The Northern California mother was distraught to learn that her daughter, who she thought was attending college in San Jose, was in jail. The letter from Covered California clearly stated under her daughter’s name, “The records show that you are incarcerated (in jail or prison).” For this woman, for whom English is a second language, she was panicked that her daughter was in jail, her daughter had lied to her, and the whole family might lose their health insurance. In reality, this cruel hoax on the mother is the result of a miserably drafted eligibility letter using questionable data sources.
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$13,000 tax bill triggered by Covered California income advice
Mr. Polk learned from his CPA on April 7th, 2015 that he owed $13,230.43 for the repayment of excess APTC for 2014. The CPA had properly taken the Covered California 1095-A and completed IRS form 8962 Premium Tax Reconciliation. It was clear on form 8962 that the addition of the Polk’s social security retirement income and tax-exempt interest had pushed the Polk household income over 400% of the federal poverty line.
Can you trust the Covered California health plan quality star ratings?
Covered California has awarded quality star ratings to health plans based on just two questions from a questionnaire surveying consumer’s experience in 2014. In addition, the quality ratings were based on a completed sample size of approximately 100 respondents out of 1,000 surveys sent out.
Reviewing Covered California’s 2016 family dental plans
Covered California has finally been able to include family dental plan enrollment to consumers who have purchased a health plan through the exchange. The dental plans overall are pretty good but they come with some conditions that limit suitability for all families.
2016 income and application changes for Covered California enrollment
Covered California has released new Job Aids that review and describe some of the changes they have made to their online enrollment application. Many of the new functions address deficiencies in the original software, other features to help consumers more easily report changes, and the new addition of enrolling in a family dental plan.
Covered California erases consumer account information
I wouldn’t have believed if I had not seen with my own eyes. For months the Covered California account of a client showed one of the household members enrolled in an Anthem Blue Cross plan. Then one day it disappeared. All Covered California can say is that they don’t see the member ever being enrolled. The client continues to pay for the phantom Anthem Blue Cross that Covered California says never existed. How was this enrollment information erased?
Helping small group dependents get Covered California tax subsidy
One of the most frustrating aspects of the Affordable Care Act is that it excludes family members from receiving the premium tax credits to reduce their health insurance if one of the parents is offered affordable employer group health insurance. One way around this problem is for the employer to offer employee only coverage. Covered California for Small Business health insurance exchange offers the employee only option for employers when they set up their group health plans.
Are agents steering consumers to most profitable Covered California plans?
Covered California has locked Certified Insurance Agents into representing all exchange plans to consumers and forbids agents from steering consumers to health plans with the best commission structures. Unfortunately, Covered California has no regulations that address any minimum compensation levels that the health plans or health insurance companies must pay agents for their efforts. Covered California announced over the summer that compensation for Medi-Cal enrollments would end for agents. Most recently Western Health Advantage (WHA) announced a split commission structure where Certified Agent enrolments would receive less compensation for Covered California plans than WHA’s off-exchange plans.
Mixing health plans from Covered California, Med-Cal and off-exchange
Every family is unique in their health care needs. There are situations when each family member may require a different health plan to meet their particular health challenges. Unfortunately, many families who enroll in a health plan through Covered California are unaware that not all the family must be on the same health plan.
Birthdays bump up premiums when reporting a change to Covered California
Many Californians have realized that when they report a change to their Covered California accounts during the year they are hit with higher health insurance premiums. This occurs when the change reported is after a consumer’s birthday. Any change within the Covered California CalHEERS online enrollment program automatically triggers the application for health insurance to be resubmitted for an eligibility determination. The new eligibility is calculated as of the individual’s age at the time of the reported change.