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Obamacare’s Popularity Overwhelms Florida Blue as System Crashes, Costing Enrollees

| January 20, 2014

At Florida Blue, it's been more sink than swim. (CathrynDC)

At Florida Blue, it’s been more sink than swim. (CathrynDC)

Florida Blue may have bitten off more than it can chew with its new plans under the Affordable Care Act. The company’s customer-service apparatus and computer system appear to be overwhelmed and unable to cope.

Already the state’s largest insurer, with more than 1 million covered lives, Florida Blue is offering 76 different health plans through the new federally operated Marketplace. In fact, the company lists more plans by itself than all other insurers put together.

But many who signed up and paid Florida Blue for their new plan between Oct. 1 and Dec. 31 say the insurer has lost them in its computer system.  Now, when they go to the doctor or try to get a prescription filled, they have to pay the bill themselves or cancel.

“Right now I’m putting off procedures, waiting until I  can get the paperwork in order,” said Merrie Beth Neely of Clearwater. She said she paid twice for her plan in December, but still doesn’t have coverage.

The Division of Financial Services reported Wednesday that it has received many calls from Florida Blue enrollees, and 42 of them filed official complaints.

Florida Blue spokesmen declined a request for an interview, but sent an e-mail saying the company is working diligently to process the high volume of enrollments that are coming in through the Marketplace at Healthcare.gov. The company said it has added staff and extended service hours at both the call centers and retail centers.

On its Facebook page, Florida Blue posted a note: “Are you a new member waiting for your ID card? We are diligently working to get these cards to you as quickly as possible,” it says. It urges those who are stuck in this limbo to contact them atsocialmedia@floridablue.com, “and we will ensure that you are able to get the care you need.”

But Neely and several others who expected ID cards — or at least member numbers — on Jan. 1 say that calling and e-mailing haven’t worked.

‘Insurance That I Can’t Use’

Neely, 48, is a PhD oceanographer, but between jobs. The only health policy she had was a stripped-down plan that covered very little, so she was careful to make sure she applied and paid for her Florida Blue policy in early December, she said.

She was pleasantly surprised to find that she could buy a much better plan than she had and pay far less for it.  But her payment got lost in the Florida Blue computer system, she said.

“Now I feel like I have insurance that I can’t use,” Neely said.

When she hadn’t heard anything from the company by the third week of December, and the deadline for Jan. 1 coverage was approaching, Neely called. She got a recording. She kept trying, kept checking the mail.

On the 31st, she was able to speak to a consumer service “specialist.” He said, “‘The good news is I can see you’re in our system. But I can’t see any of your ID card information. And you have until the 10th to pay your bill.'”

She replied that she had paid her bill — twice, actually — and had a confirmation number. “‘What am I going to do? I need to schedule appointments,'” she told him.

Her options, she was told, were to pay out-of-pocket and get reimbursed later, or try to get her doctor’s staff to see her and just trust that the payment would eventually come.

Last weekend, Neely said, she got an automated phone call from Florida Blue and a letter in the  mail, both telling her she hadn’t paid her premium in time and was going to lose her coverage. So she paid a third time on Wednesday.

‘Overwhelmingly Overloaded’

Another new enrollee who can’t get coverage is John Challenor of Miami. He too was pleased to get a better plan at a lower cost through Healthcare.gov in December, he says, but Florida Blue has not followed through.

“I think the problem is they’re so totally overwhelmingly overloaded,” Challenor said, “which I don’t quite understand, because they knew this wave of orders was coming. How could (Florida Blue) not be prepared for this?”

Challenor has paid twice for his premium, he said, using a different credit card the second time. He said Florida Blue’s payment shows up on both credit cards.

He called the state insurance complaint line. “They said, ‘Are you calling about the problems at Florida Blue?’ I said, ‘Oh, boy, obviously you know there’s a big problem.’ They said, ‘Oh, yes, everybody is calling about Florida Blue.'”

Challenor, 51, has a pacemaker and takes seven prescription medicines, he said. He’s paying for them out-of-pocket pending a resolution of his trouble with Florida Blue.

What really galls Challenor, he says, is seeing and hearing the Florida Blue commercials with the jingle “We are here for you.”

“I have a business and I would not be running commercials to get more customers if I could not handle the bank office,” he said. “They’re taking everyone’s money and not providing the product. They take a payment a can’t find it? Come on.”

 –Carol Gentry, Health News Florida

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16 Responses for “Obamacare’s Popularity Overwhelms Florida Blue as System Crashes, Costing Enrollees”

  1. Good Luck on getting the Governor, a former insurance company Executive, or his bureaucrats to take a tough stance against Florida Blue or any other insurance com pay what they owe on a timely basis.
    Thank God Florida law makes insurance companies (which deny benefits they owe) pay for their insured’s attorneys fees. Sounds like Florida Blue is going to make a lot of lawyers happy

  2. Someone Else says:

    Calling obamacare popular is like calling the flu popular, sure a lot of people end up with it, but did they really have much of a choice?

    • The Truth says:

      Did Hannity come up with that line?

    • Rick Walker says:

      I’m sure we can find stories of good and bad to reflect the status of Obamacare, you can do that with any change. But it’s interesting, the more I talk to people about their experience the more I find people are generally happy with the law. Most say they are not affected at all because they are keeping what they had with their employer. Overall, I’m seeing people are becoming less resistant once they understand that it’s not a government plan but private insurance with additional regulations. If you think about it health care has always been highly regulated. I guess only time will tell…

  3. BIG JOHN says:

    I have a very simple solution. It’s called expand Medicaire for all Americans. Charge every American $150 per month and screw the insurance industry. Require all doctors to take all Medicaire patients and eliminate the parasitic health insurance industry as an unnecessary middleman. It’s easy if you try.

  4. m&m says:

    This whole cluster f— is because of a bill written and not read by our useless politicians which were trying to fix something that wasn’t broke.. Between Obama, Polosi and Read who forced all of us into to mess should be tarred and feathered and ran out of town. I was canceled from my insurance company and the letter said said it was because of Obamacare.. Don’t worry he’ll find someone to blame.. Now he’s playing the race card because drop in the pole for effectivenes

    • A.S.F. says:

      @m & m says–The only reason you can say that our healthcare system wasn’t broken to begin with is because YOU, personally, have not been not in any danger of physical harm or bankruptcy yourself due to a lack or absence of coverage. That doesn’t mean that other people weren’t suffering and dying before healthcare reform was passed and it still doesn’t. And, as far as the “race card” argument goes, the only people are are guilty of using the “race card”, ad nauseum, are the Conservatives who bring it up every five minutes to avoid having to deal with the very real problems of racism that still exist in this country. It’s like a carnivore taking offense at being called a meat-eater while waving a half-eaten drumstick in the air.

  5. A.S.F. says:

    This is EXACTLY what I feared might happen…An acutely necessary landmark program being brought down by insufficient TECH SUPPORT!! We really need to be vetting these “computer program specialist companies” a lot more carefully and writing contracts with them that make them legally accountable for what they do (and fail to do.). Money talks, and the compensation they receive should be tied to the performance of the programs they install and maintain. It seems to me that many of these companies are making promises that they can’t deliver…and government oversight is needed to make sure that they remain, accountable for the level of service they provide and the promises they make. Healthcare needs to be delivered in a timely and convenient manner or too many people will suffer…And many will drop out of programs that could be their salvation, if they could access the services in a reasonable manner. And there are too many cynical and rapacious politicians salivating on the sidelines, just waiting for healthcare reform to fail so that they can use that as fodder to feed their own special interests.

  6. The Truth says:

    I wonder if this is going to be top story on Fox News tonight?

  7. Sherry Epley says:

    Interesting that no one is now commenting about those that are finding much better insurance plans with much lower premiums under Obamacare. So easy to bash a new idea, even if it means better health care at a lower cost for millions!

  8. Genie says:

    No record of multiple payments…..how convenient. The biggest fraud ever perpetrated in this country and nobody will be held accountable.

  9. Rob says:

    Florida Health Care was not much better. I paid in early December but didn’t get my ID card until January 14.

  10. Another50 says:

    I keep getting cancelled because the plan I chose costs me nothing out of pocket ($0 monthly premium). So they send me a bill. The total due is $0.00. I pay nothing (obviously). So they cancel me for non-payment and never send a card. So I sign up again. Over and over again. I’m just going to keep signing up, a thousand times if I have to. Let them have fun with that paperwork. The whole system is a joke.

  11. grb says:

    I filed a complain with the B.B.B. today….never received membership info, no cards. Premium was paid. If an individual did this, they would be in jail for theft and fraud. A large health care company? Not so much.

    • Donald Wayne Mathias says:

      In December they charged me the correct amount and same day also charged my again for over twice that amount
      12/26 DEBIT FOR FLBLUE HPS 8778080419 CO $24.35
      REF- 617868529071
      12/26 DEBIT FOR FLBLUE HPS 8778080419 CO $56.06
      I called and waited the 3+ hours to reach someone. My bank faxed the info to them as was requested. No response.
      In January I called them several times and also used the contact us form on the website and attached a pdf copy of the bank statement – no response. In February I called again and was given an escalation reference number and told would be contacted back within a week – Feb 7th ref# 52247137 kita winfield – again no response.

      I now plan to file in small claims court for return of my $56.06 plus court costs plus $100 in damages mental anguish and lost time on phone on hold and false promises and additional $500 in punitive damages (all to stay within small claims limits) and urge others to do the same.

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