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Life Health > Health Insurance

PPACA is always right

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Remember the adage, “The customer is always right”?

That’s not the PPACA way.

An associate referred two clients who had a Marketplace plan that they did not like, did not want, and cost too much. They had been frustrated to the point of tears after months of trying to get something else.

See also: If you like your health insurance plan…

The husband explained to me that, when his employer dropped his company plan, a rep came in from a large agency in another city. The rep “fast-talked” all the employees at a company meeting, and signed everyone up on the spot. As time went by, my client realized that he had not gotten what he thought he had agreed to. He tried to change the arrangement. The agent would never return his calls.

He was told he had to contact the Marketplace on his own, and this he tried to do, but he met with no success. My client is a physical worker; he can take down a 60-foot tree and preserve all the useful lumber in it, but he is not comfortable or effective in dealing with bureaucrats.

See also: The marriage penalty

Could I help? I was certain I could. All I had to do was contact customer service and get the documents necessary for a change in agent representation, have the clients fill them out and forward them to the company.

That might be good enough for the real world, but not in the realm of PPACA.

First, I was educated by the company; then, by HHS.

Insureds, once they have appointed an agent, cannot revoke that appointment unless they change their plan, and they can only change their plan at open enrollment, or if they qualify for a special enrollment period. The insurance company cannot help them; neither can I, until the next open enrollment. And while the consumers wait and stew, the dolt who dumped a bum plan on them will continue to collect his commission. 


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