Insurers Give Obamacare Enrollees More Time for Payments

Dec 18, 2013 4:34 pm ET

(Updates with comments from HHS in the sixth paragraph.)

Dec. 18 (Bloomberg) -- Consumers who enroll in health plans through the new U.S. exchanges will get 10 extra days to pay their first premiums and still gain coverage effective Jan. 1, an insurance company trade group said.

Those who select coverage by Dec. 23 will have until Jan. 10, rather than Dec. 31, to make their first payments, America’s Health Insurance Plans, or AHIP, said today in a statement. The group didn’t address two other steps requested by the Obama administration last week: that insurers show flexibility for people enrolling after Dec. 23 and those who get treatment from a doctor outside a plan’s provider network.

The state- and federal-run insurance markets opened Oct. 1, plagued by website delays and technical issues that took weeks to resolve. The problems suppressed sign-ups under the Patient Protection and Affordable Care Act, President Barack Obama’s signature domestic initiative, and stoked political backlash.

“Our community is taking an important step to give consumers greater peace of mind about their health-care coverage,” Karen Ignagni, president and chief executive officer of the Washington-based group, said in the statement.

The Obama administration asked insurers on Dec. 12 to give customers more time to pay and grant retroactive coverage as it seeks to enroll an estimated 7 million Americans for 2014.

Finding Coverage

The administration welcomed the move, saying it will make it easier for consumers to enroll. “We look forward to continuing to work with insurers to find ways to ensure that as many Americans as possible can find coverage,” said Joanne Peters, a spokeswoman for the U.S. Department of Health and Human Services.

The exchanges offer policies and federal subsides to people not covered through work or a government program such as Medicare or Medicaid. Fourteen states, led by New York and California, run their own online exchanges, while the remaining states use the federal healthcare.gov site.

U.S. Health Secretary Kathleen Sebelius urged the industry last week to honor any late sign-ups with retroactive coverage, allow people to pay only part of their premiums, and cover treatments for patients who go to out-of-network doctors. The department also raised the prospect of extending the Dec. 23 sign-up date. In a statement then, AHIP’s Ignagni said too many last-minute changes could make it harder to get people covered.

WellPoint’s Plans

WellPoint Inc., the biggest provider of individual and small-group health plans, said it would extend the payment deadline. The insurer has “processes in place to ensure the continuity of care and minimize disruption” for current members receiving treatment from out-of-network, the company said in a statement. The polices vary by state.

“Our goal is to ensure new enrollees can access their benefits as early as possible in 2014,” Kristin Binns, a spokeswoman for the Indianapolis-based company, said in an e- mail. “Our call centers will be staffed throughout the holidays, and teams of employees will be working to process applications quickly in this compressed time frame.”

WellPoint will also let current members change plans as late as Jan. 10 and still be covered retroactive to the first of the year, if they buy policies outside the exchange. The move may help people whose coverage is due to expire in 2014 because it no longer meets the requirements of the law.

Hundreds of thousands of Americans received cancellation notices earlier this year, sparking criticism that Obama had misled people in selling the health-care law. The president responded by giving insurers and state regulators the option of extending the plans by one year.

--With assistance from Alex Wayne in Washington. Editors: Andrew Pollack, Romaine Bostick