Wednesday, June 18, 2014

eHealth Whiffs It

So, the folks at eHealth (who generally do a pretty bang-up job communicating the ins-and-outs of the ObamaTax), recently released (and publicized) this video:

Great production values, but I'm shocked that their compliance department let this stinkburger through.

"Stinkburger," Henry?

Yes, and here's why:

The video explicitly names three events that would qualify one for a Special Enrollment Period: Job Loss, Job Change, and COBRA termination. Problem is, only running out the 18 months of COBRA is recognized as an automatic qualifying event. The other two? Nope.

But don't just take our word for it, here's the HHS list.

Do you see job loss or change as a qualifying event? No: they are only relevant if one loses coverage as a result.

Big difference, and important when considering one's options.

Two examples:

Scenario 1 (Job Loss): Joe's employer doesn't offer group (medical) insurance. When Joe quits or is laid off, this does not trigger a Special Open Enrollment (SOE).

Scenario 2 (Job Change): Joe's employer doesn't offer group insurance. Joe quits to go work for another firm which also doesn't offer coverage. Again, no SOE is triggered.

Now, one could also understand the video to mean job changes within the same employer. Same outcome.

And there's this:

The young lady says that "it's a good idea to have some proof of your loss or change in your health coverage."

Um, no, it's a requirement, there's nothing optional about it. Is that a big deal? Maybe, maybe not, but if you've just spent hours and hours on the 404Care site or on hold, and you don't have that? Good luck.

Finally, there's the time-frame issue. The video is absolutely correct that the clock stops 60 days after the qualifying event (and this is important: HIPAA requirements include an extra 3 days). But it then states that if you do make that 60 day window, "your application for new health coverage cannot be declined."

That will come as quite a shock to all the folks still waiting on confirmation of coverage.

All in all, I'd rate this a C- (at best). Which is a shame, because it had the potential to be quite helpful to folks now that we're in the long drought between Open Enrollment periods.

[Hat Tip: FoIB Holly R]

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