Covered California Shop and Compare Tool for 2017 is giving bad results by including children in premium results who are Medi-Cal eligible by virtue of the household income.
The new Covered California Shop and Compare Tool, launched in late September 2016, is broken. The comparison to tool to allow consumers to estimate their monthly subsidy and compare health plans has been giving erroneous results. The worst part is that Covered California has known about the issue and has failed to alert consumers or agents that the tool is giving bad results.
Bad Results with New Shop & Compare Tool
The re-designed Shop and Compare Tool was meant to mirror the health plan selection page of the Covered California enrollment application inside the CalHEERS program. The older Shop and Compare version was generated from an external database of information according to Covered California during a webinar in late September. It was during this webinar that Covered California said the new Shop and Compare Tool was going to be more accurate…it isn’t.
Less Consumer Information is not Good
Immediately, I noticed that the Shop and Compare Tool gave less information. For instance, the old version would let you look at the member details such as the rate per person and if any of the dependents were Medi-Cal eligible. While I was getting a quote for one family, the 2017 Shop and Compare Tool indicated that the monthly rates and Advance Premium Tax Credit was for 3 adults and 2 children. But there was no way to tell if the children were considered part of the monthly rate because the new comparison tool doesn’t give that detail.
Are the Children Medi-Cal or Not?
For this particular family, I knew the two youngest children were Medi-Cal eligible because the household income was $72,000. According to the Covered California 2016 income table, a family of 5 would have to earn over $75,651, over 266% of the federal poverty level, for the children, 18 years old and younger, to qualify for a private health plan with the subsidy. But the Shop and Compare Tool displayed a rate and subsidy for all five household members.
| Various Results | Actual Enrollment | S&C 3 Adults | S&C 3 Adults, 2 Children |
| Monthly Rate | $615.99 | $698.35 | $647.51 |
| Subsidy | $511.36 | $429.00 | $780.00 |
| Unsubsidized Rate | $1,127.35 | $1,127.35 | $1,427.51 |
S&C: Shop and Compare Tool of Covered California. Results as of 10/28/2016.
Covered California Enrollment is Correct
After I enrolled the family and got the real health plan premium and subsidy dollar amounts, I checked it against the Shop and Compare Tool. I did a plan and subsidy comparison for a family of 5 (and for a family of 3, all with the same ages. If I entered a household of 3 adults (same ages, zip code, and income) into the Shop and Compare Tool, it returned a monthly rate and subsidy that is exactly equal to the total premium for the 3 adults. In other words, the rate table is correct, but the subsidy is wrong.
Not Removing Children Based on Income
The major issue with the new Shop and Compare Tool is that it does not remove Medi-Cal dependents, children 18 and younger, from the displayed results page. The consumer assumes that their children will be covered by a private plan with the tax credits. In addition, the new comparison doesn’t give the individual cost break down by family member. Now that Covered California allows family members to select different metal tiers and health plans, it’s important to know the individual rates. Families can potentially save money by selecting a higher benefit plan for a member who needs extra health care services, while the remaining family enrolls in a lower benefit, less expensive, health plan.
Why Hasn’t Covered California Told Us?
The one tool that is supposed to help consumers decide on a health plan is broken. The other crime is that Covered California has not seen fit to alert the public to the problem. Consequently, consumers are being given misleading information on which to base their health plan selection for 2017. The plan selection page within the application seems to work fine for household’s renewing their health plan. (There may be some issues with the Bronze rate premiums when the subsidy is greater than the monthly health insurance premium.) But if a consumers doesn’t have access to their account, but wants information on health plan alternatives and costs, the Shop and Compare Tool, just days before Open Enrollment for 2017 is set to begin, gives false results.
Use the Income Table
Until the new and improved Shop & Compare Tool is fixed, it should only be used as a general guide in conjunction with the Covered California Income Table. The income table indicates at which levels children are Medi-Cal eligible and will not be offered private health insurance with the subsidy.
Close is NOT Good Enough
Even though the current Shop and Compare Tool generates a monthly health insurance rate that is pretty close to the actual amount, within 5% for my family, it still is broken. Covered California can do better for the health insurance consumers of this state. One of the goals of Covered California was to provide more transparent comparisons between health plans. But with a broken Shop and Compare Tool, they are providing more reasons for consumers to distrust them, health insurance carriers, and the market overall.
Covered California Shop and Compare Tool Instructions
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