A little gnome passed the following information onto me late last week:
the Healthcare Marketplace is currently having delays of over a week in forwarding applications to the insurance carriers. This includes enrollments for Jan 1 that were deferred to callbacks by overloading of the phone bank on Dec 15.
I had not realized that there was such a delay, I would have thought that people who were looking for January 1 coverage would have been processed on Healthcare.gov by 12/31, but I was wrong. People are still getting enrolled for coverage effective 1/1/2015 even though it is 1/5/15. Is this a big deal?
It sucks for the people who had an appointment late last week or need to pick up a prescription over the weekend, but fundamentally, it is not a big deal. Insurance companies make retro-additions all the time for all lines of business. Medicaid routinely has people switching into and out of plans up to sixty days after the fact, Commercial large group plans routinely will add and term people a month at a time, and occasionally HR will forget that Milton still works for the company and was left in the basement for several years. Medicare tends to see less retro-active movement, but there is some. The exchanges are seeing some very short term retro-active movement and enrollment plus there is a built in three month look back termination for non-payment of premiums . Retro-activity is common for all health insurance products.
So how does an insurance company handle retro-adds?