When I looked at the submitted application – there it was – I had to have selected the permanently moved to California QLE which is below loss of coverage. The permanent move to California QLE triggers the standard effective date of the 1st of the following month, in this case August 1st. So the family really did not have insurance for July!
So why is this significant? Because Kaiser was sending statements to the Covered California household for past due balances greater than one month. They were also sending termination notices even though they had already sent Covered California cancellation of the plan and Covered California terminated the enrollment. But Covered California will not investigate the erroneous terminations. They just tell the agents and consumers they have to deal with the health plan. In this case, the family has sent voluminous amounts of documents to Kaiser showing they made their premium payments.
I cannot vouch for the veracity of the image or its location in a public park. But the comments from individuals on Nextdoor were interesting because of how they broke along gender lines. Most women who commented were shocked and saddened at the noose display. Men who commented were generally dismissive and sarcastic in their replies.
It started as a small idea to honor regional Sacramento residents for their contributions to preserve our history, historical buildings and infrastructure. It quickly ballooned into a gala event that was very challenging for the small Sacramento Historical Society organization. Fortunately, we all kept the goal of acknowledging the substantial accomplishments of so many deserving people first and foremost as we organized the event.
Covered California consumers are penalized for having the good fortune of their household income’s increase. To add another layer of insult, if the consumer makes over 400% of the federal poverty level, they have to repay all the monthly tax credit subsidies they received during the year and pay for an artificially inflated Silver plan rate. Ouch!
QR codes can be read by a smart phone to open a website, map, or other internet function. From the Medicare description above, the QR code would be used for quality control and not be able to open any website with the beneficiary’s information on it.
Under the Department’s new rule, AHPs can serve employers in a city, county, state, or a multi-state metropolitan area, or a particular industry nationwide. Sole proprietors as well as their families will be permitted to join such plans. In addition to providing more choice, the new rule makes insurance more affordable for small businesses. Just like plans for large employers, these plans will be customizable to tailor benefit design to small businesses’ needs. These plans will also be able to reduce administrative costs and strengthen negotiating power with providers from larger risk pools and greater economies of scale.
The steps for reporting a change in CalHEERS have been significantly reduced. It is no longer required to provide reason and event date information multiple times when reporting a change for your consumer like address change, income updates, etc. Currently, if a household reported a change, the user was prompted to enter the reason and date multiple times, and even when not warranted. This has been updated to only ask reason and date if a household member is to be removed from the application or the plan. If the member is a primary contact or primary tax filer or primary care giver, then an option will be provided to identify a current household member in the role.
The health plan line-up includes the standard small group benefit design metal tier plans and a mix of what Oscar calls “Classic” and “Saver” benefit designs. The Classic and Saver benefit designs will have lower premiums because the members have a higher maximum out-of-pocket amount or a coinsurance percentage.
For eligible members, there is no additional cost to participate in this program or for services provided by Landmark. Covered services provided by non-Landmark providers through a referral from Landmark may be subject to cost-sharing based on members’ health plan benefits and coverage.