Covered California is ratcheting up the emails and letters to consumers on a variety of topics from immigration verification to renewing their health plans for 2015. Some of these letters for additional information, consent, or to manage verifications will ultimately be confusing to the consumer. In a Certified Insurance Agent webinar, Covered California went over the flow the letters to be sent, automatic renewal, and the new pediatric dental plans.
Agent webinar explains renewal letters and notices
While the webinar tried to be specific as to the consumer correspondence from Covered California, agents have already received email correcting previously sent emails on letters being sent. There was a promise by Covered California in the webinar to have better communication with agents so we can field client phones with better information.
Department of Managed Health Care \"Initial PDF Pipeline\" documents filed by the carrier for their 2015 premium rate review. The PDF Pipeline covers the majority of documents filed with DMHC for the review of their proposed rates. Other spreadsheets referenced in the PDF Pipeline document can be found at the DMHC website under the respective carriers filing.
|Category:||Rate Filings 2015|
|Date:||August 25, 2014|
Some of the highlights of the Individual Marketplace Agent Training: Renewal and Auto-Enrollment presentation are-
- Shop and compare tool now has 2015 rates and is no longer any good for SEP enrollments. The 2014 rates are still available on the mobile application if you havent updated the app.
- Future changes to any client account will need to be identity proofed.
- It doesnt sound as if the doctor search tool will be working for 2015 enrollment. CC is instructing members to check with their health plans to determine if providers are in-network and prescription medications will be covered.
- If Covered California receives no updates from the member, they will be auto-enrolled in the same plan if it is available with the same tax credits. If the consumers plan no longer exists, like a Catastrophic dropped by a carrier or Health Net terminating their IFP PPO plans across California, CC will migrate the consumer to a similar plan.
- Stand-alone pediatric dental plans are being terminated. All new IFP will include childrens dental benefits. Family dental plans will also be available on the exchange sometime in 2015, but they will receive no tax credits to reduce the monthly premium.
A variety of letters will be sent to Californians currently enrolled in health plans.
Consumer letters from Covered California
|NOD17||July/August||Create an online account|
|NOD11||August/September||Authorization to verify income, federal hub|
|September||Citizenship verification letters|
|NOD12||October||2015 Renewal letter|
|October||Co-branded CC and carrier renewal letter|
|Autumn||Families receive termination notices of stand alone pediatric dental plans.|
|NOD01||November/December||Notice of Determination for APTC eligibility|
|NOD60||December||CC letter confirming 2015 renewal or change of health plan|
Covered California agent email: income verification
Starting Friday, August 21, 2014 August 28, 2014, Covered California is sending notices to health plan enrollees asking permission to automatically verify their income for the coverage year 2015. Some of these enrollees may be your clients. Having enrollees permission to verify their household income will allow Covered California to calculate their Advanced Premium Tax Credit (APTC) for 2015.
APTC – or simply premium assistance – is financial help eligible consumers may receive to reduce the cost of their monthly premium. The amount of premium assistance an individual may receive is determined based on his or her income as a percentage of the federal poverty level.
Covered California needs your help explaining to members why their consent is important and assisting enrollees who need it on how to respond to this request.
Consent can be given via telephone by you as theirCertified Insurance Agents. Additionally, Certified Enrollment Counselors and Covered California service center representatives can be of assistance.
Consumers who have not provided consent are at risk of losing their APTC in 2015. Providing consent to verify income is not required but it is needed to calculate APTC.
Covered California agent email: immigration verification letter
Citizenship Verification Notice to Consumers
Covered California is required to verify proof of citizenship or eligible immigration status for all enrollees. Some consumers did not provide sufficient or any evidence of lawful presence, or Covered California was unable to verify their documents, at the time of enrollment.
On Tuesday, September 2, 2014, Covered California will be sending e-mails and letters via U.S. Mail asking these consumers to verify their citizenship or immigration status. Some of these consumers may be your clients.
Covered California needs your help with submitting verification documents for consumers who require assistance or are unsure of how to respond.
Consumers who have not verified lawful presence are at risk of losing their coverage. It is important for consumers to submit the requested documents by September 30, 2014.Past this deadline, Covered California may terminate their coverage.
Download Covered California notices and letters
Below are sample letters being sent and background information that can be downloaded to help clients navigate the consent or information requests.
- 2014 County MA PD Rates (0.2 MiB)
- CountyRate2014 (0.3 MiB)
- CountyRate2014 Revised PR (6 KiB)
- CountyRatePACE2014 (0.1 MiB)
- MA Announcement2014 (1.3 MiB)
- PartDandMABenchmarks2014 Letter (0.1 MiB)
- PDP RateNoticeA (1.2 MiB)
- Regionalrate2014 (2 KiB)
- RegionalRatesBenchmarks2014 (24 KiB)
- Enforcement Actions
- Medicare Supplement
- Preventive Services
- Resource Material
- Medicare & You 2015 Booklet (3.5 MiB)
- Medicare Notice English FINAL_Covered Caifornia (0.3 MiB)
- Medicare Quick Guide FINAL_Covered California (0.2 MiB)
- Medicare-Covered California Fact Sheet (0.2 MiB)
Letter from Insurance Commissioner Jones to Peter Lee - Proposition 45 (7-17-14).pdf
Letters between Insurance Commissioner Dave Jones and Covered California Executive Director Peter Lee and the problems of implementing health insurance rate regulating Proposition 45.
|Date:||August 22, 2014|