April 16, 2015
OLYMPIA, Wash. – At the request of Insurance Commissioner Mike Kreidler, eight insurance companies in Washington have agreed to revamp the information they provide to consumers about contraception benefits after a survey revealed alarming discrepancies (PDF, 1MB).
A 2014 phone survey conducted by Northwest Health Law Advocates (NoHLA) and NARAL Pro-Choice Washington (NARAL) of the eight health insurers selling plans inside Washington state’s exchange, Wahealthplanfinder, uncovered that women seeking information about contraceptive coverage were systematically given false or inaccurate information about their benefits.
Under the Affordable Care Act, health insurers must cover all federally approved methods of contraception with no copays or co-insurance.
The "secret shopper” survey took place from July – November 2014. Volunteers from NoHLA and NARAL called each of the eight health insurers and asked about contraceptive benefits, including:
- Which contraceptive methods they covered;
- If there was cost-sharing and if so, how much it was; and
- If the plans included restrictions on the use of certain contraceptive methods.
The insurers questioned include:
- Community Health Plan of Washington
- Coordinated Care Corporation
- Group Health Cooperative
- Kaiser Foundation Health Plan of the Northwest
- LifeWise Health Plan of Washington
- Molina Healthcare of Washington, Inc.
- Premera Blue Cross
Answers to these questions varied across the eight insurers and in some cases, among representatives of the same company. Sales and customer-service representatives routinely told callers that select methods of contraceptives had copays or co-insurance while other methods did not. Many struggled to answer or could not answer specific questions about contraceptive benefits and resisted checking for coverage of certain methods or brands when asked.
“Our study indicates there is work to be done to ensure that the women of Washington reap the full benefit of the Affordable Care Act’s contraceptive coverage requirement,” said Janet Varon, executive director of NoHLA.
“We were disappointed to find out that insurance company representatives were providing inaccurate information to their customers, but encouraged by the insurance commissioner’s work to bring insurers in line with the Affordable Care Act,” NARAL Pro-Choice Washington Executive Director Rachel Berkson said. “We will remain vigilant and monitor insurance companies to make sure they provide all methods of birth control at no cost to women, as required by the ACA.”
NoHLA and NARAL brought their results to Insurance Commissioner Mike Kreidler. He convened a meeting of the advocates and insurers on March 18, 2015 to discuss a comprehensive strategy for addressing and correcting the findings.
“I was deeply concerned by the results of this survey and am grateful that NoHLA and NARAL brought it to my attention,” said Kreidler. “Women have the right to contraceptive coverage and I expect their health insurers to provide them with accurate information.”
During the March 18 meeting, the insurers were presented with the report’s findings and asked to create written action plans to address four key areas:
- Improve education and training for customer service and sales representatives.
- Create clearer consumer materials for contraceptive benefits.
- Ensure that forms and formularies accurately describe any additional steps women would have to take to access certain benefits.
- Complete a self-assessment look-back, including an audit of calls and claims review in six and 12 months.
“I believe the insurers were as startled at the findings as we were,” said Kreidler. “They were very forthcoming and are committed to improving their customer service on these issues.”
Kreidler has set a date in October for the advocates and insurers to meet again and discuss their progress.
“We are pleased that Commissioner Kreidler is acting on the concerns raised in our report and standing up for consumers,” added Varon. “He summoned the insurers to the table and pressed them for answers and we’re encouraged by their responses.”
“We will be following up with the health insurers but we want to hear today from anyone who believes they’re not getting the coverage they deserve,” said Kreidler. “Don’t hesitate. File a complaint with my office or call us at 1-800-562-6900.”
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Release No. 15-15