Kevin Knauss: Health, History, Travel, Insurance
Posts related to the Special Enrollment Period to enroll in health insurance outside of Open Enrollment with a Qualify Life Event.
Effective Friday, March 20, Covered California opened the health insurance exchange to any eligible uninsured individuals who need health care coverage amid the COVID-19 national emergency. Anyone who meets Covered California’s eligibility requirements, which are similar to those in place during the annual open-enrollment period, can sign up for coverage through June 30.
I was in attendance at a Covered California meeting in Sacramento where agents asked if Covered California was going to publicize the individual mandate penalty in their marketing campaign for open enrollment. Executive Director Peter Lee told the audience that Covered California marketing would focus on the new California Premium Subsidy and not the penalty. But now, Covered California is using the argument that thousands of people don’t know about the penalty, when they are in charge of making California residents aware of the individual mandate penalty.
Consumers who are currently insured in the individual market directly through an insurer “off-exchange” may be eligible to receive financial help if they purchase coverage through Covered California during this new SEP. It is important to note that consumers who earn from 138 percent FPL through 600 percent FPL may receive state and/or federal subsidies which means they would be more likely to retain their coverage.
If Medi-Cal makes any changes to your account through Covered California, and you have family members who are in a private health plan through Covered California, you need to finalize the new plan. In the above scenario, an additional subsidy was applied to lower the health insurance premium.
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!
When a union goes on strike it can be difficult for union members and those trade members associated with the union to keep paying their health insurance premiums with either reduced or no income. There are options to maintaining health insurance if you know the rules of the health insurance game. These rules revolve around Special Enrollment Periods with the qualifying event of loss of coverage.
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.
Covered California and the IRS have been encouraging individuals and families that have purchased health insurance through the state or federal exchange to update their household income whenever there is a change. The simple act of reporting this change of income through Covered California is considered a qualifying event for a Special Enrollment Period. Once […]
The Covered California CalHEERS online enrollment system continues to be upgraded to fix problems and accommodate household changes, but Certified Insurance Agents (CIA) are rarely notified of the updates. As CIAs helped enroll 40% of Covered California’s households and continue to update their clients changes through the system, agents deserve to be provided regular updates […]
Covered California announced on May 15, 2014 that they will follow the HHS guidance and offer a Special Enrollment Period (SEP) for individuals and families currently on a COBRA health plan. However, people should be cautious before they leave their COBRA plan and jump into a Covered California plan for many reasons.
