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Covered California Application

Posts related to the Covered California application, consumer account, estimating income, household size, monthly subsidies, health plans, Medi-Cal, and terminations.

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Anthem Blue Cross discourages agents assisting consumers with health insurance enrollments

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For the second time since the launch of Obamacare and Covered California, Anthem Blue Cross has cut the commissions they will pay agents for assisting consumers with enrollment into individual and family plans. Anthem Blue Cross now has one of the lowest commission structures for agents helping individuals and families apply for health insurance in California. This commission cut, coupled with rules limiting Covered California delegated agents from receiving commissions, has resulted in agents thinking twice before assisting consumers with Anthem Blue Cross health plans.

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Cigna Cuts All Agent Commissions to 0% for 2017

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Cigna notified their appointed health insurance agents at the end of September that they will not pay any commissions in California for individual and family plans. In other words, or symbols, Cigna has given the middle finger to agents who assist consumers with enrollment into their health plans.

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Covered California health insurance rate proposals may be incorrect

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A really nice tool for agents and consumers to compare health insurance plan rates is the Shop and Compare Tool. Within this website you can also download a proposal that lists the available health plans by metal tier level for the household information entered. Unfortunately, I recently found that the proposal created may not always match the website results shown.

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Relationship between Covered California, IRS, & Health Insurance Tax Credits

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While Covered California does a great job of marketing their services as an individual and family health insurance marketplace, the ultimate connection of reporting health insurance coverage to the IRS is not a central part of Covered California consumer education.

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Bay Area vacuum of health care providers

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It is a reasonable expectation to assume that when a family enrolls in a health plan through Covered California that there will be local doctors to address their health care challenges. Unfortunately, some health plans have a virtual vacuum of providers in fairly large communities. This is the case for members of Anthem Blue Cross PPO individual and family plans in Livermore, California. For one family, the nearest in-network pediatrician is over 15 miles away from their Livermore home.

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Aetna chooses welfare over work

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The big headline in August was that Aetna would not be expanding their Obamacare individual and family plans in 2017. The smaller headline from a week earlier was that Aetna was seeking approval to become a Medi-Cal manage care health insurance provider in California. Just like other health insurance companies have found, welfare pays better than work when it comes to health insurance.

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Covered California to allow family members to have different health plans

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Covered California has updated their online application and enrollment program to allow families receiving premium assistance to select different metal tier levels and health plans for each household member. Previous to this update, only households who enrolled without qualifying for premium assistance could split the family member up between different plans. Beginning August 1, 2016, families receiving Advance Premium Tax Credits to reduce their monthly health insurance bills will have more consumer choice.

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Covered California to verify Qualifying Events for Special Enrollment Periods

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Covered California has come under pointed criticism from the health insurance companies for their lack of verification of a consumer’s Qualifying Life Event (QLE) for a Special Enrollment Period (SEP). That will change as of August 1, 2016, when Covered California will start a program to randomly sample consumers who have enrolled in health plan outside of Open Enrollment under a QLE. Selected consumers will have to provide verification that they actually do have a QLE that makes them eligible to enroll outside of Open Enrollment such moving into California or the loss of minimum essential coverage like Medi-Cal or employer group coverage.

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Covered California’s new Ombudsman and PPO PCP for 2017

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Covered California will be adding two elements to the health plans sold through their marketplace exchange in 2017. The first is a new ombudsman program to help consumers fight with their private health insurance companies. The second is requiring that all PPO and EPO health plans assign a Primary Care Physician like HMO plans have. Any initiative to help consumers navigate health insurance and the health care system are admirable. But both initiatives lack details that would help determine if the changes are lip-stick-on-a-pig or consequential improvements.

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Blue Shield, Covered California ignores lost SEP enrollment

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As is typically the case with enrollment disputes, Covered California says it is a Blue Shield problem and Blue Shield points the finger at Covered California. Blue Shield further states that they must wait 30 days before they request another transfer of the enrollment data from Covered California. So where does this leave the family? They have paid for health insurance in July for which they have no enrollment.

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