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,” says Merrie Beth Neely of Clearwater. She says 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 says 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 at firstname.lastname@example.org, “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.
Neely, 48, is a PhD oceanographer, but between jobs. The only health policy she had was a stripped-down plan that covered very little — the kind that is no longer legal as of Jan. 1 — 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 says.
"Now I feel like I have insurance that I can't use," Neely says.
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.
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 says 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.
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