Kevin Knauss: Health, History, Travel, Insurance
Posts on the development and implementation of the California health insurance market place, application, account, enrollment, termination.
Consumers, agents and Covered California representatives have been flummoxed over how to change the household health insurance plan after the account has been automatically renewed by Covered California for 2016. It may have come as surprise to Covered California that not everyone wants to renew their current 2015 health plan. After Covered California automatically renewed the health plan there is no visible way to change the plan…unless you know the trick.
In the last week as I’ve been bombarded with feel-good press releases from Covered California about their grand and glorious bus tour across the state promoting themselves and open enrollment, I’ve also been working with several cancer patients trying to find a health plan. From a person who is in the trenches working to enroll consumers in the best fit health insurance, the Covered California road show displays how their bus has taken a wrong turn down Marketing Lane. Californian’s need help finding health plans that include their doctors, hospitals, and cancer drugs. They could care less about a bunch of people riding around on a bus promoting their selves.
Covered California is cancelling the Advance Premium Tax Credit subsidy that lowers a household’s monthly health insurance premium for 2016 for some consumers. Through Covered California’s automatic renewal process I’ve seen several families’ tax credits disappear for 2016. Without intervention or explanation, many families who had their health insurance automatically renewed may receive a bill for the full premium amount because the tax credit subsidy was eliminated by Covered California.
At some point you get tired of dealing with idiots. At some point you need to complain with the full understanding that nothing changes because government bureaucracies and private corporation sucking off a government contract never change. As my phone showed I had been on hold for over four hours with Covered California’s agent support Pinnacle Management, I was able to finish writing the following complaint forms to Covered California.
The Northern California mother was distraught to learn that her daughter, who she thought was attending college in San Jose, was in jail. The letter from Covered California clearly stated under her daughter’s name, “The records show that you are incarcerated (in jail or prison).” For this woman, for whom English is a second language, she was panicked that her daughter was in jail, her daughter had lied to her, and the whole family might lose their health insurance. In reality, this cruel hoax on the mother is the result of a miserably drafted eligibility letter using questionable data sources.
Mr. Polk learned from his CPA on April 7th, 2015 that he owed $13,230.43 for the repayment of excess APTC for 2014. The CPA had properly taken the Covered California 1095-A and completed IRS form 8962 Premium Tax Reconciliation. It was clear on form 8962 that the addition of the Polk’s social security retirement income and tax-exempt interest had pushed the Polk household income over 400% of the federal poverty line.
Covered California has awarded quality star ratings to health plans based on just two questions from a questionnaire surveying consumer’s experience in 2014. In addition, the quality ratings were based on a completed sample size of approximately 100 respondents out of 1,000 surveys sent out.
Covered California has released new Job Aids that review and describe some of the changes they have made to their online enrollment application. Many of the new functions address deficiencies in the original software, other features to help consumers more easily report changes, and the new addition of enrolling in a family dental plan.
Covered California Certified Insurance Agents assisted 429,365 individuals for possible enrollment into the expanded ACA Medi-Cal health insurance from January 1, 2014 through July 31st, 2015. The Medi-Cal assistance enrollment figure comes from a Public Records Act Request that I submitted in early October of 2015 to Covered California. As the $58 compensation to agents for Medi-Cal enrollments ceased over the summer I felt it was important to learn the level of agent involvement with funneling Californians in Medi-Cal health plans.
I wouldn’t have believed if I had not seen with my own eyes. For months the Covered California account of a client showed one of the household members enrolled in an Anthem Blue Cross plan. Then one day it disappeared. All Covered California can say is that they don’t see the member ever being enrolled. The client continues to pay for the phantom Anthem Blue Cross that Covered California says never existed. How was this enrollment information erased?
