New York Consumers Frustrated By Insurance Delays

fromWNYC

New York's health insurance marketplace is working, but some consumers are still having problems with insurers. Empire Blue Cross Blue Shield is the state's largest insurer and the target of a lot of consumer complaints.

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The number of people who have enrolled in the Affordable Care Act may be up but many of them are uncertain whether their enrollments actually went through. They're still waiting for I.D. cards and confirmation.

As Fred Mogul, from member station WNYC reports, many of the complaints are focused on WellPoint, one the nation's largest insurers.

FRED MOGUL, BYLINE: Just after the new year, Rob Cuillo got a nasty stomach bug.

ROB CUILLO: I was sick as a dog, puking my brains out...

MOGUL: After a couple days, Cuillo began thinking it might be time for a trip to the emergency room near his home on Long Island.

CUILLO: Because I was so dehydrated, I was thinking if this goes on another day I might need maybe an I.V. to give me some liquids...

MOGUL: But lying in bed, Cuillo had another thought.

CUILLO: I'm like, wait. I don't have the Empire - I don't have a card.'

MOGUL: Cuillo enrolled last month through the New York State health exchange in Empire Blue Cross Blue Shield, a unit of Indianapolis-based WellPoint. But Cuillo's enrollment couldn't be confirmed until he paid his first premium - and he never got the bill. A couple days after his stomach virus ran its course, Cuillo got a letter in the mail, telling him how to pay the premium online. But the website wouldn't open.

CUILLO: I can mail it in to them. But I feel a little uncomfortable sending a check in the mail to people that don't answer phones. How do I know it'll even get there?

MOGUL: People have been complaining for months about crashing web pages, long wait times on phone lines and spotty customer service. But in recent weeks in New York, most companies appear to be processing enrollments smoothly

Elisabeth Benjamin, from the Community Service Society, says now complaints are centered almost exclusively on Empire Blue Cross.

ELISABETH BENJAMIN: I think we were all surprised that New York's blue-ribbon carrier is the carrier that's had, apparently, the most bumpy of rollouts.

MOGUL: Benjamin's organization helps New Yorkers sign up for health insurance.

BENJAMIN: I think a lot of folks enrolled in Empire, because of its incredible reputation. And everybody is a little flummoxed about why these problems are occurring.

MOGUL: Empire Blue Cross would not go on tape for this story. In an email, a spokesperson blamed an overwhelming and unanticipated number of applications. And said the high number of complaints in New York was because Empire is the state's biggest player. According to figures released yesterday, Empire has 18 percent of the new exchange plans, only slightly more than the next largest insurer.

Neither Empire nor state officials would disclose how many people have been affected by enrollment glitches. Donna Frescatore is the head of the New York State exchange.

DONNA FRESCATORE: I don't have a ballpark number. But I certainly think we've heard it enough time to know that it's an issue that needed immediate action.

MOGUL: The Empire Blue Cross statement says the company has added phone operators, expanded business hours and mailed out letters to customers telling them they'll receive invoices and ID cards as soon as possible.

But Sean Hayden, in Manhattan, says that's too little too late.

SEAN HAYDEN: We're done. Definitely.

MOGUL: Since November, Hayden has been trying to confirm his and his partner's enrollment with Empire. Last week, they gave up and went with a plan from a rival insurance company, with a lower monthly premium.

HAYDEN: I came in $60 cheaper. And the annual deductible, while still a little hefty, is a little bit less than what we were paying with the Empire plan.

MOGUL: And Hayden and his partner will be able to see doctors and hospitals in-network that Empire eliminated. Enrollees have until the end of March to sign up for 2014 coverage.

For NPR News, I'm Fred Mogul in New York.

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MONTAGNE: Our reports from Fred Mogul and Sarah Varney comes to us through a partnership between NPR and Kaiser Health News.

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MONTAGNE: You are listening to MORNING EDITION from NPR News.

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