Some health care enrollees didn't pay, aren't covered

  • Article by: Robert Pear
  • New York Times
  • February 13, 2014 - 9:43 PM

– One in 5 people who signed up for health insurance under the new health care law failed to pay their premiums on time and therefore did not receive coverage in January, insurance companies and industry experts said.

Paying the first month’s premium is the final step in completing an enrollment. Under federal rules, people must pay the initial premium to have coverage take effect.

In view of the chaotic debut of the federal marketplace and many state exchanges, the White House urged insurers to give people more time, and many agreed to do so.

Lindy Wagner, a spokeswoman for Blue Shield of California, said that 80 percent of the people who signed up for its plans had paid by the due date, Jan. 15. Blue Shield has about 30 percent of the exchange market in the state.

Matthew N. Wiggin, a spokesman for Aetna, said that about 70 percent of people who signed up for its health plans paid their premiums. For Aetna policies taking effect Jan. 1, the deadline for payment was Jan. 14, and for products sold by Coventry Health Care, which is now part of Aetna, the deadline was Jan. 17.

Mark T. Bertolini, the chief executive of Aetna, said last week that the company had 135,000 “paid members,” out of 200,000 who began to enroll through the exchanges.

“I think people are enrolling in multiple places,” Bertolini said. “They are shopping. And what happens is that they never really get back on to disenroll from plans.”

Kristin E. Binns, a vice president of WellPoint, one of the nation’s largest insurers, said that 76 percent of people selecting its health plans on an exchange had paid their share of the first month’s premium by the due date of Jan. 31.

Binns said the company had received more than 500,000 applications for individual coverage through the exchanges in 14 states.

Julie Bataille, spokeswoman for the Centers for Medicare and Medicaid Services, which runs the federal exchange, said the government did not know how many people paid premiums and got coverage.

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