The Register Citizen (Torrington, CT)
Health insurance exchange has major problems
Their sloppy resolution prevented us from paying a fine, but it didn’t recover the hours of time we had spent on the phone or give us any satisfaction.
After five years dealing with a flawed system, it is high time someone fixes the major issues in Connecticut’s health insurance exchange.
As a 27yearold lifelong Connecticut resident, I was grateful my husband and I could apply for insurance through Access Health CT (AHCT) since neither of our jobs provided affordable coverage. Yet the marketplace’s excessive processes and routine mistakes make acquiring (and maintaining) insurance virtually impossible. The following is only a brief account of some of these mistakes:
In 2018, we renewed our coverage, provided necessary documents, and seemed to be sailing smoothly — until I became pregnant in May 2018 and requested a change to my insurance. In switching my plan, AHCT also dropped my husband’s coverage at the same time. I spent several hours on the phone with AHCT and Anthem to resolve issue. Eight weeks later, I miscarried and went through the painful process of calling AHCT to make another change since the insurance plan I selected was specifically for pregnancy. My husband and I were again enrolled in the same plan, and I thought all was well (although we paid several hundred more dollars over the threemonth span because of these “multiple changes”).
I became pregnant again in August 2018 and returned to insurance plan that better covered my maternal care. Though everything seemed settled, during the 2019 tax season we discovered major mistakes were unresolved from the months in which I had begun and lost that first pregnancy — AHCT never correctly reinstated my husband’s insurance, so though we made our premium payments to Anthem as specified in 2018 (and even overpaid in a few cases due to misinformation), their records showed my husband without insurance coverage for four months.
I spent three months calling AHCT, disclosing my personal information, repeating the same details, and trying to resolve the discrepancy in an effort to avoid a tax penalty. In total, I spent nearly 15 hours on the phone with AHCT and Anthem representatives, sent copies of bank statements reflecting the premium withdrawals, and recounted the painful details of the lost pregnancy that had initiated all the changes. With less than a week before taxes were due, I finally “reconciled” the issue when AHCT issued my husband an insurance waiver. Their sloppy resolution prevented us from paying a fine, but it didn’t recover the hours of time we had spent on the phone or give us any satisfaction; we had paid for 12 months of insurance and wanted our record to reflect that diligence.
Now I am faced with a new battle with AHCT. We purchased our first home in March, and after following AHCT’s procedures for reporting our change of address, found they had made yet another mistake. Our mailing and billing addresses were not both updated when AHCT sent the application change to Anthem, so we continued to receive Anthem bills at our previous address (and all other correspondence at our new address). I called Anthem to resolve the issue, but as always, they need the information from AHCT. Begrudgingly I called AHCT with the Anthem representative and begged her not to open my application; I knew such action would inevitably result in another error. Anthem ultimately made the change, AHCT swore no application details were touched, yet here I am two weeks later receiving notices from AHCT stating that “I have not completed my application” and “I need to select a health plan.” My family is again faced with losing our insurance because of AHCT’s errors.
I am beyond discouraged with this flawed system and feel trapped. The insurance premiums have skyrocketed since we joined the marketplace back in 2014, and it would be impossible for our family to get insurance independently at an affordable rate. Yet the thought of investing 15 more hours of my life explaining the issues again and again to AHCT representatives on the phone is almost more than I can bear. I long to speak to someone in person — or better yet, go straight to the socalled “escalation teams” who resolve such issues, but AHCT has told me repeatedly that this is not permissible nor possible.
I’m fed up with the entirely inaccessible health care exchange in Connecticut and wish they would fix the issues or enable people to speak to representatives in person. Keeping your insurance in the midst of common life circumstances shouldn’t be so difficult — especially when you faithfully pay your bills on time.