Kevin Knauss: Health, History, Travel, Insurance
Posts on the development and implementation of the California health insurance market place, application, account, enrollment, termination.
Through casual conversation and on various Internet forums numerous agents and brokers have mentioned they arent getting paid commissions for business they submitted through Covered California. Is there a crisis of commissions not being paid to Certified Insurance Agents? Without reliable data from the agent community it is hard to tell if the missing commissions […]
Medi-Cal health insurance premiums paid to managed care health plans or Health Maintenance Organizations (HMOs) is a sizeable sum of money. The California Department of Health Care Services estimates the average monthly cost for each Medi-Cal beneficiary is $611. Expanded Medicaid, where families earning less than 138% of the federal poverty line are automatically enrolled in Medi-Cal through Covered California, encompasses a population who is often healthier and use fewer health care services than beneficiaries who qualified under the original Medi-Cal rules.
Covered California’s Small Business Health Options Program (SHOP) announced on May 7th that agent commissions will once again be delayed. This comes on the heels of last months announcement that SHOP hoped to pay commissions at the end of April. SHOP has had to completely move all billing data for the small groups enrolled onto […]
Aside from the enumerable website issues of both Healthcare.gov and Covered California, perhaps the largest problem of the ACA open enrollment centered around accessible and reliable information concerning how to enroll for the new ACA health plans. California health agents and brokers, who were handling hundreds of client enrollments each, bore the brunt of this […]
Covered California has been listed as a Gold sponsor of the California Association of Health Underwriters (CAHU). In late 2009 CAHU was very vocal that the Patient Protection and Affordable Care Act should not be passed by congress. A CAHU Gold sponsorship costs approximately $10,000 according to their website. It would be interesting to know what Covered California believes it is getting for the sponsorship?
As the date for the ACA open enrollment approached, most health insurance agents were nervous about what to expect and what role they might play in helping clients enroll in the new health plans. This anxiety was enhanced by the cold shoulder given them by Covered California and the health insurance companies in terms of training and information. At the end of open enrollment, many agents felt as if they had been abandoned by the carriers and Covered California while trying to help their clients. This has left some agents wondering if now is the time to organize into a guild and work for better training, enrollment tools and fair compensation for the assistance they provide to their clients.
Different interpretations of monthly verses annual income estimates on the part of Covered California and county Medi-Cal administrators have the potential to leave many Californians who are drawing unemployment benefits without any health insurance. At least one person has been denied the ability to purchase a private health plan with ACA tax credits while being simultaneously excluded enrollment in the ACA expanded Medi-Cal health plan. The conflicting interpretations can leave many people ineligible for either ACA tax credits or Medi-Cal.
Individuals and families who have enrolled in health plans through Healthcare.gov, or a state exchange like Covered California face new challenges as they report income and household changes. Families reporting changes to household size and income may also be triggering changes to their health plan. These changes may result in the entire family becoming eligible for Medicaid, being shifted into a different Enhanced Silver plan or losing the Advance Premium Tax Credit all together.
Just as Covered California will continue to let Certified Insurance Agents enroll individuals and families in the new ACA health plans, Health Net of California will also accept new applications for enrollment. Applications for both Covered California and Health Net must be submitted by April 15th for a May 1st effective dates. This is only for new enrollments and not for plan changes between carriers.
Consumers who were unable to create an online account or start their online application because of technical difficulties can contact a Covered California Certified Insurance Agent to explain that they attempted to get through on March 31 and experienced difficulties. Those consumers will have until 11:59 p.m. April 15 to work with the Certified Insurance Agent to complete their application and choose a plan.
