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9 Risk Factors Applying To Covered California

In addition to the advantages, we have documented at least 9 disadvantages i.e. 9 risk factors applying to Covered California.  Despite limited media attention, these factors require caution and understanding, because of the potential for problems after you apply to Obamacare.

9 Risk Factors Applying To Covered California

9 Risk Factors Applying To Covered California

We encourage California residents to study the balance of this report carefully, in order to make the best decision for your family.

9 Risk Factors Applying To Covered California

9 Risk Factors Applying To Covered CaliforniaDescription of RiskPossible Solution
Risk Factor 1The State of California (via county social services agency) verifies the financial information on your CoveredCA application and has the power to make you “ineligible” for CovCA insurance if there are discrepancies between the application, filed income tax returns, immigration documents etc.Understand that CovCA uses last year’s tax return information to estimate your APTC subsidy, however the true amount will not be known until you file this year’s tax return. Work with a Certified Agent who can discuss these issues with you.
Risk Factor 2The verification of your application occurs during an indeterminate period of time, usually between January and August, but usually after you have cancelled your former insurance.
Risk Factor 3A frequent and undesirable outcome of the agency’s application verification process is that your insurance is revoked and you are temporarily placed in Medi-Cal, pending approval by a Medi-Cal eligibility case worker. Medi-Cal representatives will use the authority of the State of California to issue a system-generated freeze, named “soft-pause” on your file at CovCA. It effectively prevents Covered California IT engineers from “fixing” or undoing this Medi-Cal action. Your only recourse is to personally visit the county social services agency and attempt to determine the identity of your case worker, and then to arrange a meeting in the hope of opting out of Medi-Cal.
Risk Factor 4Placement into Medi-Cal, outside of “open enrollment” season is not a qualifying “special event.” This prevents you from re-applying elsewhere, since no health plan will accept your application until the next open or special enrollment.If this occurs during an open enrollment period, you can re-apply directly to Kaiser or another health plan. Otherwise, you will have to stay on Medi-Cal until the next Open or Special enrollment period.
Risk Factor 5Involuntary loss of health insurance could result in losing access to your personal physician(s).There is really no remedy, except to find a Medi-Cal doctor or specialist and transfer your chart.
Risk Factor 6Involuntary placement into Medi-Cal mid-year could occur during a course of treatment, surgery etc.We have observed cases where this has happened, and it is unfortunate.
Risk Factor 7Split Family Coverage: Since Medi-Cal eligibility for children is at 250% of FPL, compared to 138% for Adults (in most cases), a common outcome of a family application is that the adults are processed for CovCA insurance with a subsidy, but the children are declared ineligible and are pended for Medi-Cal.Work with a Certified Agent who can estimate the probability of this occurrence and will be prepared to submit child-only applications directly with the insurance carrier (off-exchange) to avoid Medi-Cal. It may be necessary to submit dual applications (on and off exchange) if the open enrollment deadline is near.
Risk Factor 8f your income increases during the year, your APTC subsidy could be less, resulting in you having to repay the IRS for part or your entire APTC subsidy.Ask your Certified Agent to lower the monthly APTC subsidy to give a safety margin. When you file your tax return, you will get the difference paid to you, assuming you are eligible for it.
Risk Factor 9If the IRS determines you were eligible for qualified, affordable employer-sponsored health coverage, your APTC subsidy will be reversed, subjecting you to penalties and interest.When an employer offers an employee health insurance, a report is sent to the IRS, identifying the employee by name and social security number, even when you decline the coverage. This is how the IRS cross-checks this information. If you declined coverage, you may still qualify for the subsidy via an exception. Work with a Certified Agent or your tax preparer to see if you qualify for the exception.

Caution is advised when you buy Obamacare through CoveredCA. To read more about the pros and cons of Covered California in general, and whether you should buy the Obamacare Kaiser plan, read this story at KaiserPlanet.org.

Contact a Certified Insurance Agent to discuss all the risk factors and applying to Covered California:  click here or phone (408) 475-8219.
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Want To Change Your 2016 Health Plan? Better Act Fast

Change your mind about your health plan enrollment?  You have a short window to take action. Turn to a local Certified Agent for best results, but act fast.  As of January 22, there will only be 4 meeting slots left.  Pick one on the Eventbrite registration site, below:

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Shopping California Health Insurance

Shopping California Health Insurance? Open Enrollment ends soon for January effective dates. Smart consumers with existing insurance policies will turn to a local Certified Agent for a 2nd Opinion, because if the health plan changes after you enroll, you will be stuck with it for another year. Find someone with at least 15 years experience who is certified to compare off exchange and CoveredCA policies.  Choose one here:

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New Sutter Health Plan Includes PAMF Doctors

 

The hot news is…effective December 1, 2015, a new Sutter Health Plan will include PAMF doctors in many parts of the bay area.

Get rates and Download the Application.

Additional Sutter Health Plan Resources:

  • Side By Side Quick Comparison of Sutter Health Plan Options
  • Download and Review a sample Individual Bronze Plan EOC
  • Download and Review a sample Individual Silver Plan EOC
  • Download and Review a sample Individual Gold Plan EOC
  • Download and Review a sample Individual Platinum Plan EOC
  • Download Enrollment Guide
  • Download the Application
  • Get Rates
  • Request a meeting with a local SHP insurance agent and get a free service area map based on your home zip code.

Eventbrite - Shopping For Obamacare And Better Covered California Insurance

Open enrollment is ending soon. Register today!

 

Re-Shopping Obamacare For Better Covered CA Insurance

New York Times writer, Margot Sanger-Katz is suggesting consumers should be re-shopping Obamacare coverage. The article argues the savings could be substantial. Even the Health and Human Services agency discovered last year that “Returning Consumers Who Shop Save Money.”

Re-Shopping Obamacare

Open Enrollment ends soon for January effective dates. Smart consumers with existing insurance policies will turn to a local Certified Agent for a 2nd Opinion, because they’re smart, and it’s free.  Find someone with at least 15 years experience.

Eventbrite - Shopping For Obamacare And Better Covered California Insurance

Read the full New York Times article. Look up a local Certified Insurance Agent.

“Returning Consumers Who Shop Save Money.”

Re-Shopping Obamacare

Re-Shopping Obamacare

Local Resources & Assistance

Should We Change Our Company Kaiser Health Plan To Covered California?

Question: We are a non-profit organization located in California; is there any advantage if we change our company Kaiser health plan to Covered California?

Answer: Yes, non-profits can take advantage of a special tax credit under the Patient Protection And Affordable Care Act, if eligible (read the rest of this article at KaiserPlanet.org).

Request Consultation/Assistance

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The Cheapest Age 26 Health Plan In San Jose, California?

So What’s The Cheapest Age 26 Health Plan In San Jose?

The cheapest Age 26 health plan is the catastrophic major medical plan.  The chart below compares Age 26 health plan prices between Blue Shield, Kaiser, and HealthNet, effective November 1, 2015. Share it with someone turning Age 26!  Want to see your own quote? Complete this online form for an instant quote in 30 seconds.

Cheapest Age 26 Health Plan in San Jose

             Age 26 Health Plan

Cheapest Age 26 Health Plan in San Jose

          Age 26 Health Plan

Cheapest Age 26 Health Plan in San Jose

           Age 26 Health Plan

Estimated Monthly Premium:
$246.50
Catastrophic
Estimated Monthly Premium:
$189.28
Catastrophic
Estimated Monthly Premium:
$203.72
Catastrophic
Minimum Coverage PPO Minimum Coverage PPO  Minimum Coverage HMO
Individual: $6,600 Family: $13,200

(Combined Medical & Drug Deductible)

Individual: $6,600 Family: $13,200

(Combined Medical & Drug Deductible)

Individual: $6,600 Family: $13,200

(Combined Medical & Drug Deductible)

APPLY NOW APPLY NOW APPLY NOW

Free local assistance, Call or Text: 1(408) 475-8219

Don’t pay Obamacare tax penalties when cheap insurance is this cheap.  Start the application process today or reserve a local appointment time by completing this Eventbrite form.

Eventbrite - Shopping For Obamacare And Better Covered California Insurance

Kaiser Small Group Insurance Rate Increases Are Infuriating San Francisco Bay Area Employers

Kaiser Small Group Insurance Rate Increases are infuriating San Francisco bay area start-ups and family employers, but one Bay Area Kaiser Specialist has an answer:

“We examined two December Kaiser insurance renewals and discovered rate increases of 38.0% and 31.6%, respectively.  Yet, the Kaiser Permanente “recommended” renewal plan was not the best choice for the employer in each of these two cases.”

The specialist is a 32-year veteran of the bay area health insurance market and helped these employers find less costly Kaiser plans that were not included in the official Kaiser Renewal Package that is shipped to small business employers prior to each plan anniversary.

“Kaiser is available through many channels, including PEOs, public and private exchanges and, of course direct.  If you understand changing markets and where to look, you can often find better value.”

Our readers can request a free consultation by clicking here.
Eventbrite - Shopping For Obamacare And Better Covered California Insurance

For the full version of this story, visit KaiserPlanet.org.

President Obama Signs Healthcare Legislation

The Obamacare Penalty For Not Having Health Insurance

What Is The Obamacare Penalty For Not Having Health Insurance?

In 2015, Obamacare penalty for not having health insurance is the greater of 2% of the family IRSincome above the tax filing threshold or $325 per adult and $162.50 per child.  However, by 2016, the maximum penalty grows to the greater of 2.5% and $2,085 per family.

Need Temporary Health Insurance To Get You To The Next Open Enrollment?  

CLICK TO QUOTE

Additional Obamacare Resources:

Request Local Help Getting Insured and Avoiding the Obamacare Penalty for not having Health Insurance.

Eventbrite - Shopping For Obamacare And Better Covered California Insurance

Does The September Long Term Care Insurance Deadline Affect Women Unfairly?

An early September 2015 Long Term Care Insurance deadline may affect women unfairly, as the nation’s leading long-term care insurance issuer changes pricing methodology in California, effectively charging higher rates for females.  The old system had used unisex rates.

It should be noted that properly completed long-term care insurance applications submitted during the week of September 8th 2015, if approved by medical underwriters, will be grandfathered into the old pricing system.

Existing policyholders will not be affected by the change, but for Californians contemplating the purchase of long-term care insurance, now may be the time to make a decision whether or not to buy this family protection.

To be referred to an agent who could help you, complete the following form by September 8th or share this post with a friend who may interested.

You can find Educational Resources about long-term care insurance here:  http://www.rureadyca.org/