Covered California

Posts on the development and implementation of the California health insurance market place, application, account, enrollment, termination.

Covered California Rate Change Announcements are Meaningless

August 2, 2021 By Kevin Knauss Leave a Comment

The ceremonial announcement of health insurance rate changes, usually a modest increase, is meant for the consumption of politicians, elected officials, regulators, special interest groups, and the media. You know, all those people who have group health insurance and are not subject to the vagaries of the ACA subsidy calculation. The reality of what most consumers pay for their health insurance through Covered California is far more complicated than a celebratory press briefing announcing a 1.8 weighted average percent increase.

Unemployment + Covered California = Big Subsidy

July 16, 2021 By Kevin Knauss Leave a Comment

The unemployment subsidy benefit further increased the subsidy. Because everyone was now eligible for the Enhanced Silver 94 plan, we switched this member from the Gold to the Silver plan. The new subsidy of $1,016.53 dropped the health plan rate to $1 per month. The better member cost-sharing for copayments and coinsurance will save the family even more money.

Why can’t I buy health insurance when I need it?

July 1, 2021 By Kevin Knauss Leave a Comment

Adverse selection is wanting to enroll in health insurance under adverse conditions. The health plans, and society in general, wants everyone in the insurance pool from the beginning. When people climb out of the pool – drop coverage after getting treatment – the big health care bills must be covered by the remaining people in the pool. That raises the rates for everyone in the pool, and that’s not fair.

Covered California Unemployment Subsidy Boost

June 16, 2021 By Kevin Knauss Leave a Comment

Covered California will begin processing the extra subsidy increase for applications that indicate unemployment benefits on June 21, 2021. The unemployment insurance benefit could have been for just one week in January. The household income will be taken down to 138.1 percent of the federal poverty level, regardless of the income estimated by the consumer. The 138.1 percent income level will prevent adults from being automatically determined eligible for Medi-Cal. The new subsidy will be based on the lower income and applied to the health insurance premium.

Is Covered California Killing Small Group Plans?

June 10, 2021 By Kevin Knauss Leave a Comment

Based on the real-world comparisons I’ve done for individuals and families in small group plans, most would benefit from enrolling in Covered California. Anecdotally, I’ve talked to several employers who either have or are considering terminating their group coverage.

To Change Your Covered California Plan, Don’t Terminate Existing Health Insurance

May 26, 2021 By Kevin Knauss Leave a Comment

If you disenroll from your Covered California health plan and then try to enroll in a new plan, the system won’t give you the Advance Premium Tax Credit subsidy to lower the monthly premium. That is why it is crucial to use the change plan process in the Covered California system.

Should You Select A Covered California Enhanced Silver Plan?

May 11, 2021 By Kevin Knauss Leave a Comment

You don’t have to qualify for a Silver 94 to get a great deal. A 57-year-old individual with an estimated income of $30,000 in Nevada County will receive a subsidy large enough to make the lowest cost Silver plan from Anthem Blue Cross $1, the same as all the Bronze plans. Even the Blue Shield PPO Silver 73 at $85.11 is a better value than either the Gold or Platinum plans offered.

Has Your Child Been Kicked-Off Your Covered California Plan?

May 4, 2021 By Kevin Knauss Leave a Comment

What is most distressing to parents is that they are learning of the loss of coverage from their health plans, not Covered California. One account showed the child was still eligible for health insurance through Covered California through May, but the carrier had sent a notice of termination for April 30th.

App-Based Driver Proof of Health Insurance Form from Covered California

April 29, 2021 By Kevin Knauss Leave a Comment

The Proof of Coverage form must be submitted by the app-based driver, or other gig worker entitled to the health insurance stipend, in order to receive the stipend from the company. Covered California has done a great job of putting an easy link on top of the member’s home page. With one click, the most recent quarter’s Proof of Coverage form is generated in a PDF document.

MAGI Medi-Cal Income Budget Period Calculation Changes

April 28, 2021 By Kevin Knauss Leave a Comment

The Department of Health Care Services (DHCS), the agency that manages the county based Medi-Cal system, has worked, and struggled, to efficiently determine MAGI Medi-Cal eligibility from the income section of the Covered California application. In a February 19, 2021, All County Welfare Directors letter, No. 21-04, DHCS outlined some of the changes to Modified Adjusted Gross Income (MAGI) calculations for MAGI Medi-Cal eligibility determinations.

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Covered California