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TONY WILSON: Be aware that rate quotes on healthcare.gov may conflict

Tony Wilson

Tony Wilson

At some point today, I’m sure the conversation around the tables full of turkey, dressing and pumpkin pies will meander through a trail of things we are thankful for, including our families, football and the Affordable Care Act.

Well, some will be thankful for the ACA while others will use more colorful language to describe the law. I know because in my line of work I’ve heard from people on both ends of the spectrum and many in between.

Regardless of your position, please advise your family and friends as they pass the giblet gravy of the importance of due diligence when making their health insurance decisions for next year — especially if they utilize the healthcare.gov website.

Last week I shared my experience in shopping for plans on healthcare.gov, and this week I’d like to continue that experience with you in order to offer some advice to others who are considering doing the same.

Due to our small group plan not being in compliance with the requirements of ACA, our carrier — Blue Cross Blue Shield of Georgia — is canceling our plan effective Jan. 1. Like many others we started shopping the individual market to see what our options are there, and we turned to healthcare.gov.

(I know President Obama recently said carriers could keep those plans in place for the insured, but do you really think carriers who have invested millions of dollars in system upgrades to comply with the law will now spend millions to retro-fit only to have to return to compliance a year from now? Who do you think will pay those costs if carriers do reinstate those plans?)

After entering some basic family information, I found that there were 29 total plans available to us from Blue Cross Blue Shield, Humana and Kaiser Permanente. I zeroed in on an option from Humana — the $6,300 National Preferred Bronze plan.

The monthly premium was attractive, so I decided to look into the plan in more detail. Unfortunately, that’s where I hit a roadblock. Healthcare.gov does not offer the option for visitors to click on links to review the plan’s details via a summary of benefits and coverage.

As I continued to peruse the website I also realized I could not check the provider network associated with Humana’s plan option to see if our doctors are in the network. (The plan details and the provider search option isn’t available for the other carriers listed either.)

Being able to review the plan components and provider networks is critical, and this definitely needs to be among the “glitches” slated for correction or upgrade.

I visited the Humana website where I was able to review plan information and search for providers, but I found something of concern — the rates I was quoted on healthcare.gov were about $140 per month less for my family than what Humana was showing on its website.

I immediately contacted our Humana rep. As we worked through the issue we found that there is a problem on the healthcare.gov website — since the only age bracket option available to me for quoting was 30 to 64 the healthcare.gov website skewed the numbers down to the lower age groups in the bracket.

A 48-year-old male (I know, I don’t look that old, right?) will pay more than a 30-year-old male. My costs were incorrectly quoted on healthcare.gov — to the tune of $1,680 for the first year. This is not something you want to find out after enrollment.

Armed with the correct rates from Humana (since the carrier website quoted actual rates based on my family’s specific information) as well as the plan details and provider search option, we can now make a more informed decision.

While I am thankful for that, I do have a concern about others out there who may not know how to maneuver through this complex system. Healthcare.gov was supposed to be the one-stop shop to make it easier for everyone. Obviously, we aren’t there yet.

Eventually, the carriers will have connectivity between their websites and the healthcare.gov website for enrollment purposes and to check subsidy eligibility. That connectivity should also address the issue of inconsistent rates.

As we move closer to Jan. 1, it becomes even more critical that healthcare.gov’s full functionality be in place or major decisions need to be made. But, for now, let’s put thinking about all these things off until tomorrow.

Happy Thanksgiving to you and yours!

Questions or comments? Feel free to email me at twilson@nfp.com.

Tony L. Wilson is a partner with NUVISION Financial Corporation based in Conyers. NUVISION is a subsidiary of National Financial Partners Corp., which provides benefits solutions for companies.