North Carolina Insurance Commissioner Wayne Goodwin announced this week his plans to levy large fines against a state insurer whose technology problems have caused thousands of problems.
Goodwin told The News & Observer of Raleigh that he will charge Blue Cross and Blue Shield fines that could reach “millions of dollars” for the problems, which have caused issues with insurance coverage and payment for thousands of customers.
The nationwide computer failure that prevented enrollments under the Affordable Care Act was fixed in two months, Goodwin argued, as opposed to the four months it took for Blue Cross to adequately solve its problems.
“We’re still seeing many of the same problems,” he said. “I’m furious about it.”
Goodwin has already directed his office to investigated Blue Cross, a process expected to end May 27. Afterward, the insurer will have 30 days to respond to the agency’s findings, conclusions and recommendations.
While Blue Cross said it planned to cooperate in the investigation, the company has challenged Goodwin’s characterization of the problem.
Spokesman Lew Borman told the newspaper that “the vast majority of customer enrollment issues have been resolved,” and that “call volumes to customer service are down considerably from January.”
According to data provided by Goodwin, the state insurance department has received between 588 and 677 calls per week regarding the Blue Cross tech issues. Calls in the last two months were indeed down by about a fourth from average call levels earlier in the year.
Borman added that most customers are not affected by the problems; just 15% have been subject to fallout.
“A majority of claims are being paid normally, and most of our customers are not impacted,” Borman said. “The amount of delayed claims will shrink over the next few weeks as we continue to process additional waves.”
