Policy Changes Delayed until WA Healthplanfinder in Order

Washington Healthplanfinder is gearing up for open enrollment on Nov. 15th, but still faces serious IT challenges that impact thousands of the Exchange’s customers.

In both the September and October Washington Health Benefit Exchange Operations Committee meeting presenters described multiple issues with critical IT functions. Plan terminations as a result of incorrect invoicing, payment not being sent to carriers, and duplicate QHP enrollments for the same application continue to persist.

The Exchange has responded to some of these issues with fixes that went into effect in August and September. Payments are now sent to carriers twice per week instead of once per week, and codes fixes have reduced the number of affected accounts to around one thousand, disrupting access to care.

Impacted incorrect invoices have been reduced to around five thousand, and another code fix will be released on Nov. 2nd, just two weeks shy of Open Enrollment Two. Until the Exchange can fix the issue completely, pending terminations are being reviewed by staff to ensure accuracy and guarantee that paying customers aren’t unexpectedly dropped from coverage.

QHP Payment Chart Payment Issues Chart
According to Exchange Chief of Staff Pam MacEwan, there’s talk of legislation to end the exchange’s practice of premium aggregation and instead transfer premium money directly to carriers. Others on the committee confirmed they’ve heard plans for this legislative session. This would be a major shift from the Exchanges current methodology. Some carriers would prefer to handle it themselves, while others are not currently capable of supporting these functions autonomously.

However, Washington isn’t the only state having problems with critical IT functions. Cover Oregon has dumped its $240 million dollar exchange in favor of a Federal platform.

Washington is now one of just twelve states that use a state-based IT platform like wahealthplanfinder.org.