Sunday, July 13, 2014

Marketplace insurance customers asked to verify info

Potentially thousands of central Wisconsin residents who signed up for health insurance through the federal marketplace are being asked to clear up questions about their personal information that could affect their coverage.
Reports from the U.S. Department of Health and Human Services inspector general revealed key personal details submitted by customers, including annual income and citizenship information, don't match records the government has on file.
Individuals with inconsistencies in their applications have been receiving notification letters since early May, said Marty Anderson, director of marketing and consumer products for Security Health Plan. Security Health Plan provides marketplace insurance to customers in Clark, Marathon, Portage and Wood counties in central Wisconsin.
About 6,000 of Security Health Plan's 25,000 statewide members have received letters so far. The Associated Press reported in June about 2.1 million out of 8 million people enrolled in marketplace coverage had at least one data discrepancy in their application as of April 28.
If state statistics follow the pattern of Security Health Plan and nationwide numbers, 30,000 to 35,000 of the 140,000 Wisconsin residents enrolled in marketplace insurance could have discrepancies on their applications.
The most common discrepancies in the federal market had to do with citizenship and immigration status, but some customers are being asked to clear up name and address errors.
"Inconsistencies do not necessarily indicate that an applicant provided inaccurate information ... or is receiving financial assistance through insurance affordability programs inappropriately," the inspector general's report stated.
Congressional Republicans who called for the report were concerned people not legally entitled to receive government-subsidized health insurance could nonetheless be getting it.
Anderson said he thought the majority of discrepancies affecting Security Health Plan customers involved income documentation. For example, seasonal workers who anticipate earning less in 2014 than they reported on their 2013 federal income taxes might need to provide documents supporting the anticipated income reduction.
Security Health Plan and other insurance providers have been notified which members received inconsistency notices, but not what the inconsistencies are.
"We've been reaching out via phone and email to follow up on the federal government's notice," Anderson said.
Customers who receive inconsistency notices have 30 days to respond. The requested documentation can be uploaded through the Healthcare.gov website or sent by mail. Anderson recommended submitting the documentation as soon as possible and notifying the federal government via the Healthcare.gov hotline if documentation was sent by mail.
Those who don't respond to the inquiries could face a reduction in their premium tax credit or lose their insurance if the government learns the customer is not a citizen or legal immigrant.
"Of the people who enrolled, 98 percent are receiving a premium tax credit subsidy, and there could be a detrimental impact if they have the tax credit revoked or reduced," Anderson said. About 60 percent of those who receive premium tax credits pay 80 percent or more of their premium using the subsidy.
"We don't want to see anyone losing their coverage or their credit," he said.
Representatives from Compcare Health Services Insurance Corp., which serves Marathon, Portage and Wood counties, and WPS Health Plan Inc., which serves Marathon and Wood counties, did not provide information about how the inconsistency notices were affecting customers by the time of publication.
Marisa Cuellar can be reached at 715-384-3131. Find her on Twitter as @cuellm34.

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