Kevin Knauss: Health, History, Travel, Insurance
Posts on the development and implementation of the California health insurance market place, application, account, enrollment, termination.
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.
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.
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.
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
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.
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?
Covered California has given their online health insurance enrollment system a serious make over with the release of the CalHEERS 17.2 build. Not only has the user interface been enhanced, members must now enter their employer’s contact information before they will be eligible for the monthly subsidy. In addition, Covered California will begin notifying a member’s employer when they enroll or renew their Covered California health insurance.
Consumers who purchased health insurance through Covered California may be receiving revised 2016 1095-As without requesting one. The revised 1095-As are popping up in consumer’s Covered California accounts and being mailed to them. Consumers should carefully compare the original 1095-A sent out by Covered California to the revised document to make sure it is correct.
After Covered California acknowledged at the January 2017 Board meeting that they had system issues that affected over 40,000 consumers, new enrollment problems seem to be boiling up. Some consumers have reported that household members who are ineligible for Covered California family dental plans have been automatically enrolled in dental insurance in 2017. In some very rare instances, the Covered California system is allowing consumers to actively enroll in two different subsidized health plans.
Covered California has been studying how different changes to the ACA will impact their ability to meet their projected budget and offer affordable health insurance to consumers. At the Covered California January Board meeting they released six reports they commissioned that studied consumer attitudes toward health insurance and potential changes to the ACA.
