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Exchange Enrollment Data Improves, but Errors Remain


By Rebecca Adams, CQ HealthBeat Associate Editor

December 6, 2013 -- The accuracy of the enrollment files that are sent daily from the website to insurance companies is improving from an error rate of about one in four from Oct. 1 through Nov. 30 to a current rate of about one in 10, according to Obama administration officials.

The administration says it is working with insurance companies to identify remaining flaws. The "very preliminary" information released late last week is based on a sample of files that federal officials and insurers compared.

The problems with the so-called 834 enrollment forms fall into three categories, said Centers for Medicare & Medicaid Services (CMS) Communications Director Julie Bataille. They include enrollment information that is never sent to insurers, duplicate forms, and forms that included errors. Bataille said officials "don't have breakdowns" of the number of problems in each category.

Insurance companies are most concerned about the missing forms, which they have dubbed "ghost" or "orphan" reports. They are concerned that consumers may believe they have coverage when insurers, in fact, have no record of enrollment.

Insurers working with CMS said they are pleased that the errors are not as common as they once were, but note problems could be magnified as the volume of enrollment increases.

"The new process put in place this week is making a difference," said America's Health Insurance Plans President and CEO Karen Ignagni. "The enrollment files are getting better, but there is more work to do to ensure consumers are covered."

Traffic on the federal website continued to grow this week. About 3.7 million unique visitors through noon on Friday clicked on, which handles enrollment in the health law insurance exchanges for 36 states. The site was unusually stable this week, with no unscheduled crashes, an error rate of 0.77 percent and response times of less than 1 second.

The administration used its new queuing system, which asks consumers to get off the site and return later, on Monday morning and Tuesday afternoon. But Bataille said 93 percent of the 16,000 people who left the site returned after they got an email telling them that was running more smoothly and they could try again.

People have until Dec. 23 to sign up and until Dec. 31 to pay their premiums. Coverage is supposed to start on Jan. 1.

Insurance industry consultant Bob Laszewski said that insurers are worried about the tight time frame. He said that one of his clients estimated that only about 15 percent of people who enrolled have paid. It's impossible to predict how many will pay by Dec. 31.

"We should expect some enrollment slippage come the payment due date," he said.

If a customer doesn't pay by Dec. 31 but pays a few days later, the individual will have to wait until Feb. 1 to get coverage.


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