Cover Oregon owes insurance agents $900,000

Cover Oregon owes insurance agents $900,000

Cover Oregon owes insurance agents $900,000

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by GOSIA WOZNIACKA, Associated Press

kgw.com

Posted on May 9, 2014 at 11:10 AM

DURHAM, Ore. -- Cover Oregon says it owes about $900,000 to the health insurance agents who were trained and certified through the exchange and have enrolled thousands of Oregonians, but who have not been paid since enrollment began.

The admission came after a board meeting Thursday during which an angry agent told officials he hasn't been paid over the past half a year.

Steve Cox, a West Linn agent who said he has processed more than 150 applications, said he has been told for months by Cover Oregon staffers that his payments are coming.

"It's incompetence," Cox said. "A lot of people aren't getting paid; there are a lot of angry agents out there."

Certified agents are paid through commission payments, which are set by each of the insurance carriers. Cover Oregon passes through the commission payments to agents when enrollments are made.

Cover Oregon interim executive director Clyde Hamstreet said the corporation just sent checks totaling more than $200,000 to the agents and plans to send out more checks next week.

"We know it's a serious problem, and it's not right that agents didn't get paid," Hamstreet said, adding the agents were probably neglected because so much effort was put into enrollment when the online portal failed to work.

Oregon's exchange website was not fully operational throughout the entire open enrollment period and did not allow the general public to sign up for coverage in one sitting. Instead, Oregonians - and the agents who helped them - had to use a time-consuming hybrid paper-online process to sign up for insurance.

Last month, Cover Oregon decided to partner with the federal government on health insurance enrollment, abandoning plans to fix the glitch-filled portal - the first state in the nation to do so.

Hamstreet said he first became aware of the agent payment problem during an April 10 board meeting, when another agent complained about not getting paid. He said he added four staff members two weeks ago to deal with the payment issue.

Cover Oregon says about 1,050 agents accounted for 18 percent of Cover Oregon's enrollments in private plans. That means they enrolled nearly 14,000 of the 77,500 total enrollees in private plans via the exchange.

But in April, when the hybrid process was improved, they accounted for 30 percent of Cover Oregon's enrollments, Hamstreet said.

"I think the agents are very important to Cover Oregon's success and as we go forward, it will be even more so," he said.

The agents also made thousands of Medicaid determinations, though they do not get commissions for clients who qualify for the Oregon Health Plan, the state's version of Medicaid.

Cover Oregon officials also announced that they signed a 45-day, $2.9 million contract with Deloitte on Thursday to analyze the differences between the Cover Oregon and the OHP enrollment systems. Oregon will try to salvage parts of the current exchange technology and migrate them into its Medicaid enrollment system, but will have to improve the technology at an estimated cost of about $35 million.

The Cover Oregon board did not get to review the contract, although board bylaws say board members must review all contracts with such a high price tag.

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