ComplaintsforWashington Health Plan Finder

• Initial Complaint

  07/12/2024

  Complaint Type:

  Order Issues

  Status:

  Answered

  More info

  I was laid off last month and i'm trying to use the health finder to get an insurance plan that my current provider accepts for me and my daughter. I am making only unemployment and somehow am ineligible for state assistance. The plans do not work, nothing works. The company hangs up on me and tells me it's not their job to get me a healthcare insurance provider that works. I just spoke with the manager after 45m waiting (******) and she stonewalled me as well. This is unacceptable.

  Business response

  07/23/2024

  Washington Health Benefit Exchange has been working with this customer to secure ********************** insurance; however, the customer's provider doesn't accept the insurance selected on Washington Healthplanfinder. Unfortunately, the insurance their provider accepts is outside of our control. The customer is enrolled in ********************** and dental insurance starting 8/1 through Washington Healthplanfinder.
  

  Additionally, the customer has been advised and provided the health insurance company contact information to ask about off exchange plan options that their provider might accept. 

• Initial Complaint

  05/29/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Resolved

  More info

  I have called **************** on April 30th to let them know about my situation and that I wanted my plan changed due to my doctor suddenly being out of network and the insurance company to decline to pay for my ultrasound visits. A lady on the phone switched my plan for me, told me what my monthly premium would be and we hang-up the phone. I have had only issues from that point on. I have called, emailed, requested an appeal and a hearing with judge but all my efforts are just being ignored. Everytime I call, I get a new person on the phone and everytime they are trying to either put the blame on someone else or just give me a solution that doesn't portray to my situation. The new insurance company (Regence) has been denying my special enrollment period, they claim that I have to provide them documents to confirm I have a change of circumstances and instead of calling the ** plan finder (the actual people who changed it, they have been emailing me). Every time I called the ** plan finder they tell me to either send them letters from the message center, or that they will contact them or the last interaction was about the insurance denying it is not correct and they are not supposed to be denying it. I have made a complaint with Office of the Insurance commissioner who is also of no help. I don't know what to do at this point. I think that they should not be allowed to provide consumers with any advice or any service. I am being 7 months pregnant cannot go to visit my doctor or do the ultrasound that is needed to figure out how I am going to be delivering because of the ** health plan finder not being able to put me on a plan! (And there system shows that I am covered, yet the insurance company emails me stating that I am not and there is nothing anyone can do about it!). It's an absolute corrupt and useless system that the state of ** is providing to it's citizens!

  Business response

  06/07/2024

  The customer has been contacted directly and confirmed that she has received her membership ID card and welcome packet. The customers issue has been resolved. The carrier confirmed today, 6/7/2024, coverage shows active in their systems for 6/1/2024.  

  Customer response

  06/07/2024

   
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
  
  Sincerely,
  
  ****************

• Initial Complaint

  05/08/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Resolved

  More info

  Washington Health Planfinder has denied my daughter health coverage for the past 8 months and will not even reset her account for her to enroll on her own now that she's 20. They refuse to give her the reason why she's been denied health coverage, I take this as discrimination. They better do something instead of give her the run around. Even Health ************** on the same mess! Nobody is trying to help her or myself fix the issue but keep on giving us the run around.

  Business response

  05/10/2024

  All technical issues have been resolved and the customer has been contacted directly.

  Customer response

  05/10/2024

   
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
  
  Sincerely,
  
  *********************

• Initial Complaint

  02/15/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  This organization is scamming taxpayers out of money

  Business response

  03/01/2024

  Customers are responsible for keeping the income on their application current and accurate.  This keeps their correct tax credit (federal subsidy) amount applied to their monthly premium payments for health insurance accurate.

  Unfortunately, the customer is upset because they have to payback tax credits; however, they did not provide updated income information since June 2021, which caused the overpayment. At this point, the customer will need to reconcile with the *** in regards to the amount of tax credits they were actually eligible for based on their income.

  Customer response

  03/10/2024

  This issue is not resolved,  you have dismissed my complaint.  I was charged for insurance based on my previous year income, when in the year of being charged my rate was changed based on my new income.  This doesn't make sense to any reasonable person.  If I am given a rate based on my annual income for the previous year,  how does a subsidizes program change my rate after I payed the agreed rate? This is a scam. I agreed based on information that was taken from my tax return,  they changed the agreement 12 months later. It's unethical and I consider it theft and fraud. If you will not pursue this matter , I will be including BBB an accomplice in a lawsuit.

• Initial Complaint

  12/18/2023

  Complaint Type:

  Customer Service Issues

  Status:

  Resolved

  More info

  I no longer require access to the Washington Healthplanfinder website, nor will I ever use it again, so I attempted to delete my previously-uploaded documents and delete the account, removing all sensitive health and financial information from their database.Unfortunately, I was not able to do any of these tasks, and when I chatted with their customer support, I found that this was intentional. There is no provision anywhere on the site, or anywhere in their policies, to protect a customer's privacy by allowing them to control their own private, and extremely sensitive, data.The explanation I was given was that, "Well, you might want to log onto the site sometime in the future, even if you have ********* because you might want to search for a dental provider." This is a ridiculous response. More important, this should be *my* choice, not theirs.in this age of rampant data breaches, to be unable to remove this data is absurd, and more than a little frightening. This policy must be changed.

  Business response

  12/26/2023

  We have assisted the customer with deleting their documents and closing their application per request.

  Customer response

  12/28/2023

   
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.

  I'm still unhappy that this required a BBB complaint to spur them to action, but I've been assured that they will be reviewing their policies such that an escalation like this will not be required in the future. For now, I'm satisifed.

  Sincerely,
  
  *******************************

• Initial Complaint

  10/30/2023

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  To enroll for Apple Health you MUST go through WA Health Care Finder. This was done and even an email notification authorization is on file. However when I was approved in September for coverage if I signed up by 9/29/23 I did NOT RECEIVE NOTIFICATION! When I logged in today I saw that I missed the deadline and when I attempted to get an extension or get set up today I was told I would need a new "Qualifying event" to qualify. There is NO change in my situation. I am still dealing with the initial qualifying event that qualified me in September. I have no insurance and I am unable to pay for medical care that I need. This is causing further physical issues as well as psychological in the form of panic attacks. <-- both of these are preventing me from doing my JOB / earning the small amount I do earn. WA Health Care Finder is NOT user friendly and did NOT inform me that I qualified for Apple Health and did NOT inform me I needed to take further action to receive Apple Health. It is a racket. I don't know why I can't go directly to Apple Health to apply.

  Business response

  11/13/2023

  Our enrollment team analysts have reviewed your enrollment through Washington Healthplanfinder. They see that you called our customer support center on 9/21/23 to open a new application, and a Special Enrollment Period was opened due to the Qualifying Life Event (QLE) reported.The date of your QLE was indicated to be 7/31/23, which was the last date of your other coverage. A Special Enrollment Period is a time (outside of open enrollment) during which you have a right to sign up for or change health insurance. You can qualify for a special enrollment period within 60 days following certain life events that are defined by the *************** Act.
  
  Your Special enrollment Period (SEP) begins the first day of your QLE and will remain open for 60 days, in this instance, your SEP ended on 9/29/23 (60 days after 7/31). A letter titled "Enrollment Deadline for Coverage" was sent on 9/22/23 notifying you of your SEP and it's deadline to your preferred method of contact which we have listed as email. You can find this letter along with others in your Washington Healthplanfinder dashboard under the "Messages" tab.
  
  Additionally, just a reminder that it is currently Open Enrollment. At this time you can shop for **** healthcare plans if you are still looking for coverage. If you have any questions, or for assistance in getting enrolled, please contact our customer support center at ************** or *********************************************

  Customer response

  11/17/2023

   
  Complaint: 20801003
  
  I am rejecting this response because:
  
  The deadline email referred to in your response was sent without the actual message in the body of the email. Instead, it was an email stating there was a message in my message box at Washington Healthcare Finder.  This is NOT the method of communication I had requested.  When I say I would like communication via email, it is my permission, and request to receive messages via my email inbox NOT via your website inbox. 

  Thank you for your attention.  I am fully aware that there is nothing to be done to rectify this situation at this time.  I am also fully aware of open enrollment and the fact that I again will have to go through your ridiculous website to enroll. Which I feel is a monopoly on an already seriously flawed system.  Much like your name - you are not a healthCARE finder.  You are a health INSURANCE broker.  Huge difference. Meanwhile, I have been ill and without any coverage.  

  Although I understand nothing can be done about my situation, I do hope that you will utilize what I have explained and experienced to better serve others going forward.  However, I seriously doubt it as you do not seem to actually care as your name indicates you would.

  Regards,

  
  *******************************

• Initial Complaint

  02/21/2023

  Complaint Type:

  Customer Service Issues

  Status:

  Unanswered

  More info

  My wife's Medical Health Insurance was cancelled in error * Been trying to resolve since February 1, 2023 * United Healthcare of ****** cancelled my wife's insurance when I moved over to ******** * Having to cancel medical appointments and not fill prescriptions until this has been resolved * Trying to work with Washington Healthplan Finder to reinitiate a transaction to United Healthcare to reinstate the appropriate coverage * I have two attachments that explain the situation

• Initial Complaint

  01/13/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Resolved

  More info

  I have an account with Washington Health Plan Finder and have been unable to properly login to my account due to a faulty setup issue (my account is somehow setup as business as opposed to personal).I had to sign-up for 2023 health care completely over the phone with no visibility into my account and no way to verify how it was configured, status of application, etc.I am still unable to view any information about my account due to this error. I have called support multiple times, and they state there is a "ticket in open status". If their system is the ONLY valid system in Washington to acquire healthcare from the exchange, there is no way they can leave customers hanging for months! There is no way for me to report changes in income, figure out how my wife's QSEHRA may impact our tax credit, look at basic household information, literally nothing.I believe they should be investigated to determine how many open tickets they have, and how long it is taking to resolve. Customer facing issues should not take longer than ***** hours to resolve when it impacts healthcare.It's not right to leave constituents in the dark or demand they "call in" for support when the wait times were 3+ hours during enrollment. This needs to be resolved for me, and anyone else they are treating this way.If they can't properly run a website, then they need to let us go on the national exchange.

  Business response

  01/25/2023

  Thank you for reaching out. Our teams have been investigating and attempting to resolve since November 28, 2022 when the ticket was issued. Most tickets are resolved within 1-5 business days; however, due to the complexity of the user being associated to multiple records under the same username, resolution is taking longer than anticipated due to the complexity of having an employer and individual accounts. We want to ensure that we are working on resolving, and in the meantime, assigning an enrollment analyst to assist this customer with their needs until user access is resolved. Customer has been contacted with direct contact information of enrollment analyst.

  Customer response

  01/25/2023

  Complaint: 18811395
  
  I am rejecting this response because: While the state exchange representative is trying to be helpful (which is greatly appreciated), the underlying issues still remain:

  1. What is the Ticket number, and where can I see the resolution process and status? (I am a consumer using a consumer facing system. When there is a technical issue, I would expect to see a ticket number and a login to track its progress)

  2. What is the targeted date of completion? It has already been two months. My point is that you are way past the acceptable level for resolving a basic account issue. The representative states the issue is "complicated", it really isn't, only their IT team has made it complicated by poor programming standards. Standard ERP systems swap between business, personal, and other account types as a basic feature. Even if you couldn't perform a basic ERP function like changing account types, merging accounts, etc., you would think that even the most fundamental system could simply create a new account and migrate the info over...but I was told that's not possible either.

  This is fundamental to the complaint filed. You can't have a woefully lacking ERP system running the health exchange for an entire state where basic account features are not in place. 

  3. The representative stated that most issues are resolved in 1-5 days. That *** be true, but other very important issues could be taking months (like mine). I would like to see the stats to support the claim. If it is true that I am among a small handful of outlier issues being actively worked on, that would certainly quell my concerns over widespread systemic problems. The business should be able to readily provide that sans a FOIA request.

  Let me be clear that the people I have spoken to have been extremely polite and this issue is no reflection of the customer service team. This is a technology issue that I believe needs to be investigated to determine if it is in fact isolated, or part of a much larger problem within the state health exchange platform.

  I look forward to having my issue resolved and hopeful the resolution will provide relief to others facing similar issues.

  Again, I appreciate the representative getting back to us and providing some insight.

  
  
  Sincerely,
  
  *******************************

  Business response

  02/03/2023

  It is anticipated to be fixed by February 10, 2023.

  Customer response

  02/11/2023

   
  Complaint: 18811395
  
  I am rejecting this response because: The target resolution date provided in the prior correspondence by the business (2/10/23) was not met. I tested logging in today with my account and it is still not functional.

  Please keep case open until resolved.
  

  
  Sincerely,
  
  *******************************

  Customer response

  03/09/2023

  Greetings,
  
  Complaint ID #******** has finally been resolved.
  
  They have fixed the technical issue.
  
  ****

*Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business. ↩