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HealthCare Checkup

The Seattle Times health-care team tracks the local impact of the Affordable Care Act.

September 19, 2013 at 9:08 AM

Insurer’s letters to consumers raise red flag with state

The state Office of the Insurance Commissioner (OIC) says it has received dozens of phone calls and emails from Washington residents upset by letters from their health-insurance carriers informing them their current health plan will be discontinued at year’s end because of the federal Affordable Care Act.

The number of calls and emails is striking, given that health insurers have only just sent out the discontinuation letters, said OIC spokesperson Stephanie Marquis.

The letters inform each recipient that his or her health plan will be discontinued at the end of 2013 and suggest an alternative health plan for 2014 that is most comparable to that person’s current plan.

In some cases, the suggested health plan appears to be far less appealing than the current plan, which is raising the ire of consumers.

Jeff Reifman, 43, of Seattle, received a letter from Premera’s subsidiary LifeWise this week that suggested a health plan with a $6,350 deductible would be the “closest match” to his current LifeWise health plan, which has a $1,970 deductible. “I was pretty shocked,” Reifman said.

The letter went on to state: “If we don’t hear from you, we’ll automatically move you to this plan and you’ll be covered for 2014.”

“I think this is an example of LifeWise trying to get away with something,” Reifman said. “I don’t think they should be able to auto-migrate someone into a new plan.”

To be fair, the letter also states that if consumers have questions or want to choose a different plan they can call a customer-service hotline at LifeWise for assistance. But Reifman scoffs at the suggestion, saying he has “wasted a lot of time” talking with customer-service representatives at LifeWise in the past, with little success.

He says the letter from LifeWise left him with the impression that he had few options other than the high-deductible plan it suggested and that seemed worse than his current coverage.

One reason for this impression is that the letter fails to mention that Reifman will be able to choose from a range of health plans — and not just those offered by LifeWise — when the state’s new health-insurance exchange opens for enrollment Oct. 1.

The exchange, called Washington Healthplanfinder, will allow residents to choose from dozens of health plans for coverage in 2014.

The discontinuation letters sent out by Group Health Cooperative and Regence Blue Shield include information about Healthplanfinder, but the Premera and LifeWise letters make no mention of the exchange.

This omission has raised concerns at the OIC.

“We know that many consumers are confused by the upcoming changes and we want to make sure people understand all of the options they have for buying coverage,” said Marquis.

“We’re concerned that because Premera and LifeWise left out any mention of the new health-benefit exchange and the Washington Healthplanfinder in their letters, their customers may not know they have additional options for buying plans that could be more affordable for themselves and their families,” she said.

Premera spokesman Eric Earling said the letters don’t mention Healthplanfinder because the company has determined that “a significant number” of consumers enrolled in its individual health plans will not be eligible for the new federal premium subsidies, “which is the main reason to go to the exchange.”

Another reason is that “our interest is in making sure our customers are aware of their options available with us.”

But customer service representatives will direct callers to the exchange if they ask about plans available from other companies, Earling said.

Comments | Topics: Washington Healthplanfinder, Washington Office of the Insurance Commissioner

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