A Business Owner’s First Brush With HealthCare.govBy PAUL DOWNS
The struggles of a business trying to survive.
Well, that day has arrived. The exchange established by the Affordable Care Act is intended to allow for one-stop shopping, with uniform underwriting standards based on age, location of residence, family structure and tobacco use. My insurance company used to jerk my rates up and down without explanation, although the clear implication was that it cost more to have older and sicker workers.
Under that system, it was very difficult to shop for competing quotes. I have been getting insurance from Independence Blue Cross for years, but on two occasions, I asked a sales representative from Aetna for a quote. Both times, the representative promised savings of 15 to 20 percent but then also demanded a complete roster of my employees and their dependents.
Not surprisingly, when the underwriters were done, the rates we were quoted were almost identical to what we were already paying. So I have stuck with Independence Blue Cross for the last 13 years, mostly to avoid the hassle of dealing with a different company.
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This was not the first time I had been on the exchange. I had taken a quick look shortly after it opened, in early October, when I was curious to see whether specific plans with pricing were shown. Even in the first week of the exchange’s existence, I was able to navigate (starting here) to a pricing tool that lets you plug in your state and county and get generic sample quotes. The first page asks whether you are buying as an individual or a small-business owner. I tried both and found both options worked well. Either way, you are taken through a sequence of pages that explain how the plans work and how the individual subsidies work. And then you go on to pricing.
All of the information is clearly presented. When I tried the pricing tool, the prices I saw were for a single person and a family, but it was not entirely clear how old all of these theoretical people were, so the numbers were not all that useful because they varied widely with age.
After seeing the generic quotes in early October, I let the project sit for a while, having been assured by the media that the site was a disaster. It was not until after I got my renewal package, on Oct. 29, that I went back. This time I tried to get a specific quote — first going to the page to create an individual account, which did not work. There was no response after I clicked the link to start the application.
Thwarted, I went to the Independence Blue Cross site to see what it would be like if I tried to buy directly. It was not hard to find the page to start an application, but the actual shopping window would not load. Instead, I got a server-disconnected notice while using both Safari and Chrome browsers. Hmmm. The public and private sectors: tied in a race to the bottom.
I tried the Blue Cross site again the next morning and was able to get through. I answered a bunch of questions about the members of my family, and eventually got a tailored quote for Keystone Gold HMO: $1,379.65 per month. Interesting. My agent had quoted me $1,437.27 per month for Keystone Premier Gold, but I could not figure out what the differences were between the two plans.
I also tried the Aetna site, where I answered the same questions about the age of my family members, but here I was shown only plans in the silver and bronze categories. I could not figure out how to generate gold level quotes. I wanted to see what pricing was like for comparable coverage, and the Obamacare metal labels indicated that what I was being shown was not the same as what I had seen from my agent, so that did not help me.
I searched “health insurance” on Google and ended up at another site, United Healthcare’s, with an easy-to-use calculator. And then I noticed, after submitting my information, some very small print that briefly flashed, “Please note: Plans with requested effective dates of Jan. 1, 2014, or after have significantly different pricing and benefits.” Apparently the numbers shown on the next page were not for plans compliant with the Affordable Care Act. Utterly useless.
Late in the evening last Monday, I returned to HealthCare.gov and tried to create an account. This time I succeeded without difficulty. Logging in was straightforward — create a user name and submit personal information: name, address, Social Security number. I was tired, however, so I did not start the application immediately.
The next morning, I logged in, again without difficulty, and spent 30 minutes on an application for myself and my family, applying as self-employed buyers. I wanted to see if the costs offered to individuals differed from the costs I was quoted as part of a group buy. The first part of the application was a verification of my identity, very similar to what happens when I get a credit report online. I was asked some questions about former addresses and phone numbers that presumably only I would know. It worked flawlessly. Then I went through the usual questions about the ages and sex of my family members and our tobacco use. There were a few optional questions about our race and ethnicity, and then I got the quote.
I was shown pricing for 24 plans: two platinum, six gold, nine silver and seven bronze. In the mix was my old pal, Keystone Gold HMO, at $1,379.65 a month — same as on the Independence Blue Cross website and lower than the quote from my agent. (I have not spoken to her yet about this. I’m waiting for her to come back with the pricing she promised from Aetna.)
The next afternoon, while I was at work, I decided to look into getting pricing for my employees, using the SHOP part of the exchange, as HealthCare.gov is designed to service both individuals and small-business bosses. One of the first choices you make, on the home page, is whether to go through the site as an individual or as an employer. Having tried the individual quotes, I wanted to see what happened when I tried to get a quote for all of my workers, like the one we had received from my agent.
There is a different set of pages to navigate, with plenty of FAQs (easy to read and navigate), but in the end you do not get to see pricing online. Instead, you fill out a PDF, which is basically your business’s name and address, and a list of employees, and put it in the mail. Very 20th century. I presume that the paperwork is required because this part of the site is not functioning yet, but I do not know that for certain.
I did learn one detail about the paper application, and the individual application, that is important. The site does not emphasize this, but you must have the current version of Adobe Reader installed on your computer or you will not be able to read the PDFs. I had an older version, and when I first opened the document, it was nine pages of question marks. I installed Reader 11.04, and it was all good.
When I started shopping for my business, I set up another account at HealthCare.gov, this time using my business address. I try, in all of my financial dealings, to keep some distance between my personal life and my business life, so it seemed logical to set up another account. The application page does not distinguish between an account established for a business and an account established for an individual. You still enter your own name and Social Security number. Again, I went through the questions to verify my identity, and everything checked out. So I ended up with two accounts, with two user names: one a variation on my own name, the other a variation on my business name.
Having done that, I started on the mail-in business application. The first question asked for my “Marketplace User ID.” I was confused as to what this might be. When I completed my application as an individual, I was given a nine-digit application number. Was that what the program wanted? When I entered that number on my computer, a notice popped up saying it was incorrect. What to do? I called for help.
The application lists a phone number for a help center: 800-706-7893. I called at about 3:30 on Thursday afternoon. I pressed 1 for English and 0 for a representative, and to my surprise, the phone was answered on the first ring by Amy, who was pleasant and helpful. She told me that the Marketplace User ID was my login user name, not my application number.
I asked her what would happen after I mailed in the application, and she told me that I would be contacted by someone from HealthCare.gov to complete the process. How long would it be before I was contacted? She didn’t know. She said the representatives had not been given an answer to that question. I should mail in the application and hope for the best. I told her that I needed to renew by Jan. 1, and she assured me that it would be taken care of in time for that deadline.
That went so well — immediate service by a pleasant person who answered the questions she could — that I decided to do it again, just to see if the first time was a fluke. First, I worked on the application for a few more minutes. It asks for name, Social Security number, hire date and birth date for each eligible employee, which took a while. Then I called the help line again: same easy procedure, same instant pickup (this time from a different person), and same answers.
So I completed the application and put it in the mail on Thursday. And now I wait: both for HealthCare.gov to get back to me and for a quote from Aetna to be delivered by my agent, Maggie.
One more thing: I tried to log in to my personal account last night, and it was taking a long time to load. It could not pull up my application. Hmmm. Then this morning, I logged into my business account and found that the information from my personal application had appeared under the business login. Double hmmmm.
So here’s my conclusion. If you are using HealthCare.gov, do not make multiple accounts using the same name and Social Security number. You can apply both on the personal side (online) and business side (using the paper application) with the same login. That issue aside, the site seems to be working, and I found it to be well-designed and helpful.
As for the conclusion to my search for affordable health insurance, I cannot predict when I will be able to write it. I need to hear what my pricing will be for business plans, both from my agent and from the government. Then I will try to come up with a game plan in consultation with my employees. We will make a decision about what to do, and you will be able to read all about it here.
Paul Downs founded Paul Downs Cabinetmakers in 1986. It is based outside Philadelphia.