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Now that the year is underway, folks are find the need to "report a change" under Covered CA.  Reporting a change income apparently triggers the system and expects that you will choose a new plan.  This has been a surprise to some individuals.  They thought they would simply have a premium adjustment on their plan. 

When no plan was chosen, coverage was cancelled.  This has created all kinds of problems, particularly when the situation is noticed after the deadline for changes for that month.  The insured can be left in a period where it appears there is no coverage.  In some cases, we have been able to obtain help from Covered CA.  But it did take going through a few layers to get to someone who wanted to make the correction retroactively, so the client was not without coverage.  We are working with Covered CA to find a better way to instruct clients on the process. 

Covered CA has added new information to the FAQ section and one that I found particularly interesting is as follows:

I enrolled in a Covered California health insurance plan, but it was canceled, and I was given a new account number. What happened?

We apologize for this error. Covered California is working with its health insurance plan partners to fix your account. You do not need to do anything. If you have more than one account, the accounts will be combined, and you will receive a new welcome packet in the mail. If you submitted your application and paid your premium by the deadline, you can begin using your health coverage now.

In our experience, these corrections do not necessarily happen automatically and we advise you to follow up with Covered CA to be sure that it is fixed.  They will often "open a ticket" but nothing is done.  The "squeaky wheel" does seem to get the grease.  Hold times are not like they were initially, so call 800-300-1506 and expect to get a person in less than 10 minutes.

Another new FAQ:

If I already bought my health insurance plan from Covered California and I want to add a children's dental insurance plan, what should I do?

Call the Covered California Service Center at (800) 300-1506. Explain that you already have a Covered California health insurance plan and would like to add a children's dental insurance plan. You will pay an additional premium to get your children's dental insurance plan.

An interesting aside for those who purchased plans off the Exchange and were required to pay the extra $5 for pediatric dental or have their plan cancelled.  Agents were informed initially that there would be parity between on and off the Exchange plans and that $5 monthly premium would be added to adult coverage purchased on the Exchange. To date this has not been the case, even though it is in clear violation of the parity required by rules for the plans.  I expect next year, Anthem will simply build that premium in to their adult plans like other carriers have done. 

Finally for those that did not enroll, you may qualify for an exemption if:

·         You're uninsured for less than 3 months of the year

·         The lowest-priced coverage available to you would cost more than 8% of your household income

·         You're a member of a federally recognized tribe or eligible for services through an Indian Health Services provider

·         You're a member of a recognized health care sharing ministry

·         You're a member of a recognized religious sect with religious objections to insurance, including Social Security and Medicare

·         You're not lawfully present in the U.S.

Other hardships may include:

  • You were homeless.(it does not say for what period)
  • You were evicted in the past 6 months or were facing eviction or foreclosure.
  • You received a shut-off notice from a utility company.
  • You recently experienced domestic violence.
  • You recently experienced the death of a close family member.
  • You experienced a fire, flood, or other natural or human-caused disaster that caused substantial damage to your property.
  • You filed for bankruptcy in the last 6 months.
  • You had medical expenses you couldn't pay in the last 24 months which resulted in substantial debt.

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The application for exemptions can be found at:  https://www.healthcare.gov/exemptions. To save yourself the penalty later, it's probably good to start now.

New California legislation was passed that week that requires health plans and insurers in the individual market to provide an annual enrollment period of November 15, 2014, through February 15, 2015, for the policy year beginning on January 1, 2015.