2014 Healthcare Exchange Summary

Here's a summary of the Marketplace 2014 from an agent's perspective.

2014 was an interesting year for health insurance.  This is why I got involved in the first place.  As a bit of a background, I was a Department Chair at a local college running the IT programs.  I've also been a licensed Insurance Agent since about 1996.  I was hearing about the PPACA (Patient Protection and Affordable Care Act) and I thought, 'how interesting, there's probably not going to be another time in this industry that will actually be exciting and interesting with all of the changes going on.'  This turned out to be a very true thought.  Anyway, I trained my new replacements at the college and found a company that I fit in with and started the adventure.

The Exchanges opened and worked the day of December 9th, 2013.  A bit late.  As I remember, October 1st was the designated start date for the Exchange for Open Enrollment.  Put over-simply, the Exchange is Healthcare.gov, a platform to handle the process of qualifying and enrolling an individual or family for tax credits and matching that to a health plan.  An individual can do the entire process themselves, but most that I spoke to found this to be a daunting challenge.  For that reason, there are navigators and agents like myself here to assist in the process.

December 9th, the entire process was not perfected and of several applications attempted, we were only able to get one through the system.  Every other time, the system would crash.  This would continue for several weeks, sometimes it would work and sometimes not.  If my memory works, it wasn't until February that we were able to reliably begin enrolling people from start to finish without problems.  During this time, we were give 4 methods of applying for health coverage.  None of them worked half of the time.

March 31st, the end of open enrollment.  Systems were down the entire day.  The deadline was extended to April 15th, 2004 for people who experienced glitches, and the last day to get covered for major medical plans under the new regulations.  Though there are many other options for health coverage, major medical plans are the only plans available where an individual or family's tax credits are applied.  There are other options, contact me to find out what is available in your area.  Anyway, the final day was the madhouse that I assumed it would be, and somehow I remember April 20 being the new final deadline.  Many people waited until the last moment, system crashes were prominent during the final week, and the deadline was extended several times.  This is a good thing, it's fair in my opinion, so I was able to get several clients taken care of right at the last minute.

The entire reason for this blog, is that I wanted to be able to share this information with others.  For whatever reason I'm not sure.  But, let me go over some of the good and bad.

So, the BAD:  Insurance companies for the most part were successful in matching clients to their health plans and payments about 80% of the time, due to my calculations.  System failures are still being sorted out.  The Navigators at Healthcare.gov as well as the customer service reps at the insurance companies were not largely aware of the issues and therefore weren't enthusiastically helpful.  Sorting out all the problems was a full-time job for myself and one other person in the office until about the end of June.  The Exchange still wasn't talking to the insurers and the insurers didn't understand that what was designed on paper wasn't the way it actually worked.  The frustration was more that I would allow for my clients, I will be frustrated, but I don't want my clients to deal with that, so I fix it and let them know when it is fixed. I don't leave my clients hanging.  I finish the job.

So, the GOOD:  Insurance companies for the most part were successful in matching clients to their health plans and payments about 80% of the time, due to my calculations.  That's a 'B' in college.  An untried, untested system worked most of the time.  Here's the real net-effect... I have several clients who, prior to 2014, either 1) couldn't afford Major Medical or 2) had health conditions that would prevent them from purchasing Major Medical.  The new regulations saved lives.  Regardless of anything else, people were able to get covered and get treated.  I have several stories as examples, but due to HIPAA, they will stay confidential between my clients and myself.  We can sort out the rest later, but the important thing is that lives have been saved.  This is in the end, my purpose for being here.

For assistance in navigating the complexity of the new health options, please contact me through psyberquote.com .