Kevin Knauss: Health, History, Travel, Insurance
Posts on the development and implementation of the California health insurance market place, application, account, enrollment, termination.
One of the biggest questions I get is, “When will Covered California send me a bill for the health insurance?” Unfortunately, Covered California doesn’t invoice for the health insurance, that is left up to the insurance companies. If your application has been successfully transmitted to the insurance company you can make your first premium payment over the phone. Some applications have not, and may never, actually make it to your selected insurance company.
Applications submitted to Covered California in October and November are missing agent designations and have corrupted household information when received by one of the insurance companies. It is hard to know if these data corruptions are an aberration or if the problem may be more widespread in the Covered California system. The bottom line is that these individuals have received no billing information from the carrier and the agent is not the broker of record.
Consumers are growing frustrated as they find their current doctors aren’t included in new Covered California individual and family plan (IFP) health insurance networks. There is also widespread uncertainty about the rules of in-network providers with the new Exclusive Provider Organizations (EPOs) and California’s new 19 pricing regions. When California consumers are craving information the doctors have been silent and the insurance companies along with Covered California are providing scant information.
Covered California had high expectations for 21st century e-commerce technology but agents and consumers have resort to 19th century pen and paper. There has been an avalanche of paper applications into Covered California significantly slowing down the verification and enrollment process. The sluggish processing of applications means that some families may not have insurance coverage on January 1, 2014 as promised.
Covered California announced a marketing campaign aimed at the Lesbian, Gay, Bisexual and Transgender communities to encourage them to enroll in new ACA health plans through the exchange. The print media and billboard advertising is in addition to grants to LGBT organizations to provide outreach and education.
Covered California has estimated that nearly 100,000 households have started an application but have not selected a health plan. To help “Jump Start” these stalled applications Covered California will be distributing the contact information of these stalled applications to Certified Agents to call the applicants and offer assistance to help them make a health plan selection for an effective date of January 1, 2014.
Compared to existing small group quoting and enrollment systems from the insurers and the Cal Choice private exchange, the Covered California SHOP program seems a little clunky and unfinished. If an employer wants to realize the tax credits for contributing to employee health insurance premiums they have to have a small group plan through Covered California. Except for the option to purchase pediatric dental plans for dependent children, SHOP offers no adult dental or vision insurance.
Insurance Commissioner Dave Jones continues to wage not only a regulatory turf battle with Covered California over the issue of policy cancellations, he is also waging a war of words. No sooner had the California Health Benefits Board voted to continue with the planned cancellation of health plans for December 31st, Commissioner Jones fired off a press release to announce how unhappy he was at the Board of Covered California.
So many words have been spoken and written about the Affordable Care Act there is hardly an angle that hasn’t been touched. Obamacare101 podcast produced by Staci Joy is a well balanced presentation that features several different Californians that are touched by the ACA and Covered California, the state’s health insurance marketplace. Just like the ACA itself is controversial, some of the sincere comments by those recorded for the Obamacare101 podcast may leave one thinking, “Did he just say that?”
For a brief window of time, small businesses and nonprofits can enroll in a small group health plan without meeting all the minimum requirements. The Affordable Care Act has a special provision to encourage employers to offer a small group health plan to see if it is right for the employees and the owners. Consequently, some of the rules have been waived so that small groups can test the waters.
