As the technical improvements to HealthCare.gov continue making a difference to consumers using the website, our attention remains on addressing issues with the more “back end” parts of the system, including the creation and accuracy of 834 transaction forms. These transaction forms are processed by health plans when consumers choose a product in the Marketplace, and our priority is working to make sure that every 834 form – past and present – is accurate, and that consumers are able to successfully enroll in the coverage of their choice.
Our dedicated 834 team – led by our General Contractor QSSI and working in partnership with issuers nationwide – is laser focused on ensuring we’ve made improvements to the system for the long term, and as we move forward, addressing any issues that could potentially impact consumer coverage. This integrated team works on reconciliation issues 24/7, and maintains a telephone hotline for issuers who have questions.
Our analysis indicates that between October 1st and December 5th, the number of consumers for whom 834s were not produced was fewer than 15,000. But as the graph shows, since the beginning of December, missing 834s as a percentage of total enrollments has been close to zero. These significant improvements are due to the technical fixes put in place by the end of November.
For most Marketplace consumers, 834 creation or accuracy has not been an issue. The majority of issues occurred between October 1st and the first few weeks of November when some of these transactions were either not being generated, or had errors due to larger technical system issues. More than 70 of our software fixes over the past several weeks have focused on correcting software bugs related to 834 issues. We’re assisting health plans in dealing with inaccurate 834s as efficiently as possible.
To make sure that no consumer falls through the cracks because of earlier pervasive troubles with the site, we are contacting every consumer who has selected a plan through the Federal Marketplace to remind them to pay their premium and connect with their insurer.
We continue to work with health plans undertaking a very focused process to verify 834 information. We are double and triple checking all enrollment data across systems. This week, we securely sent data files to 300 issuers participating in the Federal Marketplace—and we’re reconciling 834s with the issuers. Every issuer’s health plan in the Federal Marketplace now has CMS files for the consumers who enrolled, or tried to enroll in their respective plans through early December. After December 23rd, issuers will receive new files.
This thorough process will continue as we move forward, so that as open enrollment continues we are able to process back end financial information as needed between CMS and issuers, so that consumers who have selected affordable health plans from the Marketplace and paid their premium to that plan, are able to access the coverage they want and need.