Hundreds in Calif. Shifted to New Health Plans Without Consent
Hundreds of California residents whose plans were canceled because they did not meet minimum coverage standards under the Affordable Care Act were enrolled in new plans automatically, even though some had already selected a different plan through the state's health insurance exchange, ProPublica reports (Ornstein, ProPublica, 1/27).
Background
Last year, about one million individual policyholders in California were notified that their current insurance plans would be discontinued at the end of 2013 because the policies did not meet minimum coverage requirements under the ACA (California Healthline, 11/27/13).
Details of Duplicate Plans
According to ProPublica, many consumers neglected to read a section of the notification letter that stated they would automatically be enrolled in a different plan unless they contacted the insurer.
The letter also stated that payments would continue to be automatically collected if the consumer's account was set up to auto-deduct premium payments.
Insurer Response
Kaiser Permanente spokesperson Chris Stenrud in an email said about 500 Kaiser policyholders were billed for plans after obtaining separate coverage through the exchange. He said individuals were "inadvertently charged before our systems recognized their enrollment in new plans through Covered California."
However, Stenrud added that Kaiser has "identified the affected members and [is] in the process of contacting them to make them aware of the mistake" and to provide them with refunds.
Meanwhile, Anthem Blue Cross spokesperson Darrel Ng said, "In cases where members neglected to inform insurers that they had selected a new plan or informed insurers too late that they had selected a new plan, members are receiving a full refund for any amount paid."
California Department of Insurance Response
Janice Rocco, deputy commissioner for health policy at the California Department of Insurance, said that insurers could have violated the law in two ways:
- Failing to provide consumers with a notice of how to cancel an electronic transfer of funds; and
- Enrolling some consumers in plans that were actually sold by affiliated companies with which policyholders had no prior electronic funds transfer agreement (ProPublica, 1/27).