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Covered California

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

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IT Issues Prevent IRS From Easily Verifying Correct ACA Subsidies For Tax Filers

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31,493 tax returns – programming errors caused the IRS to incorrectly compute the allowable PTC amount. As a result, 16,375 taxpayers potentially received approximately $5.2 million more in the PTC than they were entitled to receive, and 15,118 returns potentially received approximately $6.7 million less in the PTC than they were entitled to receive. IRS management informed us that programing was updated on or before July 31, 2016. We will evaluate the IRS’s corrective action in our annual assessment of the 2017 Filing Season.

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Covered California To Include Sexual Orientation And Gender Identity Questions

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One of the first changes consumers and agents will notice is under the information for household members. For the question of Sex (which should be gender), in addition to Male and Female, the drop down box will include Transgender: Male to Female and Transgender: Female to Male. While selecting the Sex is required, the Covered California application does not alert the consumer to the fact that rates are not based on gender AND you cannot be denied health insurance or receive a higher rate because you are transgender.

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Artificially Inflating Covered California Silver Plan Rates May Cause Chaos

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But how does an enrolled individual in a standard Silver 70 plan, who is not eligible for the CSRs, feel about subsidizing lower income plan members? Could the argument be made that some individuals are paying an inflated premium, close to a Gold plan, but only receiving Silver plan level benefits? At a very minimum, the inflated Silver plan rates are a distortion of the health insurance market place. One of the goals of the ACA and the exchanges like Covered California was to bring more transparency and accountability to the health plan selection process for consumers. If the inflated Silver plan rates, along with artificially inflated subsidies, do become a reality, the market place for health insurance will take a step backwards as plan selection becomes more confusing for consumers.

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Covered California, The Marketing Arm Of Health Insurance Companies

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In a certain sense, Covered California is no different than any other agent trying to enroll consumers and earn a monthly commission. I suppose there are other industries that must spend 1/3 of their forecasted revenue on marketing just to maintain their sales, but the percentage seems excessive on the face of it. You have to wonder how sustainable a business model is if spending 33% of the budget on marketing is necessary for survival. It also raises the question of if the exchange based model is the most efficient means of qualifying consumers for the Premium Tax Credit and distributing the subsidy.

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Covered California Has Terminated Thousands Of Agents And Navigators

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A review of 50 randomly selected terminated Covered California agents, as of May 12, 2017, showed 36 agent licenses were still authorized to transact insurance through the California exchange when reviewed through a DOI license search. 10 of the agents showed no authorization for Covered California. 3 agents were listed as Inactive and 1 had their licensed revoked. Of the fifty agents, 5 resided outside of California; 4 from Florida and 1 from Arizona.

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Using Medi-Cal During A Union Strike To Keep Health Insurance

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When a union goes on strike it can be difficult for union members and those trade members associated with the union to keep paying their health insurance premiums with either reduced or no income. There are options to maintaining health insurance if you know the rules of the health insurance game. These rules revolve around Special Enrollment Periods with the qualifying event of loss of coverage.

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Medicare Advantage Health Plans As Blueprint For Replacing Affordable Care Act

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The similarities between Medicare Advantage plan and the ACA plans through the Marketplace are straight forward. Individuals are enrolling in private ACA health insurance and the federal government is subsidizing part of the cost of the health insurance to make it affordable. One of the main differences is how the federal government reimburses the insurer. Medicare beneficiaries receive an indirect subsidy to purchase a Medicare Advantage plan according to county they live in and based on historical health care cost data. Individuals and families enrolling in a health plan through an Affordable Care Act exchange receive a subsidy based on their income.

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Covered California Income Verification, Attestation, Affidavits

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Covered California has made several changes to their income section both to the user interface and behind the scenes. In February, the income section of the online Covered California application was restyled to be more user friendly with little icons representing family members. Behind the scenes, new triggers for income verification were implemented. Plus, Covered California is trying to move away from consumers submitting affidavits and offering an income attestation form

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My Covered California Clients Would Lose $157 Per Month Under Trumpcare

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In order determine how my clients might be affected by the proposed new Premium Tax Credits under the American Heath Care Act (AHCA or Trumpcare) introduced by the Republicans in March 2017, I compared the current income based Premium Tax Credits under the ACA to the new age based tax credits of the AHCA. On average, my clients included in the comparison will lose $157 per month to help pay for their health insurance. Young individuals, under 30 years old, have the smallest change of premium tax credit under the age based rules. Within my clients, people over 55 year old will get hit the hardest losing $200 to $400 per month in premium tax credit assistance.

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Is Trump Planning To Neuter Covered California?

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Given the Republican philosophy that less government is better government, Covered California’s reason for existence may evaporate. But it all hinges on Trump’s term ‘transition’. Does he want to transition away from the Marketplace Exchanges, or is he merely suggesting transitioning away the Qualified Health Plans as a requirement for the tax credit?

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