For Americans who are using the insurance marketplaces created by the Affordable Care Act (ACA), also known as ObamaCare, there have been some difficulties. Initially, those who tried to enroll via the Healthcare.gov enrollment site had problems accessing the site. While many of the site’s glitches have been resolved since its October 1st launch, in some cases key information may not have been transmitted to health insurance companies.

The health insurance industry uses a data transmission called an “834 EDI transmission” or simply “an 834.” This data file is used throughout the industry to enroll, change, or discontinue health insurance coverage for individuals.

Early Problems with 834 Errors

Unfortunately, when the marketplaces came online on October 1st, 2013, there were problems with both the consumer-facing “front end” and the insurer-facing “back end.” On the front end, consumers were met with slow and error-prone account creation and often could not finish the application process. On the back end, insurers were receiving garbled 834 transmissions and sometimes an 834 was not generated at all.

These errors resulted in thousands of Americans believing they had enrolled for health insurance coverage even though the insurance company had no record of any enrollment. Multiple news sources reported an error rate in October and November of up to 25%.

Because so few applications were completed in the first month or two, insurance companies were able to individually look over the 834 transmissions and correct errors or contact customers when questions arose. Regardless, close to 15,000 Americans didn’t have 834 transmissions generated at all, resulting in many people mistakenly believing they had insurance when in reality, they did not.  To be sure that their applications went though, and that they are properly covered, Americans are strongly encouraged to confirm the status of their enrollment with their insurance providers.

Improvements in 834 Transmissions

Since mid-November, a number of fixes have been implemented on both the front and back end of the insurance marketplaces. Americans are now able to complete the account and application processes, and the error rate on 834 transmissions has fallen to around 10%. The administration and developers continue to make additional fixes for the issues that occur, and technicians are reconciling the 834 records from the Marketplace with the records insurers have received. The administration has an ongoing blog documenting the fixes and changes being made at Healthcare.gov.

The best news is that since December 2013, the missing 834 percentage is nearing 0. Unfortunately, this still means that in a few cases the 834 record still does not exist for a marketplace insurance enrollment.

How to Make Sure Your Insurance Is Accurate

The first step to take is to call the insurance company you enrolled with to make sure that your records have been received. You can also speak to them about the coverage plan you are enrolled in. This will help ensure that the coverage you expect to have is in place before you need it. This is also a good time to ask any questions you may have about your plan.

In addition, you can make sure your payment to the insurance company has been accepted. No coverage will go into effect until the first payment is made. However, many insurance companies will retroactively offer coverage dating back to the 1st if payment is received by the 15th. Regardless of your coverage date, it’s important to make sure that payment has cleared through your bank and has been received by the health insurance provider.

While the health insurance marketplaces have faced their fair share of trouble, improvements are being made every day. 834 transmission results are improving tremendously and Americans are more consistently able to apply via the Marketplace. Even with these improvements, it’s important to call the insurance provider to make sure all of your information is correct.

 

Sources:

http://www.1edisource.com/learn-about-edi/transaction-sets/tset/834#axzz2iTTXXNfa

http://www.kaiserhealthnews.org/daily-reports/2013/december/07/obamacare-error-rate.aspx

http://www.hhs.gov/digitalstrategy/blog/2013/12/missing-834s-percentage-now-near-zero.html

http://articles.latimes.com/2013/dec/06/news/la-pn-obamacare-enrollment-form-errors-20131206

https://www.healthcare.gov/blog/how-we-are-working-to-improve-healthcare-gov/

https://www.healthcare.gov/using-your-new-marketplace-coverage/