California Health Care
by Wendy Barnett
Health Insurance Brokers in California take note! If you are a certified agent with Covered California, they have provided a tool chest of information to assist you in your success. Not only can you access your book of business, view notices sent to consumers, obtain job aids but also watch a webinar that you missed. Follow these basic tips that show how to navigate Covered CA’s website to get all this important information and more.
Start by going to Covered California’s website. Near the bottom of the home page click on “Enrollment Partners”:
Then choose “Partner Tool Kit”:
On the Enrollment Partner Tool Kit page you can find a lot of helpful resources:
Click on “Webinars & Briefings” to find:
Click on “Agent Extranet Toolkit” to find:
Click on “Printable Materials…” to find free, downloadable materials including:
These tips will get you started on your way to discovering the wealth of information available to you from Covered California. The En...
By Esmeralda Mercado
If you’re currently enrolled on a private health plan, your rates are likely to increase by a lot. In California, the weighted average increase is 13.2%. Because this is a transitional due to factors affecting rates, everyone is encouraged to weight their options and go shopping. Most consumers will only see a rate increase of no more than 5% if they switch plans.
If you’re not already enrolled, you can get quotes and sign up during the 2017 Covered California open enrollment, November 1, 2016 through January 31, 2017. If you’re currently enrolled on a health plan, you will be able to renew your current plan or shop for a new one in October or November. Watch for a renewal packet that will provide your 2017 rates, and allow you to make changes at that time.
IMPORTANT: Don’t fill out another application; you can easily make changes on your existing coverage between October and November.
Between October and November, consumers enrolled on a private plan will r...
by Esmeralda Mercado
Effective January 1st 2017, most California private health insurance rates will increase an average of 13.2%. The actual rate change will vary, based on:
In a few cases, monthly rates will go down; in most cases, the rates will go up, some as much as 36%. For many consumers, this may mean making drastic changes to ensure that their health plan is affordable. See below for a breakdown of rate changes, as well as tips on how to minimize your 2017 Covered California rate increase.
Covered California Plans whose overall rate increases are modest improves the likelihood that your 2017 rate increase will be minimal, regardless of where you live. According to the California Health Benefit Exchange, the carriers with the lowest rate increases are Valley Health (0.7%), L.A. Care Health Plan (3.7%), Molina Healthcare (5.2%), and Kaiser Permanente (5.6%).
Here is a chart of the 2017 average rate change for the top four California carriers, according to the Health Benefit Exchan...
by Wendy Barnett
Beginning in August 2016, Covered CA will be sending notices to employers about their employees who have enrolled in Covered CA and are receiving the Advance Premium Tax Credit (APTC). The notice serves to inform employers that their employees may have indicated that their employer has not offered “affordable, minimum value standard coverage” and that they may be subject to the “employer shared responsibility payment” otherwise known as the tax penalty.
Prior to a consumer applying and qualifying for a subsidy through Covered California we highly recommend reviewing Covered California Eligibility: How do I know if I qualify? to understand what constitutes eligibility.
The Affordable Care Act (ACA) through Health Care Reform requires all large employers to provide affordable, minimum value standard health insurance to their employees and dependents or pay a tax penalty.
An employer who employees over 50 full-time equivalent employees
Exists when the employee’s co...
by Wendy Barnett
In August Covered California added some new features to the Covered California Application . One feature provides easier access to non-health benefit services to consumers with income less than or equal to 200% of the Federal Poverty Level. Some of the programs that will be offered include CalFresh and CalWorks. Applicants are given two options to apply for additional benefits that they may need.
The options can be found after the application has been submitted. Located on the eligibility page under “Additional Benefit Options,” an applicant may click on the provided link and a new window will open. Covered CA then provides these instructions :
“Based on the information you have provided it appears you may be eligible for additional assistance including food assistance. In order to determine your eligibility, you are encouraged to click on the Apply Now button.”
The applicant may then select up to 3 available forms of assistance:
And then the applicant will se...
By Wendy Barnett
CalHEERS 16.7, the newest version of the Covered CA online application, now restricts users to one account log-in per web browser. Health Insurance Brokers in California who are certified with Covered CA or enrollment counselors will not be able to open a new browser tab or window to log-in to their account and review a number of applications simultaneously. Covered CA states “we cannot support more than one log in session open at a time.”
Certified Covered CA Agent agreements are valid for 5 years, but when changes are made to the contract, or when annual training needs to be attested, an amendment is required to be signed.
The Covered CA Agent Agreement Amendment Quick Guide can help health insurance brokers in California with questions completing the agreement or what to do if their agent agreement is declined or terminated.
By Wendy Barnett
The Covered CA application, known as CalHEERS, will now electronically verify an applicant’s Medicare eligibility and enrollment. Previously, when the question on the application asked if you are currently enrolled in Medicare or receiving Medicare benefits, it would allow you to self-attest your answer. Now, your answer will be verified with the Federal Data Hub when you submit your Covered CA application or your eligibility is re-determined.
Covered CA needs to determine if you qualify for a tax credit and are eligible to enroll on Covered CA. To do this, the application verifies various qualifiers such as income, previous health insurance enrollment, citizenship or lawful presence status, and now Medicare eligibility. Generally, if you qualify for Medicare, you won’t qualify for a tax credit through Covered CA (Some exceptions apply – contact Covered CA at 800-300-1506 for help with exceptions). In order to avoid erroneous enrollments, Covered CA will now...
By Wendy Barnett
Covered California announced that beginning in August 2016 a new notice will be sent out to enrollees who are approaching or are over their 65th birthday. The notice is titled “You may now qualify for Medicare” and discusses important steps regarding the transition from Covered CA to Medicare. These steps include important information for enrolling in Medicare, cancelling your Covered CA plan, and where to get help with questions about Medicare.
It is important for Covered CA members to know what happens when you become eligible for Medicare (which usually occurs when you turn 65).
Contact the Social Security Administration at 800-772-1213 to enroll in Medicare or to ask questions. To have a smooth transition over to Medicare with no gaps in coverage, know the following dates to enroll:
Be aware of possible penalties:
Contact Covered CA at 800-300-1506 to either cancel your plan or to report a change to end your participation in your plan (if other members of you...
by Wendy Barnett
“Good changes are just around the corner” was the message given by Covered California in a webinar on August 4, 2016 put out by the Covered CA Outreach and Sales team reviewing their online application feature release 16.7. Various updates were reviewed, including changes regarding the “Shop and Compare” tool. This tool is featured on the Covered California website and helps consumers and certified Covered CA agents and enrollers to obtain quotes for plans including subsidy amounts. It promotes a more user friendly experience to “shop around” for their health insurance plans by comparing different levels of coverage, different carriers, and different network types.
At the webinar, agents were informed that the Covered CA mobile application was retired. This application allowed agents to prepare a personal proposal that could be mailed out to their clients with the agents contact information included. Covered CA stated that this application was not being...
by Wendy Barnett
On August 1, 2016, the Covered CA online application, called CalHEERS, made changes on their Remote Identity Proofing (RIDP) pages.
Text changes will appear in the description of the RIDP pages and the drop down menus to improve clarity and readability for applicants. The newest version, 16.7, of the Covered CA application aims to remove confusion about “the function of the RIDP pages and what role they play in ensuring the security of their Personably Identifiable Information (PII),” said Covered CA.
Changes for uploading ID documents have also been made. Uploading will be more streamlined by adding options for uploading different types of document. Covered CA said, “Users can now choose between two options for document types they may submit as proof of identification.”
Covered CA needs to confirm each primary applicant’s identity at the beginning of the online application or during a renewal or change report. Identity can be verified online, by phone, by uploa...