Consumers logging into their Covered California accounts hoping to renewal their health insurance may find they have lost their subsidy. Instead of the reduced premium amount they are used to paying, Covered California displays that are not receiving the tax credit subsidy and must pay the full premium amount. A common denominator for consumers who have lost their subsidy is that they had been on Medi-Cal in 2016, but later in the year qualified for Covered California and the Advance Premium Tax Credits to lower their monthly health insurance bill. The transfer of critical application information from Medi-Cal to Covered California is missing, triggering a loss of the subsidy.
It can be a difficult task to locate the faint outlines of the Negro Hill Ditch which is usually under water at Folsom Lake. But when the lake is low enough it’s possible to find the old grade and structures associated with the historic water canal that ran from east of Salmon Falls down to Negro Hill and Massachusetts Flat. In the autumn of 2016 I was able to complete my goal of walking along most of the Negro Hill Ditch.
One of the first filters in selecting an EPO or PPO individual and family plan, either through Covered California or off-exchange, is determining if your current doctor is in-network. For all the enhancements to online doctor directory search tools, they still suck. They are not consumer friendly. Consumers are given either too many conditions to select or the provider search tool offers too little information.
Some individuals and families who purchased their health insurance through a government exchange like Healthcare.gov or Covered California may be subject to the Penalty for Underpayment of Estimated Tax. The underpayment penalty is triggered when the federal income tax due is less than 90% of the previous year’s tax liability. If a tax household received thousands of dollars of the monthly Advance Premium Tax Credit (APTC) subsidy to lower their health insurance premiums, but earned too much taxable income to actually qualify for the Premium Tax Credit, the tax payer has to repay the entire subsidy. This repayment amount could easily trigger the underpayment penalty.
For the second time since the launch of Obamacare and Covered California, Anthem Blue Cross has cut the commissions they will pay agents for assisting consumers with enrollment into individual and family plans. Anthem Blue Cross now has one of the lowest commission structures for agents helping individuals and families apply for health insurance in California. This commission cut, coupled with rules limiting Covered California delegated agents from receiving commissions, has resulted in agents thinking twice before assisting consumers with Anthem Blue Cross health plans.
I would not have believed it had I not witnessed it with my own eyes. When I renewed the Covered California health plan for a client her monthly premium amount she will be responsible for will actually be lower in 2017. Even though the carrier had an overall rate increase and she was another year older, the Advance Premium Tax Credit monthly subsidy calculated by Covered California will be larger in 2017. The net result is she will be paying less than $5 per month for the same Silver health plan in 2017.
Many Californians are facing sticker shock over the new health insurance premiums for their 2017 individual and family plans. Covered California and the insurance companies have pointed the finger at the elimination of the Affordable Care Acts reinsurance provision for the health plans. However, another contributing factor is the lower copayments on specific benefits Covered California has mandated in the new health plans. Consumers will be paying less for some out-of-pocket expenses. As the health plans must make up the difference for consumer’s lower cost-sharing, the rates must inevitably reflect this reality.
Covered California has implemented several changes to health plans to increase the access of doctors for patients. All EPO and PPO members will be assigned a Primary Care Physician and they have lowered the office visit copay for most plans, in addition to the no cost office visits for preventive care. But the one accessibility challenge that has not been addressed is the office hours of most doctors. It would make far easier for health care consumers to get care if they could visit their doctor in the evening or on weekends.
The Department of Managed Health Care (DMHC), who regulates most of the individual and family plans offered through Covered California, has developed a website to allow consumers to compare health insurance companies. The Health Plan Dashboard website does not assign any performance review ratings. But it does give consumers a high level view of some of the data collect on the health plans such as enrollment, complaints, and enforcement actions for medical, dental, and vision plans.
With Folsom Lake water levels low in the autumn of 2016, I decided to hike from Rattlesnake Bar up the North Fork of the American River to see if I could catch glimpses of gold rush era history. The terrain was far more difficult than I imagine. While I know the river canyon has change since the gold rush of 1849, I was surprised at just how arduous the hiking along this stretch of the river must have been for the gold miners.