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Posted by on Feb 26, 2014 in Healthcare Reform

CAHU President’s Blog: February 24, 2014

CAHU President’s Blog: February 24, 2014

CAHU leadership continues work to ensure the spectrum of health insurance coverage choice remains vibrant for all licensed health insurance agents.  While Covered California is “a” market, I have to always remind myself and others that it is not “the” entire market for health insurance coverage in California.  As such, our members expect to be able to serve our clients in a professional manner regardless of which part of the market our client selects coverage.

Our agents work with all insurers in the many marketplaces that make up California’s  insurance universe.  Over the coming weeks I hope to be able to report on CAHU efforts to improve agent experiences when working directly with plans and specialized health insurance markets.   As the rollout and shakeout of Covered California continues, CAHU will continue to also work to resolve barriers agents have found and reported.

One of the frequently asked for changes agents requested is a dedicated call line. Last week Covered California provided CAHU with its new Agent Hotline. The line is open from 8:00 AM through 6:00 PM, Monday through Friday. While this event is not quite the equivalent to the parting of the Red Sea, it is nonetheless a significant advancement in support services for our members.

The establishment of a dedicated Agent Service Center and Agent Hotline is attributable to CAHU’s advocacy efforts and Covered California’s recognition that agents are the driving force behind individual and small business enrollments. Agents can now call in on a dedicated line for both individual and SHOP service issues. The new agent service center will have direct access to client information and will be able to make changes in real time. For those of you who feel as if these past few months were like enduring 40 years’ exile in the desert wandering lost, there may yet still be a promised land in sight.

Here are the issues:

Covered California Website: A planned maintenance update caused a software malfunction on the Covered California website last Wednesday afternoon that extended through this past weekend. Customers were still able to visit the information pages and use the shop and compare tool.  Unfortunately, both agents and consumers were unable to facilitate new enrollments or make necessary changes to existing enrollments. The system came back on line today.

Change Request Form: CAHU continues to make weekly requests for a Change Request form. We recognize the importance of having this tool available. We will keep you posted on our progress.  As of last Friday, the form was reportedly in ‘final final’ vetting.

Agent FAQs: Pinnacle is still working on a PowerPoint format for Agent FAQs. Most likely the next FAQ will be a needed revision and update on Medi-Cal enrollment training. Pinnacle is still doing some internal revisions, but is hopeful to get this out this week.

Agent Certifications & Trainings: There are still 4,500 agent certification applications that are still in progress. There are seven new statewide trainings planned for this spring. CAHU will provide you with a full list of dates and locations as they become available.

AOR Updates: Covered California advised CAHU they have transmitted all files concerning AOR to the insurance carriers. While some of the insurance carriers have updated their files, CAHU has been advised that both Blue Shield and Blue Cross are still in the process of reconciling the files.  CAHU has made a request for a complete audit to ensure the accurate documentation of this information and is working with carrier executives to expedite these updates.

SHOP: You may have noticed that the paper applications currently being use to enroll small groups is streamlined. CAHU has requested that the online SHOP platform be remodeled in this manner, as well.

Both a secure email process FAQ and a safe inbound fax number are in the works. CAHU will provide you with this information as soon as it is available.

I have also heard the complaints from agents about longer than acceptable phone time waits (up to two hours has been reported as recently as last week) when working to place non-exchange related business with carriers.  CAHU will be contacting a number of these carriers find solutions and resolve barriers to clients getting coverage plans to find out why this is happening. Look for an update on this in my next blog.

Final Thoughts: This week, I and many other members of our association, will be attending the NAHU Capitol Conference in Washington D.C. It should prove to be an opportunity to compare best practices throughout the country and develop meaningful opportunities to improve CAHU’s services to you.  We will all take advantage of every opportunity to tell our story with our members of Congress!

Until Next Week,