Covered California released a breaking news alert to agents on December 12th, 2014, that mixed households, those with children in Medi-Cal and the parents on a Covered California subsidized private plan, may face delays in selecting a health plan until the respective county finishes their review for eligibility.
New! Mixed Households: Renewal Update
County social services offices must review Mixed Households for Medi-Cal eligibility before consumers complete Covered California plan selections. Covered California is working with the Department of Health Care Services and our county partners to expedite Medi-Cal processing of Mixed Household applications.
The news alert is not clear exactly which counties are performing the eligibility reviews, how many families are affected, or how long it will take. If a family is not able to make a selection before December 15th for a January 1st effective date, Covered California has been good in the past with working with accounts to effect the promised coverage date. However, all the paperwork may be delayed until after the first of the year from the selected health insurance plan.
Breaking news for December 2014
Other breaking news from Covered California near the close of the December 15th deadline was the following.
Special Enrollment consumers aren’t auto-renewed
By Monday, December 15, 2014, consumers who:
2014 Special Enrollment may not be auto-renew if they recently applied prior to November 15, 2014 for special enrollment. Consumers need to check the enrollment status on their online account to ensure the application shows an “ENROLLED” status on the Summary Page under the “Plan Enrollment by Person” page.
If the status is showing “PENDING”, consumers must pay their premium if they haven’t already done so to the health plan carrier. The carrier will let Covered California know of the effectuated date of coverage. Once this happens, the consumers must select a health plan for the 2015 benefit year.
If the status is showing “ENROLLED”, Covered California already auto-renew the consumers to their health plan for the 2015 benefit year. No further action is needed.
Auto-renewed and would like to change their health plan must select a new health plan by 12/15/14 to start on January 1, 2015.
Did not provide consent will not receive Advanced Premium Tax Credit (APTC) for 2015 benefit year. Consumers must provide their consent to Covered California to verify their household income. If they want their current 2014 APTC to continue January 1, 2015, they need to provide their consent by 12/15/14.
No consent for verification = no ACA tax credits
New! Auto-Renewal and Premium Assistance
Consumers who renew or auto-renewed will receive a notice confirming that they have been renewed. If auto-renewed consumers contact Covered California before December 15, they can change their consent and be re-evaluated for premium assistance for January 2015. If they update their consent after December 15, they may be required to pay for the full premium amount for at least one month, based on the day that their eligibility is re-determined.
After December 15, 2014, consumers may seek your help if their health insurance has been auto-renewed and they are no longer receiving premium assistance because they did not provide consent to verify their household income. Certified Insurance Agents can assist consumers in updating their consent. However, agents will need to call the Agent Service Center to have Covered California re-determine eligibility and restore premium assistance for 2015.
If the consumer does not agree to update their consent now, explain to them that they will not be able to receive premium assistance. Consumers have until December 15 to update their consent and receive premium assistance for January 2015. After December 15, consumers may be required to pay for the full premium amount for at least one month, based on the day that their eligibility is re-determined.
New! Termination Update
Terminate Participation Link is Active
The “Terminate Participation” link is active if the consumer’s case has been auto-renewed, whether passively or actively, and a plan has been selected for 2015.
The “Terminate Participation” link will terminate both 2014 and 2015 plan benefit years. Agents who click on the termination participation link after December 1, 2014 will end the 2014 coverage as of 12/31/14 and cancel the 2015 renewal coverage.
Terminate Participation Link is Not Active
The link will remain inactive if the 2015 plan selection is not complete. The consumer’s auto-renewal started but is not complete because the health plan is no longer available.
PDF files of the above mentioned repairs or known issues.
Consumers can only get the tax credits if they have updated their consent to let Covered California check their income. Known website issues that have been repaired.
|Date:||December 13, 2014|
Consumers who purchased health plan under Special Enrollment Period may have to actively renew health plan for 2015. Known website issues that have been repaired.
|Date:||December 13, 2014|