One of the confusing aspects of the Affordable Care Act is the interchangeable tax terms people use when defining a household. The federal and state exchanges use the terms children or dependents when describing members of a household. The IRS uses the more accurate, but confusing terminology, of personal exemptions as the true test for […]
Posts related to the implementation of the Affordable Care Act and potential changes to the rules, primarily in California.
Blue Shield and Blue Cross struggle with renewal letters to members
In the confusing landscape of health insurance regulations post ACA implementation, numerous health insurance companies have sent out renewal letters to members with errors. Blue Cross, Blue Shield, Health Net and even Covered California have had to send follow-up letters to correct erroneous information. Unfortunately, this incorrect correspondence only leads to more confusion surrounding the benefits and renewal […]
Kaiser keeps the premiums, ignores plan activation
Ms. B had been faithfully making her premium payments for her Kaiser health plan she purchased through Covered California during open enrollment in 2014. When she went to use her health plan, Kaiser told her that the plan was not active. But the enrollment summary of her Covered California account shows she is enrolled. It […]
Insurance agents forced to register new voters in California
At the September Covered California Board meeting the members voted to adopt voter registration regulations that will mandate that Certified Enrollment Counselors (CEC) and Certified Insurance Agents (CIA) offer voter registration assistance to individuals that are applying for health insurance through the state exchange. In essence, CECs and CIA will now be doing volunteer work […]
Covered California MAGI Training
Covered California provided some very important training to insurance agents on determining ACA MAGI for clients…twelve months late. The information offered on household income for tax credits should have been offered months ago before we started the first open enrollment. While the maxim of “better late than never” is apropos, content was at times needlessly […]
Covered California income change triggers new health plan selection
Covered California and the IRS have been encouraging individuals and families that have purchased health insurance through the state or federal exchange to update their household income whenever there is a change. The simple act of reporting this change of income through Covered California is considered a qualifying event for a Special Enrollment Period. Once […]
Anthem Blue Cross set to terminate 79 health plans in California
In the proposed rate increase filing with California Department of Managed Health Care (DMHC) on August 1, 2014, Anthem Blue Cross included 79 health plans that they would be terminating at the end of year. Titled Exhibit P – Terminated Plans, effective 2015, Anthem Blue Cross lists 39 pre-ACA and 40 post-ACA individual and family […]
IRS releases draft ACA tax credit reporting forms
The IRS has released drafts of the tax forms that will be used to reconcile the amount of Advance Premium Tax Credit (APTC) received from an insurance exchange against how much the individual or family was entitled to based on their modified adjusted gross income. The various components used to determine the APTC (income, household size, dependents, employer sponsored insurance, […]
IRS mid-year ACA tax credit check up
The IRS issued a mid-year ACA tax credit check up advisory to remind individuals and families to report household changes if they are receiving Advance Premium Tax Credits to lower their monthly health insurance premiums. Most notable is the admonition that if the household income exceeds 400% of the federal poverty lineas reported on their […]
Covered California approves Navigators soliciting health insurance
The Covered California Board approved a resolution at their June 2014 meeting to allocate $16.9 million toward establishing a Navigator program. Under the new Navigator program organizations awarded grants will be encouraged to open store fronts, theyll receive bonuses for exceeding enrollment projections and theyll be allowed to advertise their services. Short of requiring an […]