2021 Covered California Renewal and Open Enrollment Changes

The renewal period in Covered California can be fraught with peril when making changes to your application. For 2021, it looks like Covered California has done a good job of separating 2021 from 2020 when it comes time for renewal. This should reduce errors from changes made inadvertently to the current year, when they were meant for the renewal year.

Renewing Covered California Coverage

Consumers can renew their health plans with changes to their household beginning on October 1^st. Then on October 31^st, the Covered California systems will begin automatically renewing existing members into their current health plan for 2021 with the current household information. Open Enrollment for anyone not already in Covered California begins November 1^st.

Even if you have been automatically renewed, you can still make changes to your household application (add or delete family members, change estimated income, etc.) for 2021. You can also change your health plan. But you must switch to a different plan by December 15^th if you want it to be effective January 1, 2021.

Health Plan Changes

There are very few changes to the standard benefit metal health plans for 2021. The biggest change is that the maximum out-of-pocket amounts for the Bronze, Silver, and Gold plans are increasing from $7,800 to $8,200 per individual, double for family. There were modest changes to the Gold plan copayments for primary and urgent care visits, plus imaging. The Bronze HDHP maximum out-of-pocket is increasing from $6,900 to $7,000. For a complete summary visit Covered California Health Plan Summary.

Income Update

It is very important to check your estimated income, especially if it is very low. For example, if you are a single individual, and your estimated annual income is $17,600 – which is Medi-Cal territory – you will be put into a Carry Forward Status. If you don’t increase your income, you will be determined Medi-Cal eligible for 2021. This is the same if you have children and your income falls below 266 percent of the federal poverty level under the new income chart.

The latest Covered California income chart is for 2020 enrollment for the 2021 plan year. Once the federal government announces the new 2021 federal poverty levels, which will be slightly higher, then Covered California will adjust the income chart to reflect the new income amounts. The new 2021 income amounts will apply to people applying for coverage in 2021.

Consumers enrolling in 2020 for 2021 coverage fall under the existing published income guidelines. Those income amounts will hold through out 2021 unless you make a change to your Covered California account, and then, the higher 2021 income levels will be applied.

Covered California expanded some informational responses on their application. When reviewing your application, make sure everything is properly checked marked. For instance, the is a an expanded information section on the tax filing status of household individuals. Otherwise, the renewal process is like submitting your application for the first time where you have to read and check mark all the disclaimers and then get an eligibility determination.

For the 2021 plan year, the default is your 2020 health plan. The system will not automatically give you a comparison. You need to “Go Shopping” and use the Shop and Compare Tool to view your options. However, in the Shop and Compare Tool, it will highlight your existing plan.

Health Plans Expand in California

You may see some plans that were not available in 2020.

• Anthem Blue Cross will be offering HMO plans in Orange County
• Anthem Blue Cross will expand their EPO plans to Imperial, Inyo, Kern, and Mono counties
• Oscar will expand their EPO plans into San Mateo County

For adult dental options, Blue Shield DPPO and DHMO plans will be offered in most regions of the state. Guardian DPPO will take over for Premier Access. If you have Premier Access DPPO it may be terminated and you have to enroll in Guardian. Otherwise, the dental selection, if still offered for 2021, should rollover into the new year.

Rate Increase?

Pay no attention to any reports of increasing or decreasing health insurance premiums for 2021 when it comes to subsidized Covered California enrollment. First, your rate will increase because you, and everybody in your household is another year older. Rates are based on age. Second, the subsidy is based on the Second Lowest Cost Silver Plan.

If the Second Lowest Cost Silver Plan (SLCSP) increased by more than your plan, your subsidy will be larger. As in this example, Kaiser is the SLCSP. If you have the Blue Shield PPO Silver that had a premium decrease, and your income is the same as last year, you will receive a larger monthly subsidy. This larger subsidy may off set the increase for the age rate increase.

If the SLCSP rate decreased, from 2020 to 2021, but your health plan rate increased, the subsidy will drop. In this example, the SLCSP Blue Shield PPO has a rate decrease of 2.2 percent, while the Kaiser Silver plan increased by 3.7 percent. Some Kaiser members may realize a rate increase greater than the Kaiser rate increase because the SLCSP plan decreased. The SLCSP can change every year, and can be different for different ages.

Medi-Cal continues to be a complicated situation with Covered California. If, through the renewal process or Open Enrollment, you are erroneously determined eligible for Medi-Cal (usually caused by an income date error), guidance states you have until 8 PM that evening to make a correction in the Covered California application. After the cut-off time, the information is sent to the county Medi-Cal office and no changes can be made.

Once you or one of your household members has been determined eligible for MAGI Medi-Cal, you must work your county Medi-Cal office to change that determination. If you attempt to report changes on your Covered California application, they will eventually be disregarded. All changes must go through Medi-Cal even ones not related to income such as a change of address or adding a new family member.

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