Column 18- agent status update, fraud, diabetics

What is the status of local agents?

For those of you waiting for your agent to help you with enrollment in Covered California, the list is getting longer.  Unfortunately, a glitch in the system doesn't give you an accurate report when you enter a zip code and ask for all within an expanded radius (greater than 1 mile).  So you need to keep entering our local zip codes to find your agent: 96001, 96002 etc.  These glitches are making this all a bit more challenging, but not impossible. It appears certifications are finally getting out.  We have many more local agents showing up on the site.  You don't have to go it alone!

Covered California reports 2074 agents certified in the state and over 21,000 more pending.  Add this to the Enrollment Entities, Certified Enrollment Counselors and County eligibility workers, there will be about 39,000 places to get help with enrollment.

As of press date we had received an indication that the Anthem plans on the Exchange were finally granted written approval. The off-exchange commercial plans are still subject to approval.  It is my understanding that one of the reasons many of the enrollments have not been completed is due to the fact that the carriers are actually waiting final approval for the products from the Departments of Insurance and Managed Health Care.  Until final approval is granted no one can actually enroll in the plans, so you will see reference to "applications started".

I have been hearing rumors of risks of fraud, how do I protect myself?

There has been some press about the concerns regarding fraud and identity theft.  First if someone talks to you in a threatening or with a message for fear like "It's the law, you have to do this, now!" that's a good reason to be wary.  If someone calls you and says they are from the government and you must give them personal financial information, DON'T.  Ask for their identifying information and look on the Covered California website to see if they are listed.  If not, do not do business with them.  You have time to do your research.  Also no one is allowed to charge you a fee to process this paperwork.

I don't understand why someone would not just wait until they get sick to enroll in a plan.  Will that work?

No, there are a couple of safeguards built in.  First there is only one open enrollment period each year.  This year it runs from Oct 1, 2014 to March 31, 2014.  But in the future it will only be in the fall.  There are special enrollment periods should you have a special event like losing other coverage. So, enrolling at the Emergency Room door isn't going to work as a long term strategy.  Also the penalties for not enrolling increase each year.  That will also encourage folks to consider enrolling. 

News you can use if you or someone you know is diabetic:

Part of the Affordable Care Act is emphasis on keeping the population well, not just treating sickness.  That is why you are seeing enhanced benefits for annual physicals and well care.  In the spirit of this theme the National Council on Aging, YMCA, and Anthem are working with Stanford University on a study. The goal is to find out how well community-based programs can help members better self-manage their health. The workshops and study are funded by the National Council on Aging through grants from the Bristol-Meyers Squibb Foundation and Anthem's foundation.

This is a national program called "Better Choices, Better Health® - Diabetes program". It's a Type 2 diabetes management program built by Stanford University. The program is made up of six, free, online or in-person workshops. Each one connects trained, peer facilitators with people who have diabetes. Together, they work to learn, share and solve problems. Those who attend get the personalized facts they need to help them better control their health issue. Results have shown the program helps people lower their blood sugar, cut down on emergency room visits and improve communication with caregivers.

Those who meet certain criteria can sign up for the free workshops and voluntary associated research study.. They can find out more by either calling 866-553-1282 or going to www.selfmanage.org. The workshops are free.

If you sign up and want to share your experiences feel free to send me an email.

Note: All information in this column is provided" to the best of my knowledge" subject to final regulation by the respective agencies.