Health Insurer Blue Cross Facing a Lot of Consumer Wrath

Policy holders are very upset over the double billing, conflicting information and no insurance cards. There are long waits to talk to customer agents too. One of the largest insurers of the state of Illinois – Blue Cross and Blue Shield is struggling with the complexities of the Affordable Care Act and at the same time deal with angry and confused consumers caught in a purgatory between old and new policies – at times paying for both. The phone lines are jammed with queries making people turn to Twitter and Facebook to voice their grievances.

Many of the issues stem from a last-minute reversal by the White House that allowed some policyholders to keep their old insurance plans, even if they didn't adhere to new requirements of the complex health law. But since this came about in late November, when many consumers had already opted to buy new plans on the new health exchanges.

Customer service agents already were under pressure, helping customers, many of whom were buying coverage for the first time, navigate new plans offered under the health law. A mid-December decision by the federal government to extend the deadline for people to buy policies effective Jan. 1 put more pressure on carriers to handle enrollments and resolve issues.

Blue Cross ran out of time, leaving about half a percent, or "a couple thousand," of its Illinois individual policyholders enrolled in two plans simultaneously and charging them for both, the company said. Austin Waldron, the chief customer service officer for Blue Cross and Blue Shield of Illinois and its Chicago-based parent company, apologized to customers and blamed the issues largely on the late and unexpected changes implemented by the Obama administration and the state of Illinois that allowed customers to keep existing plans.

By the time the insurer sent customers letters informing them of the change, much of the processing for new policies already had occurred. Wary of canceling consumers' plans while they mulled a decision on whether to go with their new plan or keep their existing coverage, Blue Cross intentionally kept plans active until they heard from customers, Waldron said. "We got caught in that period between the president's announcement and the state's decision" on whether it would allow insurers to offer plans once slated for cancellation, Waldron said. "We're thinking, 'We don't want to just cancel everybody.' We were faced with trying to do a lot of comparisons, and it's a lot of work to figure that out."

Blue Cross promised to issue refunds to those customers. The company also said last week that it would reverse a $9.95 processing fee some customers were charged for paying online or by phone. The company had resolved many of the issues affecting enrollees who selected coverage effective Jan. 1, though "we have a couple of thousand (customers) left to sort through which policy they have," Waldron said. He acknowledged that many of those policyholders may have been unable to get through to Blue Cross agents because of excessive wait times, the result of two forces.

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"Clearly, the kind of wait times people were experiencing are not up to the standards we're used to," Waldron said. "I've been here for more than 30 years, and I've never seen anything like it. And I'm not very happy about it, either, because our commitment is to serve our members." Despite nearly doubling the number of call center agents to 850, wait times in some cases still exceed an hour, he said. Another 150 call center workers are scheduled to start this week to help handle continued high levels of customer calls.

Blue Cross hadn't finished processing 10 to 15 percent of its enrollments for January coverage till a week back, leaving many of those who paid for coverage without an identification number or an insurance card. It expected to complete most of that work by Saturday. "Clearly, the kind of wait times people were experiencing are not up to the standards we're used to," Waldron said. "I've been here for more than 30 years, and I've never seen anything like it. And I'm not very happy about it, either, because our commitment is to serve our members."

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References:

Hannah Punitha (IRDA Licence Number: 2710062)

Peter Frost, January 2014

Source-Medindia