Govt 2
I was sitting on the toilet waiting to be sworn in by the judge. I was about to participate in what would surely be a historic moment for the American legal system. I couldn't take all the credit for being in this position since it would never have been possible without the help of the Affordable Care Act.
Eight months earlier I had gone to the Covered California website soon after it had been launched in support of the roll out of ObamaCare. The website took me through a 6-step application process. One of the preliminary questions seemed innocuous but proved to be the catalyst for an insane series of events. The question was: "When do you expect coverage to begin?" I keyed in January 1, 2014. The 6th step presented plan options from which to choose. I wanted to check with our family physicians before I selected a plan so I pended the application and logged off.
I spent the next few months checking with various office managers to determine which plan options would be accepted. Eventually I selected a Blue Cross plan with coverage to begin April 1, 2014.
A month later I received from Blue Cross the first of many letters threatening to cancel coverage claiming coverage began 1/1/2014 and I owed premiums for the months of January through March.
I called Blue Cross and was told by one of their customer service reps:
1. Yes, she could see on her computer screen correspondence that confirmed my wife's coverage began in April rather than January, but Blue Cross could not change the effective date.
2. The effective date was established by Covered California and only they could change it.
3. She could not inform Covered California of their error nor forward them the information that verified that April was the beginning of coverage.
4. It was up to me to convince Covered California to change the date.
I called Covered California and spoke with one of their customer service reps and was told:
1. Yes, the answer to the "when do you expect" question was used to establish the date coverage began; and no, she couldn't imagine who would be stupid enough to do such a thing either.
2. I was not the first person to scream insults and threats because of this senseless action.
3. She had no access to any Blue Cross documents or information, nor was she interested in me sending them to her as she had no authority to correct the date.
4. My only recourse was to file an appeal.
5. And yes, long before the appeal process was concluded, my wife's coverage was certain to be cancelled.
The first part of the appeal process required 6 weeks for Covered California to formally refuse to correct the date. I eventually received a notice instructing me as follows:
1. Make myself available for a phone hearing to be presided over by an administrative judge at a specified date and time about 8 weeks away.
2. Forward prior to the hearing any documentation I wanted presented to the judge.
While I waited for the hearing date to arrive, I received from Blue Cross a letter alerting us that my wife's coverage had been cancelled. A few days before the hearing, I was notified the hearing date had been rescheduled 5 weeks later.
On the rescheduled hearing date I wasn't feeling very chipper. Something about the previous evening's meal was unsettling. I was supposed to be available to participate in the hearing between 10:00 a.m. and 11:30 a.m. so I carried my cell phone with me. I was on the toilet when the phone rang and I of course had to answer it. It was the clerk of the court for the California CDSS State Hearings Division asking me to identify myself so the hearing could commence. I was told that taking part in addition to myself was a Ms. J. Andrade of Covered California and the honorable C. Battersby was presiding.
Judge Battersby introduced himself and went over the purpose of the hearing. . I debated considered switching my cell phone to speaker but decided against it. The judge then instructed Ms. Andrade and me to raise our right hands to be sworn in. Thankfully he did not ask that we stand. When Judge Battersby asked me to swear to tell the truth I responded, "I do", fighting off a strong urge to add another "do". I was asked quite a few questions and answered them truthfully since they did not include "Where are you?", or "What was that sound?" I figured if they knew the full details of my situation they would agree there was no need to get carried away by that part of the oath that insists on "the whole truth".
The documents I supplied made it simple for Judge Battersby to grant my appeal and instructed Ms. Andrade to change the effective date to April. Ms. Andrade's response to the Judges decision was that such a change would require 2 months to implement.