Must Listen--Grace Periods ACA

This has nothing to do with Florida Blue although it is their video. I encourage everyone to listen on another ACA glitch that refers to grace periods. Please start at 10:15

Payment issues described MAA webinar - YouTube

THANK YOU for posting this! We have had severe payment issues with our clients-clients who have been on the books for years and suddenly their policies are terminated with no notice. I have been going around and around with BCBSTX in regards to just this issue.
 
This is incredibly important to know. Thank you for sharing that. For those listening to the video, you might want to skip everything before the 10:13 point, and listen up to the 14:45 point.

Essentially, if the client keeps making payments in the grace period, they never leave the grace period, and on the 90th day their coverage is terminated. For the grace period to end, a payment must reach the insurance company BEFORE the due date (and, of course, there can be no balance due from prior months). Otherwise, the grace period keeps ticking up from 30 days to 60 days and then at that magic 90 day mark the policy is terminated.

Of course, this is for on-exchange subsidized business, because they are the only folks that get a 90 day grace period.

https://www.youtube.com/watch?v=QBsSnwmAJsU&feature=youtu.be
 
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This is incredibly important to know. Thank you for sharing that. For those listening to the video, you might want to skip everything before the 10:13 point, and listen up to the 14:45 point.

Essentially, if the client keeps making payments in the grace period, they never leave the grace period, and on the 90th day their coverage is terminated. For the grace period to end, a payment must reach the insurance company BEFORE the due date (and, of course, there can be no balance due from prior months). Otherwise, the grace period keeps ticking up from 30 days to 60 days and then at that magic 90 day mark the policy is terminated.

Of course, this is for on-exchange subsidized business, because they are the only folks that get a 90 day grace period.

https://www.youtube.com/watch?v=QBsSnwmAJsU&feature=youtu.be

In Texas this is happening with both ON and OFF Exchange and with our legacy policies as well. What further complicates the matter is the fact that our BCBS clients do not all have the 1st as their policy date. (Those not part of the migration still have their original policy date.)

Also, clients who have had PAC's set up are seeing their PAC's come out on that original PAC date; however, if they were part of the migration and their policy date is now the 1st, their draft may be coming out after the first if their draft date has not been changed via completion of a new EFT authorization form. This then sends these people into the continuous loop of the 30, 60, 90 day grace period until that PAC date is changed to a date before the 1st of the month. Though this should not be occurring with this book of business who are on legacy policies, this is happening.

We pull our book of business 2x per week to review grace period and terminations and these people do not show on these lists and appear to be paid to date, according to BCBS, only to see them terminated a few days later. When we go in and review their payment history we see this 30, 60, 90 day grace period occurring due to their payments appearing to be received late.

In review of our book of business, having to go in and review each client's payment history, I believe this issue is much bigger than most realize.
 
We pull our book of business 2x per week to review grace period and terminations and these people do not show on these lists and appear to be paid to date, according to BCBS, only to see them terminated a few days later. When we go in and review their payment history we see this 30, 60, 90 day grace period occurring due to their payments appearing to be received late.

Wow. This explains some things that I see happening. I pull up my book of business to see the "paid to dates". For subsidized Exchange business, it can still show as several months late, if the govt subsidy check has not reached the carrier yet. So, I call the carrier and find that the CLIENT has paid their portion, and all is well. Or so I thought. I now realize that just the fact that "the client has paid their portion" is not enough information, because the client may have paid it past the actual due date, meaning the grace period is still ticking up from 30 days to 60 days and then to 90 days.
 
THANK YOU for posting this! We have had severe payment issues with our clients-clients who have been on the books for years and suddenly their policies are terminated with no notice. I have been going around and around with BCBSTX in regards to just this issue.

I'm replying and updating my own post regarding grace periods and my experience.
Personally, I've done three consecutive payments in an ACA Cigna plan outside the stipulated day one (first of the month) period (7/11;6/19;5/05). I called in and the automated system reports a zero balance. I wonder if this means a zero balance but 3 months within the grace period? Maybe I'm calling to see what a real person says about the matter before I'm terminated.
I'll keep members interested posted.
 
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I'm replying and updating my own post regarding grace periods and my experience.
Personally, I've done three consecutive payments in an ACA Cigna plan outside the stipulated day one (first of the month) period (7/11;6/19;5/05). I called in and the automated system reports a zero balance. I wonder if this means a zero balance but 3 months within the grace period? Maybe I'm calling to see what a real person says about the matter before I'm terminated.
I'll keep members interested posted.

Keep in mind I was referring to BCBS in Texas. BCBSTX is where we have seen all of our issues. Also keep in mind, this 90 day grace period is supposed to be for ON Exchange only; however, it appears the BCBS system is utilizing this 90 day grace period on all of the policies. Again, this has not been confirmed but just our observation with our book of business (both ACA and pre-ACA plans).

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Do we know if this is FFE only or does it apply everywhere?

The 90 day grace period is supposed to be for FFE only; however, this specific issue is in regards to BCBS both ON and OFF Exchange.
 

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