Column 24 Q and A

My plan is grandfathered.  Can the insurance company still cancel it?

It's important to understand that an insurer can cancel a block of business if they do not single out an individual. Some carriers decided to leave the individual market in 2014 and have will not renew individual plans.  In the past this would have left uninsurable individuals with very few options.  With the new law, the carriers that are writing business must take all eligible applicants during the current open enrollment period that ends 3/31/2014. 

I am a full time student with little or no income.  Can I qualify for a subsidy on the Exchange?

You are subject to all the same criteria as anyone else when applying for subsidies.  One important distinction to make is whether you are claimed as a dependent by someone else, such as your parent.  The subsidy calculation is tracked back to the tax paying "entity".  If you are claimed by your parents as a dependent then your eligibility is based on the combined income of all of you. If not, then you are likely eligible for MediCal with little or no income.

 

What if I have health insurance coverage through the VA?  Do I have to apply for coverage on the Exchange?

No, you do not have to apply for coverage.  The VA coverage meets the requirements of the new law.  However, if you wish to apply for additional coverage, you may do so.  However, you are ineligible for subsidized coverage if you have VA coverage.  Having VA health care does not preclude other members of your family from getting those subsidies for marketplace plan, but it will impact their subsidy.

I had a case this week, where the family income qualified the husband and wife for Bronze coverage at a premium of about $54 month.  The subsidy for the two who are age 60 or so, would have been about $900 monthly.  But since the husband is covered by the VA, the wife's subsidy is reduced to about $250 monthly and now she would need to pay about $250 for her coverage. That's still half of what she would have paid.

 

Application tips for Covered CA:

*When you are entering marital status for children, use single not "never married".  The site doesn't like that category and it can gum up the application.

*When you take copies of ID documents like drivers license or things that have a picture, do not simply photocopy.  It is better to scan and make a .jpg that shows the face clearly.

*Be prepared to send copies of your social security retirement statements if you recently retired and your income has changed dramatically.

*Even if you submit your own application, considering choosing an agent.  An agent will assist you after the insurance is in force.  You do not pay extra to have this service.  Simply log on to your account and look for the icon in the upper right corner that says "Find help near you".  Click on this and at the next screen click on "find a certified agent".  There you can input the name of the agent or now that the zip code search is working you can input your zip code and find someone in your neighborhood. You will notice that it says that you can change agents at any time, so if you are not happy with the service, you can simply make the change through your site.

If your agent has submitted a paper application, it may be a good idea to follow up and call Covered CA.  We were told on Wednesday that if the client doesn't show up on our online portal by Thursday that we need to submit online applications.  Most of us are extremely frustrated by this, because we have some in since October and they are still not processed.  We will be working with our clients to resubmit all of those this weekend.

*Information provided in this column is "to the best of my knowledge based on press deadline