State leaders questioning Blue Cross and Blue Shield of North Carolina

RALEIGH, N.C. (WNCT) – Multiple state agencies are probing the coverage issues Blue Cross and Blue Shield of North Carolina (BCBSNC) had at the beginning of the year and those it may still have.

BCBSNC is the largest insurance company in North Carolina and, in many counties, is the only company to offer a health insurance plan on the federal marketplace.

Customers reported troubles with their plans that included billing issues and not being enrolled in the plan they selected. BCBSNC was flooded with calls and worked to keep people updated on the progress.

On January 11, the North Carolina Attorney General’s Office requested answers to the issues, asking a response on how the problems occured, what BCBSNC was doing to correct the issues, the number of those affected and answers to other questions.

BCBSNC sent a response on January 22. It blamed “unprecedented demand” and a deadline extension for the Affordable Care Act enrollment period.

It said as of January 21, BCBSNC made refunds to 4,637 members and found it had under-billed 25,000 members.

It said as of January 21, BCBSNC had received 83 complaints from the North Carolina Department of Insurance (DOI). WNCT checked with DOI and found that as of January 26, that number jumped to 450 complaints.

A DOI spokeswoman said that staff members met with BCBSNC on Tuesday about the ongoing issues. She said high priority cases are for those with urgent medical needs.

The DOI will work with all cases on an individual basis to ensure fair treatment.

The spokeswoman said after urgent consumer needs are meet, Commissioner Wayne Goodwin and his department will review the BCBSNC system failure and take action if needed.

WNCN reported Brad Wilson, BCBSNC CEO, said during a radio ad, “These difficulties are unacceptable and we apologize.  To improve this situation, we are working around the clock—bringing in more staff and expanding customer service hours.”

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