Mike Kelly’s experience with The Hummel Report

The million dollar advertising campaign is one that you probably have seen on television, on Facebook or on billboards around the state. And it was one of those ads that caught Mike Kelly’s attention in December. So he checked out HealthSourceRI’s website and quickly got the answer he was looking for.

“You can just go on and give basic information and it will give you the cost,’’ Kelly said. “And the cost was about one-third of what it cost to buy a plan on my own directly through an insurance company.”

HealthSourceRI is the vehicle to make the Affordable Care Act — ObamaCare — a reality in Rhode Island. And it was designed for people like Kelly and his wife, who own a small business in Barrington. They have no other employees, so Kelly was just looking for insurance to cover them and their two sons.

“Before I completed enrollment, I called and had the girl go through my entire application with me before I submitted,’’ he said. “I didn’t want to submit it, and then it went up three times what it said. She went through it and said, ‘No that’s your cost. Go ahead and submit it. ‘”

That was December 4. He got confirmation the next day, and he made his first payment immediately. He would periodically check his account on the website.

“The money cleared, we have our cards, it started January 1. We got all of the welcome packages from insurance companies. And then it said I was disenrolled. I didn’t even know what that meant. Disenrolled. So I called and that’s where the nightmare began.’’

Over the next month, Kelly would be cancelled and re-enrolled repeatedly without ever touching his account. He talked to 15 different people. Because he didn’t have coverage, his wife had to cancel three scheduled doctor’s appointments even though they had paid their premiums. And he spent more than 21 hours on the phone trying to get it worked out.

Kelly is not alone and his situation mirrors that of many who have contacted The Hummel Report over the past several weeks. They want the insurance, but are having problems with the logistics of getting enrolled. So we took those complaints to Christine Ferguson, director of HealthSourceRI, who says she’s trying to deal with a higher-than-expected number of people wanting to enroll. The numbers tell the story: In the first four months HealthSource RI has had more than 16,000 people enroll, the call center has received 179,000 calls and the website has received nearly half a million visits.

“One of the things we did was ramp up the number of people because we were slammed,’’ Ferguson told us. “We didn’t expect the level of response that we got so we underestimated. So we’ve brought in another 30 people and they’ve been trained.’’

In one week, Kelly spent more than nine hours with representatives of the call center.  “They’re pleasant and they try to help, but I think they’re way undertrained. They might just be throwing people in there because of the volume of the phone calls and not giving them a chance to be trained properly. They all give you a different answer. They all say they’ll call back and none of them do.’’

Ferguson said her people were trained as well as they could have been at the time. “No private sector company would have brought something up this fast; no private sector company would have had five federal data hubs that they had to relate to plus all of the carriers.’’

Before our interview last month, Kelly thought he had everything straightened out. But he contacted us a few days later saying he’d been cancelled again. That prompted a call to him from Ferguson personally.

“I know normally people are always trying to defend and say there’s not a problem. I’m not trying to defend, right?’’ Ferguson said. “We absolutely know that we’re going to encounter all kinds of issues as we go along. We’ve built in ways to deal with them. It’s critically important that people let me know when there are problems.’’

She remains upbeat about what she believes HealthSourceRI can do in providing coverage. “We really have a shot at having an impact on the cost of healthcare,  how healthcare is delivered and finally for the state to have the data and the analytics that answer the questions about where our money is being spent and how it’s being spent.’’

Mike Kelly agrees with that, but says the state needs to walk before it can run. “The message is: train your people. Train ‘em. Don’t let someone just answer the phone who doesn’t know what they’re talking about. You have to train them.’’

The Hummel Report is a 501 3C non-profit organization that relies, in part, on your donations. If you have a story idea or want make a donation go to www.hummelreport.org. Or mail Jim directly at jim@hummelreport.org.