Kevin Knauss: Health, History, Travel, Insurance
The federal ACA subsidy is more generous limiting the household health insurance responsibility for health insurance premiums to 9.8 percent of household income. While the California Premium Subsidy may add a few dollars of subsidy below 400 percent of the FPL, it is really focused at upper income households. The California subsidy limits the household responsibility to between 14 and 18 percent of the household income.
The ACA states that if a married couple apply for the premium tax credit subsidy through Covered California, they must agree to a Married Filing Joint federal tax return status. If you are the victim of domestic abuse or your spouse leaves you, there is little interest in working with that person to file taxes jointly.
The big unknown is how you will use health care services in the next year. If you historically visit a doctor for the occasional sports injury, allergies, or to have wax removed from your ears, even if you visit the doctor more than 3 times (the Bronze 60 limit), you may still be money ahead with the Bronze plan.
Not all Blue Shield health plans will be receiving the premium credit. The credits will be applied to fully-insured employer groups (except flex-funded), dental and/or vision plans, Medicare Supplements, and individual and family dental and/or vision plan subscribers. Blue Shield states they are issuing premium credits as permitted by state regulators and Covered California.
You use the Attestation of Income form after you have diligently reported your MAGI using the Covered California income section of the application. The most difficult part of the Covered California application is the income section. Take your time and make sure the entries are correct and ensure that the start and stop dates of the income streams are also correct.
Therefore, I request that all health insurance and specialized health insurance companies provide their policyholders with a partial premium refund no later than December 31, 2020. These refunds should be reflected in the November or December 2020 premium statements sent to policyholder or certificate holders, if refunds have not already been issued.
Pay no attention to any reports of increasing or decreasing health insurance premiums for 2021 when it comes to subsidized Covered California enrollment. First, your rate will increase because you, and everybody in your household is another year older. Rates are based on age. Second, the subsidy is based on the Second Lowest Cost Silver Plan.
Blue Cross will offer the standard benefit design metal tier plans through Covered California and off-exchange, direct from the carrier. They will also offer a few non-standard benefit design plans available off-exchange. Blue Cross will offer a Silver HMO plan off-exchange with no medical deductible and 0 percent coinsurance for medical services. The copayments are a little higher than the standard Silver 70 ($50 office visit, $85 specialist visit, emergency room visit $750) and the maximum out-of-pocket is $8,550 versus the $8,200 for a standard Silver 70.
California is broken into 19 different rating regions. Sutter Health Plus HMO plans are offered in 9 of those regions. The least expensive rates – based on the Bronze plan for a 40-year-old individual – are in the Sacramento, El Dorado, Placer, Yolo counties service area. The most expensive are found in Santa Clara County, 15.92% higher than the Sacramento region.
If Obamacare is repealed by the Supreme Court, California will step into the vacuum. It may not be pretty and I am sure there will be a new tax on something, but California will figure a way to continue with the health insurance subsidies through Covered California.
