Health plan sign-up is smoother, but still time-consuming and confusing

Enrolling in health insurance on the state's exchange is not as overwhelming a task as last year, but still often cumbersome and confusing, say users, insurance brokers and state-designated counselors.

Dates are approaching for open enrollment for the second year of NY State of Health: Monday is the deadline if you want coverage to begin Jan. 1, and Feb. 15 is the final sign-up day for coverage during 2015.

"It's much better than last year," said Stacy Villagran, who directs the Nassau-Suffolk Hospital Council's "navigator" program. The hospital council is one of three state-designated agencies on Long Island whose job it is to help people with enrollment.

When the exchange debuted last year, it had its share of problems. Initially, the website was slow and people frequently had to wait a long time for help from a representative in the exchange's call-in center.

As a result, many called the hospital council or showed up in person to ask questions and didn't necessarily enroll, Villagran said. That is happening less this year, she said.

By the end of November 2013, the hospital council had seen 592 people and had completed 288 applications. By the end of last month, the six navigators had assisted 370 people and done 260 applications, about half of which were renewals, she said.

Gwen O'Shea, president of the Health & Welfare Council of Long Island, which subcontracts as a navigator agency, said three staff members have been "unbelievably busy" helping several hundred people enroll so far.

While this year has been easier than last, she acknowledged that signing up for insurance on the exchange "takes time and it isn't as streamlined" as making an online purchase.

That is a recurring criticism from brokers.

Jack Glanzer, president of The Granite Insurance Brokerage in Garden City, said the process is less confusing than last year, but he still finds it "overly and unnecessarily cumbersome." He encountered waits of 15 minutes or more on the exchange's help line, he said.

Like Glanzer, Steve Sekur, an independent agent in Seaford, complained that the site "is a little awkward. It's not smooth, like when you're ordering something online."

And, he said, "when people call on the hotline, they don't always get the right answer."

A spokesman for the New York State Department of Health said the agency is not having "any issues" with the website or hearing complaints about the call center, but he urged people to contact the exchange if they have problems.

Jason Samel, executive vice president of JayMar Insurance Agency in Jericho, said he believes the problem is more systemic. He said he worries that people won't thoroughly read renewal letters that NY State of Health sent in November or go online to see what information about them is there -- and which could be wrong.

Of about 200 people he has helped enroll or renew coverage, Samel said, about 10 got letters from the state that had misinformation. One included information about a client's subsidy on the first three pages of the letter, and the fourth page then stated the client was not eligible for a subsidy. The discrepancy took hours to resolve, Samel said.

The Health Department would not comment on the letter.

People need to pay attention and consult a professional if necessary, Samel said.

"My big message is: Get educated, use a broker, use a navigator who knows this stuff inside and out," he said.

Melissa Adams, 57, of East Northport, was doing just that on Tuesday at the Dolan Family Health Center in Greenlawn, when she met with Liliana Gomez, a navigator with the hospital council. Last year, she said, she signed up for an Empire BlueCross BlueShield plan with the aid of the help line.

Adams, unable to work after being in a car accident, said she can't afford her current coverage and wanted to apply for Medicaid. But after four conversations on the help line in which "each one was saying something different," she decided to travel to the Greenlawn center.

She said her meeting with Gomez was helpful. As of Thursday, she hadn't completed her application, she said, because when she went to the website, it was down.

The process went more smoothly for Garrett Reichelt, 28, of Manhasset. A graduate of chiropractic college who no longer is covered by his parents' insurance, he found the online application confusing.

His hope was to get a lower-cost plan or perhaps Medicaid, until he finds a job.

On Wednesday about 5 p.m., Reichelt was the last person that day to meet with Gomez. He said the outcome was worth the wait: He signed up for a Medicaid plan.

"It was great. I'm excited," he said. "I think I'm done."