5 On Your Side

Blue Cross hiring additional staff to avoid repeat of open enrollment issues of 2015

Posted November 30, 2016 6:00 p.m. EST
Updated November 30, 2016 6:39 p.m. EST

Many customers of Blue Cross Blue Shield of North Carolina describe their 2016 open enrollment for the Affordable Care Act as a disaster.

Thousands of people filed complaints about the process a year ago, charging Blue Cross with overbilling them or enrolling them in plans they never signed up for.

For others, there was confusion about whether they had coverage at all. When people called Blue Cross, some waited three hours or more on the phone to get answers. Others couldn't reach a representative at all.

The problems, which the company said were the result of IT problems and high enrollment numbers, led to a historic $3.6 million fine by the North Carolina Department of Insurance.

5 On Your Side questioned the state's largest health insurer to find out what changes have been made to prevent a repeat of issues in 2017.

Blue Cross officials say they've made "operational improvements," but they still expect a strain on customer service representatives because of demand.

The company is the only insurer offering ACA plans across the state.

Officials said those needing coverage should not wait to sign up. Customers should research the available plans, in-network physicians and pharmacies ahead of the Dec. 15 enrollment date. Once a policy has been set up, customers can print a verification of coverage document from Blue Cross' website.

CEO Brad Wilson wouldn't speak with 5 On Your Side, but he said in a statement that customers shouldn't expect major differences in how they go about getting coverage.

"The Affordable Care Act coverage remains in place through Dec. 31, 2016, and we still are offering ACA plans in all 100 counties for 2017," the statement said. "Nothing about enrolling for your health care plan in 2017 is different. It is important that those in need of individual health insurance policies sign up for coverage now."

One potential issue for this sign up period is that Blue Cross expects an additional 240,000 or so customers from carriers no longer offering ACA plans next year.

Company spokesman Lew Borman admitted that spike in customers "will put a strain on customer service capacity."

Borman added that Blue Cross has plans in place to respond, including hiring hundreds of additional staff members to answer calls.

Additional staff will be on standby, Borman, said to respond to customer service needs as they arise.