Covered California
Covered California has reaffirmed their policy that only Certified Insurance Agents can call into the agent service center and request assistance for a Covered California consumer for whom they have been properly delegated. Support staff to the agent cannot call the service center on the agent’s behalf and make any changes or inquiries. Callers to the service center will authenticated by the agent’s name and Department of Insurance license number.
From an Agent Alert email from Covered California
Service Center Authentication Policy
- Consumer privacy is important to us, and we are committed to protecting their information. Review the Covered California Service Center Agent Authentication Policy as a reminder of our security practices.
- Agents are authenticated by providing their name and valid California Department of Insurance (CDI) license number or Covered California certification number
- Callers may not provide another Agent’s information
- Any caller seeking information on a Covered California consumer’s case MUST be listed as a delegate or authorized representative by the consumer
- Agent’s staff/assistants are not authorized to make changes to a consumer’s case on behalf of a delegated agent or Authorized Representative
- Agent’s staff/assistants are not authorized to request delegation to a consumer’s case on behalf of a delegated agent or Authorized Representative
- Agent’s must be authenticated and have the case Primary Contact on the phone when requesting a new delegation or change of delegation to a consumer’s case
This is the current authentication policy and is being followed at all Covered California service centers. Covered California service center representatives, as well as, Certified Agents must follow this policy to ensure the security of consumer health and personally identifiable information.
Only Agents Should Call Covered California For Consumers
This has been a chronic problem from the beginning of Covered California, especially for agencies that employ multiple agents. In the multiple agent scenario under one company, in order for the agency to receive the commission checks from the health plan and then split them between the owner and the agents, there could only be one agent to whom the health plans or Covered California were sending checks to. Initially, Covered California did not have the ability to set up agents as sub-agents of a larger organization.
This meant that there could be only one agent number and license enrolling individuals and families into Covered California. If the agency had multiple agents, they all had to log in as that one agent. That meant the agents could see all the clients assigned to the one super-agent. Some agents have also been having their own customer service representatives calling Covered California and making changes on their behalf.
Covered California has changed the system to allow sub-agents to a larger agency, but obviously problems still persist. The latest update to the agent portal in September allows users logged in to see the Social Security numbers for all the clients and family members. Before the update, only the last four digits were visible to the agent or use logged into the system.
