Florida Blue ACA clients face glitches

Members’ troubles include billing and coverage issues

Florida Blue is apologizing to customers who continue to have issues with their Obamacare plans.

“We appreciate the patience our members have shown as we manage a high volume of customer interactions and as we work to help people who have experienced problems,” the company said in a statement Thursday.

Since January, frustrated Florida Blue members have been turning to social media and their local news outlets to vent about billing discrepancies and lapsed coverage.

“They overbill me every month and tell me I haven’t paid when I actually have. Then they deny claims until I call and verify that I have in fact paid. Every. Single. month,” one person wrote in a Facebook post.

“Shouldn’t the insurance commissioner be involved to make sure the company straightens this out?” asked Kim Blanton, who told the Orlando Sentinel that her brother has been paying his premiums for the past two months, but his policy is still inactive.

Florida Blue officials said most of the current issues “center around verifying [whether] a plan is active and paid.” The glitches have affected “a very small percentage” of members, the company said in a statement.

“Our first priority is our members, so as we have become aware that someone is experiencing a problem, our Service team has been acting quickly to contact each person individually and promptly [to] resolve the matter,” the insurance company wrote.

But Denise Mouras said she had a different experience with the company’s service team.

She said she signed up for a Florida Blue plan in December during open enrollment through an agent, but when she logged into the insurance company’s website, she saw her old plan from last year. She tried to fix the problem through customer service, with no success.

“I would call the customer service line, and they kept putting you on hold and then said in 48 hours everything would be taken care of. And then it wouldn’t,” said Mauras, who lived in Orlando until recently.

Florida Blue officials say that the company has faced some glitches this year because of the

large number of people who have signed up for Obamacare plans.

The nonprofit insurance company is the largest health insurer in Florida and has the largest Affordable Care Act membership in the state. That membership doubled during this enrollment period to just over 1 million people, partly because of the exit of other insurance carriers, officials said. In some counties, Florida Blue is the only available option this year in the ACA marketplace.

“If this was any other company, I would have been gone,” said Mouras, reflecting on her frustrating customer service phone experience. “But I couldn’t go anywhere, because the open enrollment period is over.”

Anne Packham, the lead ACA navigator in Central Florida, said consumers can contact her team for help. To make an appointment, visit www.coveringcfl.net or call 877-564-5031.

Another resource is Florida’s free Insurance Consumer Helpline, which is operated by the Office of Florida Chief Financial Officer Jeff Atwater. The helpline connects Floridians with trained insurance experts for free. Call is 877-693-5236 or visit www.myfloridacfo.com/ division/consumers/NeedOurHelp.htm.

Mauros eventually got her coverage, thanks to social media.

Shortly after she wrote a complaint on Florida Blue’s Facebook page, she got a reply with an e-mail address, which she then used to send “a very detailed email, with ticket numbers and dates and information. And they finally got it straightened out.”

The 62-year-old retiree, who now lives in Lee County, said without an Affordable Care Act plan, she would have had to go back to work in order to be able to afford individual health insurance.

At her age, just a little more than two years before qualifying for Medicare, her main source of worry is going without coverage.

“I play tennis and I fell on the court today,” she said. “And I thought to myself ‘Good thing I have insurance.’”