Kevin Knauss: Health, History, Travel, Insurance
Posts related to the Covered California application, consumer account, estimating income, household size, monthly subsidies, health plans, Medi-Cal, and terminations.
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.
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?
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.
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.
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.
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.
At the August 2015 Covered California Board meeting James DeBeneditti, Deputy Director of Plan Management, reviewed the options and challenges for offering vision insurance on the Covered California online enrollment website. The only viable option reported was to put a simple link on the Covered California website to vision insurance providers. For the inclusion of the hyperlink Covered California would charge $10,000 and take a 10% commission. The $10,000 implementation fee is essentially an advertising cost for the vision plan while Covered California acts like an unlicensed insurance agent collecting a 10% commission for selling vision insurance.
Covered California has released a series of marketing videos to develop interest and drive sales to their small employer group plans. Formerly known as SHOP (Small business Health insurance Options Program), the small employer group offerings, authorized as part of the Affordable Care Act, has been re-branded as Covered California for Small Business. The small employer group marketplace exchange initially flopped as it was beset with an online application process that failed and subsequent management problems that resulted in billing nightmares for many clients. Fortunately, they seem to have righted the foundering small group boat at Covered California.
Covered California has been sending out a variety of letters notifying consumers that they must send in verification for such items as proof of income, citizenship and Social Security numbers. Unfortunately, these letters are not being reflected in the consumer’s Covered California Documents & Correspondence Summary section. Letters are missing from Summary section To date, […]
A review of Covered California Navigator enrollment and payment data for 2015 reveals that a majority of organizations awarded grant money to enroll individuals and families in qualified health plans failed to meet their enrollment goals stipulated in the grant award agreements. Fifty-five of the Sixty-five organizations listed that received Navigator grants failed to meet […]
