Thousands of Covered California enrollees face higher-than-expected bills from their insurers because the exchange sent incorrect tax credit information to the health plans.
The exchange confirmed it gave insurers wrong subsidy information for about 25,000 policy holders, resulting in inaccurate bills. Insurers are now sending out new bills correcting the errors, and in most cases that means higher premiums than consumers had initially anticipated.
鈥淚t feels like this is a bait-and-switch,鈥 said Beth Freeman, 53, of San Bruno. 鈥淣ow what am I going to do? I don鈥檛 know if I can afford it.鈥
Freeman said she owes about $330 per month more on her premium than she had expected.
Covered California said it doesn鈥檛 know what caused the problem. 鈥淲e are focused on reaching [enrollees] and making sure they know what to expect,鈥 said spokeswoman Lizelda Lopez. 鈥淲e will do an analysis afterwards to understand all the details.鈥
Lopez said Covered California originally sent consumers their correct tax credit amounts in notices during the renewal period, but it gave the incorrect amounts to their insurers.
However, , an insurance agent in Sacramento, said a Covered California representative told him in a phone conversation that consumers had found incorrect tax credit amounts when they signed onto their online Covered California accounts.
Tax credits are the income-based subsidies that about 90 percent of Covered California enrollees receive to lower their monthly premiums.
In another mistake related to tax credits, Covered California聽 in December that about 24,000 policy holders hadn鈥檛 provided consent for the agency to verify their income, even though the agency thought they had. Without that consent, their 2017 tax credits, at least temporarily.
鈥淚 don鈥檛 know what鈥檚 going on,鈥 Knauss said. 鈥2015 and 2016 went fairly smoothly. Now we鈥檙e starting to see these weird glitches.鈥
Lopez said most consumers affected by the latest mistake will owe more out of pocket than they originally thought, and that health plans are entitled to bill them for the difference.
鈥淪ome may,鈥 she said. 鈥淪ome may not.鈥
The recent tax credit error has left consumers like Freeman feeling shocked and frustrated.
She had struggled through administrative headaches with her Covered California plan last year, so when it came time to renew it 鈥斅爋r choose a new one 鈥 for 2017, 鈥淚 was very cautious and nervous. I shopped around and got information from the folks at Covered California and Blue Shield,鈥 she said.
She said Covered California gave her inconsistent information about the amount of tax credits she would receive. So she called the exchange twice to confirm the number, and was told both times it would be $800 a month. That was more than she expected, and it allowed her to afford a more expensive plan with better coverage, she said.
After receiving an updated bill last week that showed her actual tax credits were hundreds of dollars less than expected, Freeman called Covered California again and was told the problem had been caused by a 鈥渃omputer data error,鈥 she said. The agent told her there was nothing Covered California could do and that she should try to negotiate directly with Blue Shield, she said.
鈥淚 subscribed to Blue Shield based on the information given to me and confirmed by Covered California,鈥 she said. 鈥淚t鈥檚 unethical that Covered California is unwilling to accommodate me so I can stay in my contracted plan.鈥
Enrollees in this situation can call Covered California鈥檚 special hotline at 844-623-2070 for more information.
If their updated premiums are unaffordable, there鈥檚 still time for enrollees to switch health plans before open enrollment ends on Jan. 31, Knauss said.
But Freeman already has seen new doctors with her new plan. 鈥淲hy must the consumer carry the burden of these errors?鈥 she asked.
鈥淐overed California continues to mismanage and, worse, misinform the public when they make errors. And there鈥檚 no accountability, no follow up.鈥
This story was produced by , which publishes , an editorially independent service of the .
