Great job Mr. President!
The hospital bills are hitting Larry Basichâs mailbox.
That would be OK if Basich had health insurance. But he doesnât.
Thing is, he should be covered. Basich, 62, bought a plan through the stateâs Nevada Health Link insurance exchange in the fall. Heâs been paying monthly premiums since November.
Yet the Las Vegan is stranded in a no-manâs-land where no carrier claims him, and his tab is mounting: Basich owes $407,000 for care received in January and February, when his policy was supposed to be in effect. Instead, heâs covered only for March and beyond.
Basich has begged for weeks for help from the exchange and its contractor, Xerox. But Basichâs insurance broker said Xerox seems more interested in lawyering up and covering its hide than in working out Basichâs problems. Nor is Basich the only client facing plan-selection errors through the exchange, she added.
Xerox, meanwhile, said itâs working every day to fix Basichâs problem, and its legal counsel is routine.
In the rollout of the Affordable Care Act and its insurance exchanges, you can find a success story for every failure. But Basichâs case is extreme.
WHOâS RESPONSIBLE?
Basich said he began trying to enroll on Oct. 1, the day the exchange website went live. Like many consumers, he fought technical flaws during multiple sign-up attempts. In mid-November he finally got through and chose his plan: UnitedHealthcareâs MyHPNSilver1.
âIt was like reaching the third level of Doom,â Basich said of the torturous sign-up process.
Basich paid his first premium on Nov. 21, and within days the exchange withdrew the $160.77 payment from his money-market savings account. Because Basich paid a month before the Dec. 23 deadline, his coverage was to begin Jan. 1.
Weeks ticked by, but Basich received nothing to confirm he had insurance. Nevada Health Link kept telling him he was enrolled, but UnitedHealthcare said he wasnât in their system.
Basichâs predicament went critical on Dec. 31, when he had a heart attack. His treatment, which included a triple bypass on Jan. 3, resulted in $407,000 in medical bills in January and February that no insurer is covering.
Basich and his insurance broker, Tamar Burch of Branch Benefits Consultants, said the issue appears to be confusion at the state exchange. Xeroxâs system says Basich chose a plan from another insurer, Nevada Health CO-OP, even though Basich has paperwork that shows he selected MyHPNSilver1. In short, Xerox canât seem to decide where Basich belongs, Burch said.
So the exchange is trying to compromise, putting Basich with Nevada Health CO-OP for January and February, when he incurred his bills, and with UnitedHealthcare from this month on. But CO-OP officials say Basich is not their member.
Nevada Health CO-OP CEO Tom Zumtobel told the exchange board on Feb. 27 that the nonprofit carrier spent seven days with Xerox determining Basichâs eligibility, only to find that Basich hadnât chosen the groupâs coverage.
âIf he had picked our health plan, we would be advocating for a solution. But he didnât pick us,â Zumtobel said. âWe need someone on the board to advocate for him.â
Why have four months passed without a resolution?
âXerox is truly out of their league. They need to understand they are an administrator, they are not an insurance company,â Burch said. âThey need to understand their boundaries. They donât understand this world. Everybody is at the mercy of Xerox, and they are not doing this right.â
Xerox representatives responded that theyâre working hard to make it right.
The hospital bills are hitting Larry Basichâs mailbox.
That would be OK if Basich had health insurance. But he doesnât.
Thing is, he should be covered. Basich, 62, bought a plan through the stateâs Nevada Health Link insurance exchange in the fall. Heâs been paying monthly premiums since November.
Yet the Las Vegan is stranded in a no-manâs-land where no carrier claims him, and his tab is mounting: Basich owes $407,000 for care received in January and February, when his policy was supposed to be in effect. Instead, heâs covered only for March and beyond.
Basich has begged for weeks for help from the exchange and its contractor, Xerox. But Basichâs insurance broker said Xerox seems more interested in lawyering up and covering its hide than in working out Basichâs problems. Nor is Basich the only client facing plan-selection errors through the exchange, she added.
Xerox, meanwhile, said itâs working every day to fix Basichâs problem, and its legal counsel is routine.
In the rollout of the Affordable Care Act and its insurance exchanges, you can find a success story for every failure. But Basichâs case is extreme.
WHOâS RESPONSIBLE?
Basich said he began trying to enroll on Oct. 1, the day the exchange website went live. Like many consumers, he fought technical flaws during multiple sign-up attempts. In mid-November he finally got through and chose his plan: UnitedHealthcareâs MyHPNSilver1.
âIt was like reaching the third level of Doom,â Basich said of the torturous sign-up process.
Basich paid his first premium on Nov. 21, and within days the exchange withdrew the $160.77 payment from his money-market savings account. Because Basich paid a month before the Dec. 23 deadline, his coverage was to begin Jan. 1.
Weeks ticked by, but Basich received nothing to confirm he had insurance. Nevada Health Link kept telling him he was enrolled, but UnitedHealthcare said he wasnât in their system.
Basichâs predicament went critical on Dec. 31, when he had a heart attack. His treatment, which included a triple bypass on Jan. 3, resulted in $407,000 in medical bills in January and February that no insurer is covering.
Basich and his insurance broker, Tamar Burch of Branch Benefits Consultants, said the issue appears to be confusion at the state exchange. Xeroxâs system says Basich chose a plan from another insurer, Nevada Health CO-OP, even though Basich has paperwork that shows he selected MyHPNSilver1. In short, Xerox canât seem to decide where Basich belongs, Burch said.
So the exchange is trying to compromise, putting Basich with Nevada Health CO-OP for January and February, when he incurred his bills, and with UnitedHealthcare from this month on. But CO-OP officials say Basich is not their member.
Nevada Health CO-OP CEO Tom Zumtobel told the exchange board on Feb. 27 that the nonprofit carrier spent seven days with Xerox determining Basichâs eligibility, only to find that Basich hadnât chosen the groupâs coverage.
âIf he had picked our health plan, we would be advocating for a solution. But he didnât pick us,â Zumtobel said. âWe need someone on the board to advocate for him.â
Why have four months passed without a resolution?
âXerox is truly out of their league. They need to understand they are an administrator, they are not an insurance company,â Burch said. âThey need to understand their boundaries. They donât understand this world. Everybody is at the mercy of Xerox, and they are not doing this right.â
Xerox representatives responded that theyâre working hard to make it right.
