For independent health insurance agents, such as me, who don’t have access to an already established secure network through a large agency, we have to be more diligent in securing all the different parts of the internet communication puzzle.
Covered California
Posts on the development and implementation of the California health insurance market place, application, account, enrollment, termination.
Deflating income under 400% to keep health insurance subsidy
Built into the Affordable Care Act is the loss of the health insurance subsidy when the household income exceeds 400% of the federal poverty line. For older adults whose income might be greater than 400% of the federal poverty line they face losing the Advance Premium Tax Credits that makes their health insurance premiums affordable. In some instances the health insurance premiums can shoot up to over 20% of their income.
Medi-Cal advocate smears health insurance agents
Medi-Cal advocate Beth Capell smeared the reputation of all health insurance agents by insinuating that agents enroll Medi-Cal eligible children in private plans just for the commissions they derive from those enrollments. Ms. Capell is assuming, incorrectly, that all health agents put money above the best interest of their clients. It’s unclear where Ms. Capell’s animus towards health agents springs from when thousands of agents have assisted tens of thousands of families with enrollment in Covered California and Medi-Cal health plans.
No more letters from Covered California
In a March update to the Covered California enrollment software, individuals and families who indicated their preferred method of contact was email will actually start to get notifications from Covered California to their email addresses. The email will alert the consumer that there is an electronic letter in their secure Covered California Mailbox. This doesn’t mean Covered California will stop sending out reams of confusing letters to members, it just means that people can read them or delete them online.
Removing a household member from Covered California
There are a variety of reasons why a household member needs to be removed from a family’s Covered California account. In some unfortunate instances a family member has died. Other times a young adult ages-off the plan or a spouse gains other coverage such as Medicare.
County Medi-Cal Eligibility Questions and Answers
Two years after the launch of Covered California and expanded Medi-Cal, California’s Department of Health Care Services and each of California’s fifty-eight counties, that individually administer Medi-Cal managed health plans for eligible residents, are still grappling with numerous questions regarding eligibility, enrollment, and the integration with the Covered California application.
Covered California updates income reporting and former foster youth enrollment
On March 7 Covered California updated their online enrollment program with adjustments to how changes to income are calculated, plus new required fields for attestations from former foster youth. The Covered California CalHEERS program was also updated with new federal poverty level (FPL) incomes. A significant update will affect children in San Mateo, San Francisco, and Santa Clara counties where the higher household income of 322% of the FPL makes more children 18 years and younger in those counties eligible for Medi-Cal.
Does Covered California think you are in jail?
Covered California has released a form for consumers to attest that they are not in jail or incarcerated. Consumers who purchase health insurance are ineligible for the premium assistance tax credits if they are in jail or incarcerated in a prison. It’s unclear how Covered California knows if an individual is in jail or why, if they have been released, they aren’t alerted that a person has been released from custody.
Medi-Cal set to snatch Bay Area kids from parent’s plans
Covered California sent out a notice that some children in the Bay Area will be deemed Medi-Cal eligible and will be taken off their parent’s health plan as of April 1, 2016. The expanded Medi-Cal kids’ option only applies to the Bay Area counties of San Mateo, San Francisco, and Santa Clara. Because these counties have a higher cost-of-living, they have higher income eligibility for the Medi-Cal kids program. Whereas most families have their children dropped in Medi-Cal if their Modified Adjusted Gross Income is below 266% of the federal poverty line (FPL), in these Bay Area counties children qualify for Medi-Cal with a household income of 322% of the FPL.
Comparing VSP vision insurance from Covered California
Covered California has struck a deal with VSP vision insurance plans to offer Covered California members vision insurance. The VSP vision insurance plan is only available to Covered California members. For the bare essentials of vision coverage, the VSP – Covered California plan is very competitive when compared to other insurance plans on the market. However, there are some eye wear options that don’t have specific copayment amounts and could cost the plan member more in the long run.
