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.
The family did not understand what was going on. Why was their subsidy unilaterally changed by Covered California with no warning? They did not trust Covered California to get the numbers correct. I created a spreadsheet to see if the new subsidy and subsequent totals matched what they were eligible for at the estimated income.
Annual income. When entered on income section, Covered California will take the total amount and divide it by 12 and distribute an equal amount in each month. For example, you enter an annual income amount of $12,000 beginning in January. Each month through December will be allotted $1,000 to add to your monthly income and annual income totals.
If you never check your Covered California secure email box, opt to receive important letters delivered to your home address. The notices will alert you if you are losing your subsidies, health insurance, or being put into Medi-Cal.
Health insurance agents are not paid by Covered California. We are paid by the health plans, either PMPM or a percentage commission. There are 13 different health insurance carriers and 13 different agent commission structures.
Sue and Bob received $3,840 in excess Advance Premium Tax Credit for the year. Because their final income is over 400 percent of the federal poverty level, they must repay all the excess health insurance subsidy.
Is it equitable that a married couple with substantial savings and high net worth receive significant health cost savings while a similar married couple with no savings but slightly higher income is subjected to higher health care costs? No, it is not equitable. It is a government program that is missing the mark on equity. Stated another way, the reduced cost sharing and no deductible health plans are not fair because the household income does not reflect the real financial state of the individual or family.
However, if you are in a region where Aetna CVS Health is the second lowest cost Silver plan, you may see a dramatic premium increase. This is because the Aetna CVS Health is slated to increase approximately 0.2 percent. This means that the subsidy with the Aetna CVS Health second lowest cost Silver plan will only slightly increase for 2024 over 2023. If you have the Blue Shield PPO with a 15 percent increase in that region, your 2024 subsidy will not change by much and you may be paying a considerably higher amount for your health insurance if you keep the Blue Shield plan.
When the income estimate was increased in their Covered California application, the subsidy was properly calculated for the remainder of the plan year. The first thing Sandi and Thom notice is that they lost the Silver 87 plan and with the higher income are now only offered a Silver 70. Another disturbing problem for them is that instead of $336.57 monthly premium, their new premium for the Silver 70 is $657.31. They went from paying $16 a month for a great Silver 87 plan to $658 per month for Silver plan that has higher copays, coinsurance, and deductibles.
If there is no existing enrollment of any family member into a Covered California health plan, the default plan selection in most cases will be the lowest cost Silver plan. For many people with low incomes, there may be no monthly premium for the lowest cost Silver plan. If you don’t like the plan selection, you can change it.
No one at Covered California calls the IRS for information and the IRS does not send Covered California any of your information. No one at Covered California will ever see your federal tax return unless you provide it to them.
