Marketplace Navigators Changing Clients Plans

[Tkruger]

Well, if we didn't have enough that we had to battle with the ACA now it's come to my attention that when clients call the marketplace that the Navigators are looking at their plan and telling them of cheaper plans with other carriers.

Spoke with a client to follow up on setting up the monthly auto draft. He/she informed us that when she called the Marketplace to ask about where to send the citizenship info the Navigator told her she was paying too much for her plan and that a zero dollar bronze plan with no copay and much higher deductible was better for her.

She took the advise of the MP rep and now pays out of pocket each month she goes to the Dr. She was a "Sick" client and it was best for her with the original Silver plan we set her up with that offered co-pays and a $ 500 deductible...

WTF?

 

[Yagents]

This is another reason why I love doing exchange business.
Did you remain the AOR?

 

[Tkruger]

No didn't remain AOR mainly because the client opted to go with a carrier we didn't represent.

I can just see it now...A letter/email from the company stating we are not appointed to sell their products and to cease immediately. The agent\agency info is still attached to the application...

Our only course of action is to contact the marketplace, get a supervisor with a double digit IQ to tell use who the rep was and file a grievance with the regional CMS office.

 

[AllenChicago]

If that happened to my client, a whole lot of people would know that "trained" Navigators are breaking the law by playing insurance agent. I'd also have the Marketplace restore the client's plan back to the way it was..if that's what they want.

 

[FLM2]

How can that be done once Open Enrollment is over?

 

[Tkruger]

It was done during open enrollment. Said client called before it ended.

 

[G.Gordon]

I had a client that needed to change her middle initial.

E to K

Called the plan and was told to call the marketplace.

Called the marketplace, they went through the application, changed initial, and instead of leaving them in the same plan and enrolled separately to keep the deductibles and MOOP separate, the marketplace enrolls them in the right Gold plan, but together.

We called to get it fixed, they Hix'd it, yep, they will be separated again on 3/1, but it was supposed to be retro to January.

Now they have had to pay medical expense toward three deductibles, January, February, and now, if they don't fix this, March will start a new benefit year.

What a screw up.

 

[sman]

Well, if we didn't have enough that we had to battle with the ACA now it's come to my attention that when clients call the marketplace that the Navigators are looking at their plan and telling them of cheaper plans with other carriers.

Spoke with a client to follow up on setting up the monthly auto draft. He/she informed us that when she called the Marketplace to ask about where to send the citizenship info the Navigator told her she was paying too much for her plan and that a zero dollar bronze plan with no copay and much higher deductible was better for her.

She took the advise of the MP rep and now pays out of pocket each month she goes to the Dr. She was a "Sick" client and it was best for her with the original Silver plan we set her up with that offered co-pays and a $ 500 deductible...

WTF?

I had a client call me Monday wanting to update her income since they would be receiving more this year than last. She couldn't get logged in to healthcare.gov so I told her to call and tell them you want to update your income so the subsidy can be adjusted.

She called me back about 30 minutes later and told me they got the income info updated and they changed her to a different carrier (one week after OEP ended). She was excited because the premium was about $30 less per month. I then asked her if the person she spoke with checked to make sure her doctors, hospital and meds are in the network of the new carrier. Of course they didn't. And guess what, one of her doctors isn't in the network and the hospital she prefers isn't in the network and one of her meds isn't on their formulary. Her MOOP is also higher.

I reminded her that we discussed that very plan back in November and we decided not to go with it because of the network limitations. Of course she asked what she should do now. I told her she'll need to call them and ask them to undo what they did. I'm not even going to fight for the business at this point. I'm so fed up with on-exchange crap I don't want to deal with it anymore.

 

[Zanetti90]

Two if my client where having issues with Humana enrollment. Called marketplace navigator redid the app with aor. Told both times to redo it. Hate how this system work. We all should call our congressmens and let them know whats up

 

[AllenChicago]

Two if my client where having issues with Humana enrollment. Called marketplace navigator redid the app with aor. Told both times to redo it. Hate how this system work. We all should call our congressmens and let them know whats up

Zanetti, to quote Joe Biden, "I feel ya man!" It's a shame you got that same Told moron both times you called in. But things were finally made right? Hope so!

I had problem with numbskull navigators not accepting a policyholder death, even after 2 calls. Only way was to cancel checking auto deduction. I'm not putting no more marketplace plans on checking auto. Just askin for trouble eventually.