The Washington Health Benefit Exchange, which operates the state’s insurance marketplace, Washington Healthplanfinder, today announced that existing customers will begin making premium payments directly to their insurance companies effective Wednesday, Sept. 23, at 5 p.m. At that point, the Exchange will no longer aggregate premiums and cannot accept customer premium payments.
Moving forward, customers will receive monthly invoices directly from their insurance companies as well as important information on payment deadlines, collection policies and grace periods.
“This change will be beneficial to our customers while also improving account coordination between the Exchange and insurance companies,” said Pam MacEwan, CEO of the Washington Health Benefit Exchange. “By taking the Exchange out of the payment process, customers and insurance companies can work directly on any accounting-related issues. This frees the Exchange to do what we do best, providing easy comparison of health plans, access to financial assistance and help with enrollment.”
Last December, the Exchange Board voted for this change to address billing and invoicing concerns brought forward by both customers and insurance companies. The Exchange has billed and collected premium payments for health insurance coverage since opening Oct. 1, 2013.
“This was something our Board felt was important to do for customers and have completed prior the upcoming open enrollment period (Nov. 1, 2015 –Jan. 31, 2016),” added MacEwan.
In 2014, the Exchange handled nearly $560 million in premium payments. That year, qualifying Washington Healthplanfinder customers received $330 million in federal tax credits to help pay for premiums and over $54 million in cost-sharing reductions to lower costs of hospital and doctor visits.
The Exchange and its system integrator, Deloitte, have worked closely with the insurance companies to prepare the technical infrastructure and transfer hundreds of thousands of customer accounts by the cutover date. All parties are expecting that a small number of existing customer accounts and invoices may require additional information to be properly processed. The Exchange, Deloitte and the insurance companies are ready for this and have established joint customer response teams to handle any reported customer issues as quickly as possible.
The Exchange offers the following tips to help customers through this transition:
- Prior to 5 p.m. on Wednesday, Sept. 23, customers should make their October premium payments to the Exchange. After 5 p.m. on Sept. 23, customers should make their October premium payments directly to their insurance company.
- Beginning at 5 p.m. on Sept. 23, Washington Healthplanfinder will be taken offline through the end of the week. The Exchange Customer Support Center will be available on a limited basis to answer customers’ questions during this system maintenance. More information is available at wahbexchange.org/news-center/outages-maintenance.
- Customers with health and dental insurance provided by two different companies must remember to make payments to each company. They can expect to be invoiced by each company.
- Customers who have been determined eligible for tax credits and cost-sharing reductions do not have to worry. This change does not impact customers’ eligibility for financial assistance.
- After Wednesday, Sept. 23, customers that have billing or invoice questions should first contact their insurance carrier before calling the Exchange.
- The Exchange and insurance companies are committed to working together to make this transition as smooth as possible and ensure that any customer billing and invoice issues are identified and quickly addressed. All insurance companies will have direct access to designated operation and finance teams at the Exchange.
- If customers experience a delay in invoicing or resolving an issue, they should make payments to their insurance companies in the amount they previously paid to Washington Healthplanfinder until the issue is resolved. This will ensure their coverage continues.
- For more information on what this payment change means to you, please visit wahbexchange.org/payments.
- The state’s 1.8 million Medicaid customers are not affected by this change.
This change does not impact small business customers that purchased coverage through Washington Healthplanfinder Business. The law requires the Exchange to continue to aggregate premiums for these businesses.
About Washington Healthplanfinder
Washington Healthplanfinder is a new online marketplace for individuals, families and small businesses in Washington to compare and enroll in health insurance coverage and gain access to tax credits, reduced cost sharing and public programs such as Medicaid. The next open enrollment period for Washington Healthplanfinder begins on Nov. 1, 2015 for health insurance coverage beginning on Jan. 1, 2016. The open enrollment period will extend through Jan. 31, 2016.
About the Washington Health Benefit Exchange
The Washington Health Benefit Exchange is a public-private partnership established in accordance with the Patient Protection and Affordable Care Act of 2010 (ACA) to implement a new health insurance marketplace for individuals and small businesses. The Exchange is separate from the state and governed by an independent 11-member board. For more information, visit www.wahbexchange.org.
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