of this year. If they miss the Dec. 31 payment deadline, the earliest they could get coverage by starting over would be for February.

Nibert said Blue KC is scrambling to make would-be buyers aware of the deadline.

“You’re not technically enrolled until payment lands in the insurer’s hands,” emphasized Jeremy Milarsky, a navigator at Primaris in Columbia who is trained to help people sign up for coverage.

Blue KC and Coventry, the other insurer offering policies to Kansans and Missourians through the ACA marketplace, aren’t saying how many consumers have enrolled through the marketplace so far. But it’s enough people that the Blue KC office noted the trend in slow payments.

Nationally, it has been reported that the enrollment information from about 3 percent of would-be premium buyers on the marketplace hasn’t been conveyed to the appropriate insurance company. That glitch contributes to insurers’ concerns that some consumers may not pay on time.

“Not all new enrollees are making it onto the nightly report (insurers) get from CMS,” Nibert said, referring to the Centers for Medicare & Medicaid Services, which operates the federal health insurance website.

If the insurer doesn’t get prompt notice of an enrollment, or if the insurer’s billing process is slow, or if the consumer fails to read the fine print about when payment is due, the policy won’t be purchased in time to be effective Jan. 1.

Insurers take steps to explain that advance payment is needed. Here, for example, is what a consumer who signs up for 2014 coverage can read from Coventry after choosing a policy:

“To activate your new coverage, you must pay your first month’s premium by your plan’s due date. Your plan will contact you in the next few days with details on how to pay, or visit your health plan online to make your payment now if your plan accepts online payment. Your payment must be received and processed by the effective date to be fully enrolled. Contact the plan’s customer service if you have any payment questions or issues.”

But insurers and brokers fear that some consumers, unfamiliar with the process of buying health insurance, won’t understand that the reference to “due date” means Dec. 31 for the first payment to be received for coverage to kick in Jan. 1.

Newell Mitchell, an insurance broker who has been helping Kansas City area residents sign up for coverage, said consumers need to be careful about assuming the enrollment process would go perfectly.

“Not everyone is hearing back right away from the insurance company,” Newell said. “One lady I signed up last week hadn’t heard back after a week, so she had to call the company’s customer service line, and they told her the premium cost and how to pay it.”

To reach Diane Stafford, call 816-234-4359 or send email to stafford@kcstar.com.

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