Covered California

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

Covered California’s Voter Registration Numbers Don’t Add Up

August 30, 2017 By Kevin Knauss Leave a Comment

After sifting through all the reports and data, I’m not sure if either agency is accurately reporting voter registration inquiries through Covered California. While the online registration numbers look comparable between the Secretary of State and Covered California, it is unclear if the data is a measurement of a click to open an online registration web page or an actual complete voter registration action. The voter registration card requests from Covered California seem wildly inflated compared to what the counties are reporting to the Secretary of State. However the Secretary of States figures may also be corrupt by potentially erroneously high requests posted by San Bernardino County and the lack of requests from huge counties such as Los Angeles.

Sacramento Business Consultant Offers Recommendations For Fixing Obamacare

August 24, 2017 By Kevin Knauss Leave a Comment

Based on the data I’ve seen, the ratio of the actuarially fair cost differential of insuring someone in their 20s and someone in their late 50s or early 60s is roughly 5 to 1. Setting the ratio at 3 to 1 causes distortions that unfavorably impacts young adults and, as a result, degrades the risk pool. Insurance companies are reluctant to put themselves in a position in which they risk losing money with additional customers and will set prices for older adults so that they can recover their costs in that age group. The 3 to 1 ratio limits how much they can reduce premiums for young adults. The resulting premiums represent “unfair” insurance for young adults and discourages them from purchasing insurance. Discouraging young adults from purchasing insurance exacerbates the adverse selection problem in the insurance market and reduces the incentive for insurance companies to compete for older customers.

I Lost My Blue Cross Health Insurance, How Do I Find A Replacement?

August 8, 2017 By Kevin Knauss 2 Comments

If you reside in any of the above counties you will be able to keep your EPO plan. If you reside in any other county, and you have an Anthem Blue Cross EPO or HMO plan, through Covered California or off-exchange, you will need to select a new insurance carrier for 2018. The exit of Blue Cross from the individual and family market does not affect employer group health insurance plans or their Medicare Advantage plans.

Secrecy Surrounds Covered California Health Insurance Rate Determinations

July 28, 2017 By Kevin Knauss Leave a Comment

Both DMHC and CDI make their rate review process as transparent as possible to the public. This is not the case for Covered California. The reason Covered California gets to negotiate rates in secret is because the health plans are considered contractors and the rates are considered bids. I learned this after I filed a Public Records Act request asking for the rates submitted to Covered California.

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

July 27, 2017 By Kevin Knauss 2 Comments

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.

Covered California To Include Sexual Orientation And Gender Identity Questions

June 23, 2017 By Kevin Knauss Leave a Comment

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.

Artificially Inflating Covered California Silver Plan Rates May Cause Chaos

June 19, 2017 By Kevin Knauss 9 Comments

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.

Covered California, The Marketing Arm Of Health Insurance Companies

May 26, 2017 By Kevin Knauss Leave a Comment

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.

Covered California Has Terminated Thousands Of Agents And Navigators

May 12, 2017 By Kevin Knauss Leave a Comment

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.

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

April 29, 2017 By Kevin Knauss Leave a Comment

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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