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HealthCare Checkup

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

October 29, 2013 at 8:00 PM

How does state’s insurance exchange rate?

Photo by marsmet491, from Flickr's The Commons.

Photo by marsmet491, from Flickr’s The Commons.

Compared to the dismal performance of the federal website created to sign people up for health insurance, the Washington state exchange has scored favorable reviews and thousands of people are enrolling online. Between the Oct. 1  launch date and Oct. 25, nearly 49,000 state residents had enrolled in Medicaid or an insurance plan through Washington Healthplanfinder.

“We tried to create an experience that was user friendly and that people were familiar with,” said Bethany Frey, a spokeswoman for  the state exchange. She said they were aiming for a hybrid between the travel site Expedia and Turbo-Tax.

While the Washington exchange is racking up enrollees, we wondered how easily and accurately the whole machine was running. So we broke down the process of shopping and signing up for health care coverage step by step. Based on our experience, feedback from consumers and state officials, here’s how Healthplanfinder rates:

Browse plans without creating an account

Score: Needs improvement

By simply entering your birth date, Zip code, gender and income, the exchange will pull up all of the available plans, the cost of the premiums, and an estimate of the federal tax credits you qualify for.

In browsing mode, you can see which insurance plans you qualify for, premiums, deductibles and co-pays. A link to “more information on this plan” gives additional details on costs for maternity care, diabetes, prescription drugs, emergency room visits, and more.

There are a couple of weaknesses to the browsing. You have to re-enter your personal information each time you return to the site, and it automatically closes the site if you stop browsing for more than 15 minutes. You can select one doctor or one hospital and the site will show which plans they are covered by, but it won’t allow searches for multiple providers at once. It also can be tricky to move back and forth between screens.

Also, if your income level is low enough, the site automatically redirects you from browsing to applying for coverage through Washington Apple Health — the state’s new name for Medicaid — without explaining what it is.

But Washington does get credit for even offering the browsing function without requiring someone to create an account — a feature missing from the federal exchange site.

Creating an account

Score: OK

For the first couple of days after Healthplanfinder launched Oct. 1, some people experienced long wait times in creating their accounts, but those problems have been fixed.

Engineers are adding pop-up prompts to help people enter correct information into their profiles, but there are still confusing spots. In particular it can be tricky to navigate questions regarding who someone is buying insurance for, whether it’s for themselves or family members or both.

Also, if you are logged into your account, our testers found that they could no longer browse and compare the different plans and had to log out first, though officials with the exchange said that should not be the case.

Proving identity and eligibility

Score: Great

The state exchange site can interact with federal databases to confirm an applicant’s identity and legal status as a resident without any apparent problems.

Calculating federal tax credits

Score: OK

Until last week, the exchange site incorrectly calculated the tax credits that are used to help customers pay for insurance premiums bought on the exchange. The state site asked applicants their monthly income, but the federal site receiving that data read it as their annual income, so the subsidies were reported as being higher than they should be. The state fixed the error within 24 hours of discovering it, and is contacting everyone affected by the problem.

Finding a navigator/in-person assister or broker

Score: OK

You can search by your location and preferred language for people to help you navigate the site. But the site needs to more clearly explain the difference between your two options in assistants: Navigators can help you create an account and move around a site, but cannot advise which plan to choose. Brokers are paid by insurance companies and can suggest specific plans to meet your needs.

Accurately send information to insurance companies

Score: Great

One of the many problems discovered with the federal insurance exchange site is the applicant information was inaccurately transmitted to insurance companies. Washington’s site has not experienced similar problems.

Information in multiple languages

Score: Great

Since Oct. 1, the site is available in English and Spanish. When customers create an account, they can request follow-up information in a variety of languages, or ask for a translator. The site also encourages people to call the toll-free help center if they need translation services.

Customer support

Score: Needs improvement

The exchange’s toll-free call center has been swamped with calls, resulting in wait times of 21 minutes on average, as of this week. From now through December, the state is adding an additional 145 customer service representatives, nearly doubling their staff.

So while the state’s exchange is doing an enviable job compared to many sites around the nation, there are still some spots where it could be better, and officials appear committed to making tweaks and fixes to get the whole thing humming along.

Finally, here’s how we scored the site, in a glance:




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