Eight hours on the phone

My son James started his own business last year. For the prior 15 years he'd been an employee and gotten medical insurance through his company. He decided to get some medical coverage as a self-employed person for 2023. Actually, I was somewhat of an influencer because he's 43 now and that's about the age things can come up. Besides, I'm his business manager.

When we've got coverage through work we usually don't pay much attention to its costs because we're not paying for it directly. When we're buying it ourselves, we do. So when James and I had the discussion he emphasized he doesn't want to pay a whole lot. 

Because his business is only a year old, his income for 2022 was fairly low. So I checked out the state Exchange to see if he was eligible for a supplement for his insurance cost. He was.

My husband and I are insured with Kaiser Permanente in Washington, so that's where I started. Kaiser has really good coordination of services and we've had excellent care for many years. I went on their webpage to apply for James' coverage using the Exchange. The site said to enter the net taxable income. I subtracted the standard deduction amount from his net income and went to the Exchange site to order the insurance. The price on the Exchange was $300 more a month than on the Kaiser site!

I called Kaiser. They said the Exchange determined the price. I called the Exchange. They said Kaiser determined the price. I was pretty annoyed to be in the middle of two "it's not our problem" statements. I called our lawyer to make an appointment the next day to talk about possible "bait and switch" consumer fraud.

I called Kaiser the next morning and got a different customer service person. I explained my problem. They said if a person gets a W-2, they enter the net taxable income on the form. But if they're self-employed, they enter the net income (without the standard deduction amount). When I entered that amount and went to the Exchange, the numbers matched exactly. I ordered less expensive insurance. Then I called the lawyer and canceled the appointment.

I was in IT before I retired, and I knew the sentence on the Kaiser form was misleading for self-employed applicants. I called customer service and asked to speak to the technical department. They transferred me to sales. The man didn't understand what I was talking about. He said, "Well, you got the insurance, right?" I said yes, but I wanted the tech people to add a phrase to the form about self-employed people applying. He said, "I'll call someone and get back to you."

He didn't. Maybe he thought I was an unreasonable old person instead of a customer wanting to prevent other self-employed people from having the same problem.

Eight hours on the phone, on hold for much of it because "We're experiencing a higher than usual call volume." My son James is happy with the insurance I chose for him. But I feel bad for all the other confused self-employed people who thought they were getting good assistance, but ended up with insurance they couldn't afford.