Some Find Health Insurers Have No Record of Them

Record-keeping snags could complicate the start of insurance coverage this month as people begin using policies they purchased under the health care overhaul.

Insurance companies are still trying to sort out cases of so-called health insurance orphans, customers for whom the government has a record that they enrolled, but the insurer does not.

Government officials say the problem is real but under control, with orphan records being among the roughly 13,000 problem cases they are trying to resolve with insurers. But insurance companies are worried the process will grow more cumbersome as they deal with the flood of new customers who signed up in December as enrollment deadlines neared.

More than 1 million people have signed up through the federal insurance market that serves 36 states. Officials contend the error rate for new signups is close to zero.

Insurers are seeing cases in which the government has assigned the same identification number to more than one person, as well as so-called “ghost” files in which the insurer has an enrollment record but the government does not.

But orphaned files — when the insurer has no record of enrollment — are particularly concerning because the companies have no automated way to identify the presumed policyholder. They say they have to manually compare lists of enrollees.

“It’s an ongoing concern,” said Robert Zirkelbach, a spokesman for the industry trade group America’s Health Insurance Plans. “Health plans can’t process enrollments they haven’t received from the exchange.”

The files have cropped up since enrollment began last fall through HealthCare.gov.

Insurers worry that the back-end problems will grow more acute as they process the wave of customers who signed up at the end of 2013. More than 2 million people had enrolled by the end of the year, either through HealthCare.gov or state-run websites.

This article appeared in print on page 2 of the January 10th, 2014 edition of Hamodia.