A group of Covered California Certified Insurance Agents have begun organizing the early stages of a class action lawsuit against Covered California for unpaid compensation. Led by John Dickey who earlier took Covered California to small claims court, the goal is to enlist enough health insurance agents with verifiable losses to establish a base for a class action law suit against California’s Marketplace exchange.
2014 Open Enrollment
It is no secret, and Covered California readily admits, that there were challenges when it came to proper attribution of the Certified Insurance Agent on new enrollments during open enrollment beginning in 2013. Consumer enrollments in private health plans facilitated by an insurance agent that were transferred to the consumer’s chosen health plan were at times missing the agent information. This occurred with online applications submitted through Covered California’s CalHEERS program and with paper applications faxed over to the exchange.
Agent delegation and Medi-Cal
Some agents still have not been properly delegated as the agent of record with some carriers on Covered California enrollments. In addition, Covered California announced in 2014 that agents would be paid $58 for each household that was determined to be Medi-Cal eligible after their application had been submitted by an agent. While some agents have been paid the Medi-Cal compensation, many have not. Covered California recently announced that they will no longer be compensating agents the $58 as apparently the California budget no longer supported the compensation arrangement, according to an email letter received by agents.
While there is the issue of unpaid commissions because the agent was never delegated in the Covered California system or properly transferred to the health insurance company, many agents experienced long delays in receiving commissions for their small employer group plans enrolled through Covered California. Some agents received no commission for close to a year on these groups. In May Covered California finally started sending out sporadic commission checks to agent. Some agents feel that if a commission check is over 60 days late, Covered California should have to at least pay interest on the unpaid commission.
But before any class action lawsuit can move forward, the Pasadena law firm handling the potential lawsuit must garner enough agents who were certified to enroll consumers on the Covered California exchange with verifiable losses to establish the class. Specifically they are looking for agents who have
1) unpaid commissions for any and all carriers for enrollments done through Covered CA;
2) unpaid commissions from any and all carriers on enrollments done outside of Covered CA;
3) unpaid commissions for Medi-Cal enrollments; and
4) any other damages that an agent wishes to share not directly tied to unpaid commissions.
If you are such an agent, please contact John Dickey at
to add your name to the list of Certified Insurance Agents who have incurred losses as a result of Covered California actions.