When I looked at the submitted application – there it was – I had to have selected the permanently moved to California QLE which is below loss of coverage. The permanent move to California QLE triggers the standard effective date of the 1st of the following month, in this case August 1st. So the family really did not have insurance for July!
I don’t mind enrolling people into Medi-Cal. I’m a one-person operation and I enjoy chatting with people. But I have to draw the line with people who insist on me answering a million questions and then failing to give me the appropriate information to complete their Covered California Medi-Cal eligibility application. I also will not knowingly participate in any misrepresentation or fraud so a person can either be enrolled in Medi-Cal or be determined eligible for the tax credits through Covered California.
The health plans and Covered California may give lip service to the value of the agent community, but it is not reflected in the compensation we receive. I’m not trying to get rich as an insurance agent. My net revenue listed on my Schedule C for 2016 was $34,000. If the new compensation schedules significantly erode my insurance revenue then I will have to find other income streams. Maybe Covered California will hire me to answer phone calls; I hear they have a great benefits package.
In yet another sign of the erosion of health insurance commissions for agents, Cigna has informed their appointed agents that they will not pay commissions on most of their California health plans in 2016. Cigna has stripped away any agent compensation for their 2016 Silver, Gold, and, Platinum plans sold during open enrollment. In addition, there will be no commissions paid on any health plan that an agent helps a client enroll into during a Special Enrollment Period in 2016.
Designating an agent to help you enroll in a new individual and family plan or a small group plan offered through Covered California is pretty simple. Not only can the agent help with the application when he or she is your designated agent, a health insurance agent also provides another level of customer service for future changes.
The misguided training was a missed opportunity to explain the importance of Covered California and how the ACA will help millions of people get access to affordable health insurance and quality care. Instead we were told that health plans were expecting lots of sick people to seek care and they were cutting back on their providers. You know, “those people” were going to use the system they had been shut of for years by insurance companies who were just “following the rules” of being able to deny sick people health insurance. It wasn’t the fault of the insurance company, one trainer opined.
How can anyone make an informed Medicare decision when they are only presented with options from one insurance company?
To me, stories are at best anecdotes and at worst flat out embellishments of the truth twisted to make the insurance product appealing.