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Monday, December 9, 2019  Spokane, Washington  Est. May 19, 1883
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News >  Spokane

Washington health exchange changes billing system

Individual customers to pay insurers

OLYMPIA – The Washington health exchange is cutting out the middleman between insurance companies and their customers who sign up for individual plans using the agency’s online finder.

In this case, that middle man is the agency itself.

Starting this week, some 158,000 customers who bought individual or family plans through the Washington Health Plan Finder will send their premium payments to the insurance company not the agency, which had been collecting from customers and paying insurers. That was the system the state used since 2013, when it set up the exchange to qualify for federal money under the Affordable Care Act, which some people call Obamacare.

“This change will be beneficial to our customers while also improving account coordination between the exchange and insurance companies,” Pam MacEwan, chief executive officer of the Washington Health Benefit Exchange, said in a press release Tuesday. “By taking the exchange out of the payment process, customers and insurance companies can work directly on any accounting-related issues.”

In the last two years, some customers experienced “accounting-related issues” in which they paid their premiums to the agency but their chosen insurance company had no record of it, or the state was charging the wrong amount and getting corrected took months.

A year ago, the agency acknowledged problems with some 6,000 accounts, many of them involving billing. Last December, the board that governs drop billing for individual plans as a way to address complaints from customers and insurance companies. MacEwan said it was making the change now, before the new enrollment period starts on Nov. 1.

Customers will pay the same amount, they’ll just pay it directly to the insurance company, Caitlin Kuiper, an agency spokeswoman, said. The change won’t affect any tax credit a customer might be receiving that lowers the premium.

Through 5 p.m. Wednesday, customers should make their October payment to the benefit exchange. After that point, they should send their October payment, and all subsequent payments, directly to the insurance company, which will be sending invoices to the customers. Those who have health and dental coverage from different companies will receive separate invoices, and will make separate payments.

Customers who have problems with billing or payments should first contact the insurance company.

The change does not involve the state residents on Medicaid, nor does it affect people who have insurance through an employer that signed up through the exchange.

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