Kevin Knauss: Health, History, Travel, Insurance
Posts pertaining to issues regarding enrollment in Covered California, Medi-Cal, Medicare, resolving problems.
The Covered California sales seminar for 2015 open enrollment held on December 3rd covered numerous topics. While new sales collateral, store front signage and immigration updates were covered, the bulk of the webinar was devoted to tips, tricks and more work-a-round solutions for enrollment system glitches. The last part of the seminar was a 16 […]
Covered California presented a short seminar and long video about the updates and changes to the CalHEERS online enrollment system. The presentation should have been entitled Bugs and Workarounds because there are more known issues than anyone at Covered California is willing to admit with the program. The breadth of the issues and challenges with […]
Covered California released several Job Aids or technical summaries related to ACA open enrollment for 2015. The guides cover a variety of different consumer situations from changing plans, making the initial binder payment, and the overall functionality of the CalHEERS online enrollment system. Some of the functions can only be performed by certain certified agents, counselors or […]
Covered California staff is forecasting that SHOP enrollment will double by the end of 2014 and double again during open enrollment for 2015. A list of assumptions was given for the stellar forecast enrollment during the May 2014 Board meeting where the topic was revenue projections from fees charged on individual small group members. Based […]
Outside of open enrollment there will be few opportunities to switch health plans unless the individual or family has a qualifying event such as moving to a new region. In all cases, if you are making the change through your Covered California account, you’ll need to terminate participation in the current health plan, create a change report and then select a new health plan.
In what has become routine for Covered California, they alerted agents to another CalHEERS enrollment website problem late on a Friday afternoon. The latest email notified agents that the system has been calculating the wrong Advance Premium Tax Credit (APTC) on submitted applications. While the Covered California email blast wasn’t real specific, it sounds like the APTC number is wrong when the applicant confirms the health plan purchase, but correct in the “Eligibility Results” page.
Covered California has provided basic statistics and pretty pie charts on enrollment numbers into the ACA health plans that they offer. But what is left out is the statistical data that economists and demographers would like to have to ascertain if the Affordable Care Act is merely working or if it is actually fulfilling the promise to reduce health disparities in our communities with affordable health insurance.
While a significant number of California residents have successfully applied, the Covered California website and enrollment systems presented significant challenges and failures not only for those applying but also insurance agents, enrollment Counselors and the health plans themselves. The management at Covered California has consistently ignored the failure of their design and process and sought only to promote their perceived successes.
If you missed completing your application online December 23rd because of the Covered California melt down you now have another opportunity to enroll. But instead of calling Covered California or faxing over your application you’ll have to find a Certified Insurance to enter you application into the CalHEERS program online for you. Insurance agents never charge clients for their services. They are always paid by the insurance company or health plan by either a one-time payment, fixed monthly monthly or a commission percentage.
Covered California has estimated that nearly 100,000 households have started an application but have not selected a health plan. To help “Jump Start” these stalled applications Covered California will be distributing the contact information of these stalled applications to Certified Agents to call the applicants and offer assistance to help them make a health plan selection for an effective date of January 1, 2014.
