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Friday, December 13, 2019  Spokane, Washington  Est. May 19, 1883
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News >  Spokane

Health exchange changing payment process

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 155,000 customers who bought individual or family plans through the Washington Health Plan Finder will send their premium payments to the insurance company, not the state agency, which had been collecting from most 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 news release Tuesday. “By taking the exchange out of the payment process, customers and insurance companies can work directly on any accounting-related issues.”

Last year, the agency handled about $560 million in payments from customers that then went to insurance companies. Over time, about half of all accounts had some issue that put them in a “gray area,” although most were relatively minor like a late or missed payment, said Michael Marchand, an agency spokesman.

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 fixing it took months.

A year ago, the agency acknowledged problems with some 6,000 accounts, many of them involving billing.

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

Through 5 p.m. today, 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 send 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 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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