Consumers who purchased a health plan through Covered California 2014 may lose their monthly tax credit in 2015 if they don’t give permission to allow the state exchange to verify their income through the federal hub. The sudden loss of the Advance Premium Tax Credit in 2015 applies to consumers who did not give Covered California authorization to verify their income in future years when they initially applied. Without the ongoing permission Covered California will discontinue the tax credits for these consumers in January 2015 and the health plan member will receive an invoice for the full premium amount.
Tax credits cut for lack of consent
The revelation of the loss of ACA tax credit was detailed in a presentation by Covered California to agents in 2015 renewal cycle webinar on October 8th. Most Covered California health plan members will be automatically re-enrolled into their current health plan for 2015 with the new rates announced earlier this year. For consumers who enrolled, but did not give ongoing permission to verify their income, their health plan will be renewed but without the Advance Premium Tax Credit.
Report a Change for income verification
If the consumer does not Report a Change on their Covered California account granting consent for income verification by December 15th, they will receive an invoice from their health plan for the full premium amount. Individuals and families can grant permission for the consent their ugh the Report a Change function after the deadline, but there was no mention if the new ACA tax credit eligibility would be retroactive to premium amounts already paid. Download the slides of the presentation at the end of the post.
Health plans terminated
Covered California informed agents that they had sent out an incorrect consumer notice for members of Contra Costa Health Services and Health Net health plans. The original notice mentioned they would be automatically renewed into those health plans 2015 plans. However, Contra Costa Health Services is pulling out of Covered California and won’t offer individual and family plans through the exchange. Health Net is terminating all their PPO plans and replacing them with either an EPO or HSP. (See Health Net cancellation and HSP plan notification)
In either case, current members of Contra Costa Health Plans and Health Net PPO plans must make a new plan selection by December 15th. If no plan selection is made, the individual or family will have their current plan terminated on December 31st and no new plan will become effective. This will leave the consumer with a gap in coverage. However, they can still enroll in a health plan during open enrollment which continues through February 15th for a March 1st effective date.
Halloween Plan cancellations
Other nuggets of information from the presentation included that individuals in a catastrophic plan who turned 31 during the 2014 Calendar year will be migrated to a Bronze plan offered by the same carrier. (Catastrophic plans are available to individuals 30 years and younger). Households who have not provided proper immigration or naturalization documents will have their current plans terminated on October 31…Happy Halloween. (See also: Covered California sends pre-termination letters to immigrants)
New baby problems
Finally, on October 13th, the Covered California online enrollment program, CalHEERS, will be switching to renewal mode. The presenter did have many details, but the functionality to either enroll for a December 1st start date under the Special Enrollment Period triggered by a qualifying event could be seriously impaired. In addition, there may be functionality issues with adding a new household member such as the birth or adoption of a child. Some of these scenarios may require the assistance of a call center representative to make the appropriate enrollment or household addition.
October 8th, 2014 sales presentation slides from webinar hosted by Covered California. Topics covered: renewal cycle, closed plans, income verification authorization, timelines.
|Date:||October 10, 2014|