Wisconsin Commissioner of Insurance Warns Consumers About Federal Exchange Glitches

Wisconsinites who have purchased health insurance on the federal exchange need to look out for two issues plaguing consumers. First, for some plans, the exchange is not displaying the correct information about deductibles. Other consumers are finding they are not actually enrolled because their information was never sent from the exchange to the insurance company the consumer purportedly bought insurance from.

Wisconsin’s Commissioner of Insurance released the following notice to consumers about the problems:

Madison, WI—While many Wisconsin consumers have purchased insurance coverage through the federal exchange Web site (healthcare.gov) without issue, it is imperative that OCI notify consumers of technical problems that continue to exist with the Web site that may affect them. Healthcare.gov is the federal government’s health insurance exchange Web site which has experienced a myriad of technical problems since its launch on October 1, 2013. The purpose of this notice is to inform Wisconsin consumers of the issues so that they can be proactive and avoid problems down the road.

Inaccurate Plan Information Posted by Healthcare.gov
In some cases, healthcare.gov is displaying plan information that does not match the information the insurer submitted to healthcare.gov. This incorrect plan information is the direct result of technical problems with the federal Web site and not errors caused by the insurer. One of the chief errors is in the display of cost-sharing information. For example, some plans are listed without a deductible when in fact a deductible requirement is tied to the plan.

“The posting of inaccurate plan information is one of the more harmful consumer-facing ‘glitches’ to date,” explained Commissioner Ted Nickel. “Consumers rely on the information posted to Healthcare.gov to choose a plan that meets their medical and financial needs. Access to accurate information is critical to their decision-making process.” Specifically, some consumers who purchased a plan on healthcare.gov will not get the plan as described on the Web site due to a technical error by the federal Web site.

OCI strongly encourages consumers using healthcare.gov to verify plan information by reviewing any insurer materials that may be accessible through healthcare.gov. If there are discrepancies between the plan details in those documents and the summary information provided on healthcare.gov, consumers should contact the insurer directly to avoid purchasing a plan that is inaccurately displayed on the Web site.

For those who have already purchased a plan, OCI recommends reviewing the actual plan document (which shows up on the Web site as a pdf file). If the plan document is different than information summarized on the federal Web site, consumers should contact the insurer to find out what their options are. If the plan document is the same as the Web site’s summary, consumers should feel confident that they purchased what they initially intended. OCI has contact information for all insurers selling health insurance in Wisconsin posted on their web site at: http://oci.wi.gov/healthcare_ref/find_health_insurer.pdf.

Federal Government Enrollment Transfers to Insurers
The transfer of enrollment information is another area of concern. Enrollment information is sent from the federal government to insurers. OCI has learned that, in some cases, this information transfer is delayed or not occurring at all. It is extremely important to note that this error in transferring the information from the Web site to the insurer is a technical issue with the federal Web site and that the only way to ensure coverage has been secured is through confirmation from the insurer. “Consumers who enroll through healthcare.gov but do not receive correspondence from the insurer confirming enrollment should contact the insurer directly to verify they are enrolled and payment has been received,” stated Commissioner Nickel. If consumers have received confirmation from the insurer, they should feel confident that coverage has been secured.

Consumers with questions about these issues can contact their insurance company directly or reach out to the Wisconsin Office of the Commissioner of Insurance.