A Huge Problem Nobody Has Talked About

Yagents

Guru
5000 Post Club
12,149
Arizona
I've been concerned about this, and here it is.

This could happen, and believe many of my clients will be subjected to this:

1. Client stops paying premium, finally lapses after 90 days, but the MP kept sending tax credits to the carrier. Will these be refunded and reconciled by the carrier and MP?

2. Client changed plans in Feb 2015, but marketplace never sent cancellation notice to old carrier, and kept sending tax credits for 3 months or more. I'm being paid by some carriers STILL (Cigna, etc) on plans that were terminated via the marketplace.

3. Client had 14' plan, we used Sherpa for 15', old plan was never cancelled by Sherpa or other WBE or carrier direct method.

i can go on, but you get the drift.


Colorado family says tax bill for exchange error an unending disaster - The Denver Post

Swan, a weight-loss coach, signed up for family coverage through the exchange for 2014, but changing job circumstances for husband Martin Shopes led her to contact the exchange to cancel that Kaiser Permanente policy effective Feb. 1.

Shopes got coverage through his employer. Swan signed up for an individual policy with Kaiser. Her 18-year-old son had CHP+ and later Medicaid.

The Swan-Shopes family continued to receive monthly bills for their share of the canceled plan's premium after tax credits, a whopping $3 plus change. And the monthly premium tax credit of $903, for which the family was eligible only in January, presumably was credited to insurer Kaiser.

At first, the notices for unpaid premiums were alarming, Swan said, but surely the matter could be straightened out before this year's income tax filing deadline. It couldn't, despite the hours spent on hold or talking to and e-mailing people at Connect for Health and Kaiser.

The exchange told Swan it had no record of her new individual plan, she said. Kaiser could find only her family plan. She later tried to cancel that plan when she joined her husband's employer-based policy.

Then the tax bill came. According to the 1095, the family had received $10,837 in tax credits, which paid premiums for a plan they had tried to cancel. The family's change in income meant they no longer qualified for subsidies.
 
Too many people that add no value have their hand in the till on this. The exchange was never needed, just another layer of admin that creates problems it cannot solve.

Obamacare will go down in history as the biggest govt cluster-f ever devised.

Can someone 6' tall get one of these 14' or 15' plans you are talking about?

you-must-be-this-tall.png
 
Here's another one, the morons at HC.gov never considered.

You can't terminated a plan within 15 days of today.
Client going on medicare June 1st.
She didn't follow my instructions to terminate HC.gov account.
So, we did it yesterday with a June 3rd term date (15 days out).

Will this client, who is NOT allowed to have a MP plan when on medicare be on the hook for the full APTC amount, or partial pro-rated amount, will it be reconciled.

Fricken moronic system. :goofy::goofy::goofy::goofy::goofy:
 
Here's another one, the morons at HC.gov never considered.

You can't terminated a plan within 15 days of today.
Client going on medicare June 1st.
She didn't follow my instructions to terminate HC.gov account.
So, we did it yesterday with a June 3rd term date (15 days out).

Will this client, who is NOT allowed to have a MP plan when on medicare be on the hook for the full APTC amount, or partial pro-rated amount, will it be reconciled.

Fricken moronic system. :goofy::goofy::goofy::goofy::goofy:

As much as I hate saying this I have essentially given up on trying to fix things when a clients' policy gets off kilter, it's the only way I can remain sane as the stupidity keeps mounting on a daily basis.
 
Too many people that add no value have their hand in the till on this. The exchange was never needed, just another layer of admin that creates problems it cannot solve.

Obamacare will go down in history as the biggest govt cluster-f ever devised.



you-must-be-this-tall.png

I agree! The longer it exists the more problems are found.
 
Yes, I have seen this happen, too, Yagents: just try terminating a plan. My Cigna statement is loaded with 'active' people that were terminated 12/31/14 and switched to BCBS because the Cigna directory is so poor. I keep getting paid and then get chargebacks.

Why can't people get their plan canceled when they want to yet get terminated when they don't want to? Why aren't the carriers sending the money back to the MP when the policy is no longer active?

I don't get it. Just a huge mess. So many problems with no way to solve as the agents are being pushed out of the way with so much disrespect for us.
 
Back
Top