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Originally published March 27, 2014 at 5:12 PM | Page modified March 27, 2014 at 8:50 PM

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As health-care sign-up deadline nears, 11,500 mired in glitches

The Washington Health Benefit Exchange disclosed that about 11,500 applications were “stuck,” a result of data-processing problems, missing information or income-tax issues. That number was down from 15,000 at the end of February.


Special to The Seattle Times

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As the March 31 deadline to sign up for 2014 health-insurance approaches, Washington state’s online exchange has enrolled more than 500,000 people in qualified plans or in Medicaid.

The overwhelming majority of those enrollments were completed online smoothly, at least after the first tumultuous weeks of the exchange’s launch.

But potential technical website problems remain a concern.

This week, the Washington Health Benefit Exchange, which runs the Washington Healthplanfinder website, disclosed that approximately 11,500 applications were “stuck,” a result of data-processing problems, missing information or income-tax issues. That number was down from 15,000 at the end of February.

Potential technical problems are also a big reason the Obama administration this week said federally run exchanges would allow people signing up for insurance to go beyond March 31 if they start the application before that date but were unable to complete it in time. All they have to do is check a box indicating they tried.

In Washington state, applicants need to get insurance before 11:59 p.m. March 31 unless technical issues prevent them from completing the process. The state said it would grant more time to those people on a case by case.

The cases of “stuck” applications are small in number but show the kinds of problems people can run into. The ongoing snags have been frustrating and time- consuming for those caught in limbo. For example:

Ryan O’Keven, 31, Seattle, self-employed mortgage broker:

O’Keven, who moved to Seattle from California last year, began his application when the exchange opened for business in October. There was a delay initially because his wife was still in California. He finally got his wife added to his selected plan and he made his first payment on Jan. 6.

“That’s when things began to unravel,” said O’Keven. He received a letter at the end of December or beginning of January indicating the application had been stuck but that as long as everything was completed and paid for by Jan. 15, they would backdate the coverage to Jan. 1.

He said that’s the last he heard. He does know the coverage did not start Jan. 1.

O’Keven said he had signed up for a gold plan. But when he called the exchange to confirm payment for March, he was told that his plan had been changed to a bronze plan. “I’d never requested that,” he said.

“I think I’ve spent 11 hours on the phone with the exchange over the last two months,” O’Keven said. “I told them that needed to be fixed.”

According to O’Keven, the day after he inquired about the change to bronze, his health plan was canceled. He didn’t know why.

O’Keven said he was told initially that there was a glitch in the system. More recently, he was informed that he was ineligible because he and his wife couldn’t prove their citizenship.

“That shouldn’t be the case since we’re both citizens,” said O’Keven.

O’Keven this week said he is still without insurance. His account is listed as “enrolled,” though the start date is indicated as April 1. He says the exchange has told him verbally that they are working on backdating the coverage to March 1.

Bethany Frye, spokeswoman for the Washington Health Benefit Exchange, said the exchange has not been able to confirm the cause of O’Keven’s first application being terminated in February.

She said, however, that a new application was submitted on March 4 for coverage starting April 1. “No other action needs to be taken on his account as his application issues are now resolved for April coverage,” Frye said.

Lynn Durfy, 60, Seattle, retired:

Durfy and her husband had an insurance policy with Lifewise that was in effect until Dec. 31. The couple decided to stick with Lifewise for a new policy, choosing a silver plan on the exchange. It was to take effect Jan. 1.

When she received the paperwork, Durfy said, it wasn’t the plan she thought she had signed up for.

She decided instead to apply for a Premera Blue Cross gold plan. This time, she applied via the Healthplanfinder website after having signed up the first time over the phone.

Because she had paid for January with the silver plan, and because the Premera gold plan was to take effect Feb. 1, she said, there shouldn’t have been any lapse in coverage.

She grew concerned, however, when the website did not update her account. “Nothing was changing,” she said.

She discovered that the exchange had entered her enrollment date as March 1 instead of Feb. 1.

“Because of that,” she said, “I didn’t have coverage for the whole month of February,” she said. Unfortunately, she had surgery on her hand on Feb. 11.

“I’ve got massive doctor bills all denied from the month of February, even though I have coverage,” she said.

Durfy said she applied to the exchange for an emergency appeal, but things grew “bizarre.” “I was granted an emergency appeal,” she said. “However, they advised me that the presiding officer only had jurisdiction to rule on tax-credit issues and I did not have a tax-credit issue.”

According to Durfy, she has spent more than 67 hours on the phone with the exchange. “At no time did anyone either help me or make any attempt to correct the error that they had made,” she said.

The exchange’s Frye said changes Durfy made to her account on Jan. 15 caused her first payment to be applied to February. Because of the frequency of changes in Durfy’s account, Frye explained, her enrollment date was moved to March 1.

“Our records show she has not had a lapse in coverage due to these issue; she is just not in the desired higher-tier plan,” said Frye.

Durfy said her medical bills are being rejected by the insurer.



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