The extra $3,000 is clearly stated on the 1095-A. I have seen it. The question is, “What did Kaiser do with the extra $3,000 and how did they not figure out that they were receiving no consumer premium to attach to the monthly subsidy?”
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Kevin Knauss: Health, History, Travel, Insurance
The FAQs released today detail existing federal rules governing health coverage provided through the individual and small group insurance markets that apply to the diagnosis and treatment of COVID-19. The FAQs clarify which COVID-related services, including testing, isolation/quarantine, and vaccination, are generally currently covered as EHBs in these markets. The purpose of the FAQs is to provide guidance to Americans enrolled in individual or small group market health plans, including HealthCare.gov consumers. As questions and issues continue to come to CMS, they will be addressed and added to these FAQs.
Why can’t people who earn too much money to qualify for either MAGI Medi-Cal or the subsidies through Covered California just be allowed to pay the monthly capitation rate for these plans? They are less expensive than private insurance and would offer some protection from the corona virus health care costs.
The federal government will consider only public benefits received directly by the person who is applying for the change in status, or if they’re listed as a beneficiary of the benefit. This means that your family members accessing public programs will not be considered as part of your public charge determination.
When the Byrd’s put all their information into the application, it calculates that they should pay no more than 7.30% of their income toward health insurance ($3,352 per year), and subtracts that from the annual cost of the Second Lowest Cost Silver Plan ($16,368 – $3,352 = $13,014.12) The exchange then divides the annual $13,014 of the subsidy by 12 months to get a monthly subsidy of $1,084.50.
The Change Log Table shows that Sacramento County Medi-Cal returned the client’s household size to 2 and added the deceased spouse back into the household. The only notification the client received that Medi-Cal had meddled with her account was when she received a notice from Kaiser informing the client that her coverage had been terminated.
Occasionally, I am asked whether I am an insurance agent or a broker. The underlying premise of the question is that the person does not want their insurance options limited to only those insurance companies the agent represents. The assumption is that a broker will not steer the client into an insurance policy that he or she receives the highest commission for. For the purposes of this discussion involving health insurance, there are no brokers, we are all agents. But not all agents are equal when it comes to the health plans they represent.
I was in attendance at a Covered California meeting in Sacramento where agents asked if Covered California was going to publicize the individual mandate penalty in their marketing campaign for open enrollment. Executive Director Peter Lee told the audience that Covered California marketing would focus on the new California Premium Subsidy and not the penalty. But now, Covered California is using the argument that thousands of people don’t know about the penalty, when they are in charge of making California residents aware of the individual mandate penalty.
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