Covered CA Website Causes Suffering During Open Enrollment

Covered CaliforniaCovered CA website causes suffering during open enrollment this week after being fortified for high utilization.  An interview with a San Jose-based Certified Agent provided the following observation:

Today, I assisted at least 4 different clients on their renewal process and/or to start a new application.  The website directed all of the clients into Medi-Cal, even if their income was well above 140% FPL

Calling Covered California directly is not an option, due to five-hour wait times.  Cases such as these require special handling, which is a free benefit of Certified Agents.  For example:

I had a family of three come in with a total annual household income of $49,666.73 and they were placed on Medi-Cal.

Certified Agents can provide local assistance with such glitches, and often times are willing to meet you in person. Open Enrollment is here, changes are coming, and websites are frustrating.  If you did not use a Certified Agent last year, now is a good time to find one…they are a free service of Covered California and are here to help.

Obamacare: Not Easy!   ............  Cake Pop, Anyone?

Obamacare: Not Easy! ………… Cake Pop, Anyone?

Kaiser California Individual Members Pay Twice in December 2014

California Marketplace

The Affordable Care Act hits Kaiser Members hard

Yes, Kaiser California Individual members pay twice in December 2014, in order to help Kaiser Permanente catch up with industry standards.

As explained in a Kaiser Permanente November news briefing to its marketplace partners, Kaiser’s status as a prepaid health plan requires monthly payments before the last day of each month. Apparently, throughout 2014 Kaiser has not been billing its members for prepayment, and now plans to catch up in time for January 2015.

What Kaiser California Individual & Family members need to know:

  • You will receive two separate bills in December- one for the December 2014 premium and a second bill for the January 2015 premium
  • Both bills must be paid by December 31st.

The news briefing goes on to say certain members may have extra time to pay, based on their Evidence of Coverage or Membership Agreement.  To get free assistance from a California Kaiser agent, send a request to info@coverage-ca.com or phone 1 (408) 641-8950.

Remember, Open Enrollment begins November 15th:  Changes are coming and websites are frustrating. Read our related article about CoveredCA’s problems. If you did not use a Certified Agent last year, now is a good time to find one…they are a free service of Covered California and are here to help.

Anthem Blue Cross Doctors & Hospitals

Which Anthem Blue Cross network accepts your plan?

Covered California

Covered California

Deciphering the confusing Anthem Blue Cross Doctors & Hospital networks

California insurance consumers should be extra cautious during open enrollment season (November 15, 2014 to February 15, 2015) that their doctor was not been dropped by their health plan (see related story about the thousands of California HealthNet plan members who are forced to take action by December 15th).

Don’t ask your doctor- he or she probably won’t even know it happened, due to the confusing network games that insurance companies play.  For example, see the confusing Anthem Blue Cross Doctors & Hospital network references in the table below…

Provider Directory Reference Guide

PLAN NAME AT COVERED CALIFORNIAOR IT MAY LOOK LIKE THIS ON YOUR ID CARDOR LIKE THIS ON THE ANTHEM WEBSITE
Anthem Silver 70 PPOAnthem Silver Direct AccessPathway X-PPO via Exchange/Silver Direct Access
Confused?Call for free assistance:1 (408) 641-8950

For what its worth, we are providing a link to the entire directory guide from Covered California:

PROVIDER DIRECTORY GUIDE

There are lot’s of doctors, coming and going from these networks…some accept group plans and others accept individual plans, but the names are confusing for them, too.  We strongly advise you to hook up with a local Certified Agent (it’s a free service from Coverage California) and make sure you don’t make a big mistake for all of 2015.

Remember, Open Enrollment began November 15th:  Changes are coming to certain PPO & HMO networks.  Read a related article about CoveredCA’s here.  If you did not use a Certified Agent last year, now is a good time to find one…they are a free service of Coverage California and are here to help.

HEALTH NET PPO PLAN CLOSURES AT COVERED CALIFORNIA

Health Net PPO Plans California

Health Net PPO Plans

Open Enrollment 2015 begins November 15th

Open Enrollment 2015

Health Net has shipped 90-day plan closure notices to Health Net PPO members (see related story about Anthem Blue Cross) in Covered California who are currently enrolled in PPO plans (Individual or Family PPO plans).  These notices shipped October 2nd, as Health Net moves its PPO portfolio off-exchange.  For the time-being, Health Net will not offer an individual or family Health Net PPO plan through Covered California.

What can you do to keep Health Net PPO plan coverage?  Fortunately, you have options… If you wish to keep the same doctor and stay on a similar plan directly (i.e. off-exchange) with Health Net, CLICK HERE to request free assistance.

If you wish to talk with someone to get information about the remaining PPO plans at Covered California, CLICK HERE.

Caution should be observed if you purchased a plan during the last open enrollment:  Effective after this Open Enrollment, Insurers are shifting doctor and hospital networks.  Do not take chances with your policy.  Before you renew, talk with one of our representatives for FREE.

See our related story about Covered California Open Enrollment Notices.

Remember, Open Enrollment begins November 15th:  Changes are coming to certain PPO networks.  If you did not use a Certified Agent last year, now is a good time to find one…they are a free service of Covered California and are here to help.

Covered California Open Enrollment Notices

Covered California Notices

Covered California is shipping envelopes by Mail for Open Enrollment season (see above)

Members will receive Covered California open enrollment instructions over the next two weeks, informing them of the Renewal Process.  If you need assistance understanding the 2015 changes, click here to request help.  Read story, If you want to review details about last year’s open enrollment or just get a free quote at this website.

Due to an online systems limitation from October 13 to November 3, 2014 only, you will be unable to login to your account in order to report changes for the 2014 plan year.  Covered California has developed a work-around during this period and you can receive assistance from Certified Insurance Agents here.

Remember, Open Enrollment begins November 15th:  Changes are coming to certain PPO networks.  If you did not use a Certified Agent last year, now is a good time to find one…they are a free service of Covered California and are here to help.

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Breaking News: COBRA Coverage California Open Enrollment May 15 – July 15

Beginning Thursday, May 15, Covered California will launch a limited-time special-enrollment period for people who have COBRA health insurance, either Federal COBRA or Cal-COBRA (COBRA Coverage California), and would like to switch to an exchange plan.

People who have health coverage through COBRA (the Consolidated Omnibus Budget Reconciliation Act) will be eligible to shop for and buy coverage through Covered California from May 15 through July 15, including local assistance from Certified Insurance Agents, at no additional charge.  The two-month window mirrors a U.S. Department of Health and Human Services (HHS) ruling announced May 2 that allows COBRA enrollees to buy plans through the federal exchange up to July 1.

Read the full press release here or jump ahead for a Rate Quote, right now!

Open Enrollment Closed March 31, 2014

This article was originally written for the Fall 2013 open enrollment season.  See our related story about Covered California Open Enrollment Notices for the 2015 open enrollment.

Remember, Open Enrollment begins November 15, 2014.  Changes are coming to certain PPO networks.  If you did not use a Certified Agent last year, now is a good time to find one…they are a free service of Covered California and are here to help.

Original Article

We heard the Website is overwhelmed.  CoveredCA put out a message to agents, today that Paper Applications may be completed and signed and faxed to the following phone numbers, BY March 31, 2014:

FAX NUMBERS FOR COVERED CALIFORNIA PAPER APPLICATIONS:  1-888-329-3700 OR 1-916-636-3400.  Frequently, you get the “all circuits are busy” signal.  Unfortunately, the State of California did not plan adequately.

Paper Application

Customer Service:  1.800.300.1506

Website Problems Challenge December Deadline For California Individual Family Enrollment

For January 1st coverage, the December deadline for California Individual Family enrollment is just days away, yet the Covered California website is down for repairs.  Fortunately, you can download an application today, and even request free assistance from a local Certified Insurance Agent.

FREE RESOURCES FROM COVERAGE CALIFORNIA:

Already started an online application, but frustrated with results?  Get free help from a San Francisco bay area Certified Insurance Agent.  How?  Beginning November 26, 2013, simply login to coveredca.com and follow the instructions below:

GETTING HELP IF YOU HAVE ALREADY REGISTERED ON COVERED CA

  1. CLICK “Find Help Near You” in the upper right corner
  2. CLICK “Find An Agent”
  3. CLICK the name search box and type in “DEREN”
  4. CLICK on the search results for “Marc Derendinger”
  5. CLICK the “Continue” button
  6. CHECK the 3 agreement boxes and Accept this person as your designated agent.

Don’t worry, you can change or revoke this designation at any time, but the benefit to you is getting access to a personal advocate with 30 years industry experience…free of charge!

Now that you have completed the designation, call us and we start helping you right away!

408.475.8219

California Marketplace

2014 Health Plan Options For Californians

For rate comparisons of new group health plans, click here.  For non-group e.g. individual family plans click this link.  Have an individual Kaiser plan?  Read this article.

Got questions? Frustrated with the Affordable Care Act?  Life’s too short to waste time with all this:  Request free consumer assistance from Certified Insurance Agents, below:

Request Free Assistance

 

Treasury Department Changes “IRS Use It Or Lose It” Rule

We heard rumors the IRS would modify or eliminate it’s Section 125 forfeiture requirement, also known as the “IRS use it or lose it” rule, in Flexible Spending Account (FSA) plans.  Well, the news is out:

October 31, 2013, the Treasury Department issued Notice 2013-71, providing employers more flexibility with medical reimbursement accounts.  Effective with 2014 plans years, plans that do not offer a grace period, may allow up to $500.00 to roll-over.  Currently, left over balances are forfeited to the plan (which often falls under the indirect control of the employer).

The key elements in this IRS Use It Or Lose It notice are 1) the $500 carryover is an alternative to the existing grace period rule, and 2) the plan must be amended in a timely manner.  Talk to your Section 125 administrator or employee benefits broker or attorney, for more details. For a copy of this notice, click here.

For a big picture look at the effect of the Affordable Care Act in California, read our related story.

For additional employer requirements under the Affordable Care Act legislation click here.  For rate comparisons of new group health plans, click here.  For non-group e.g. individual family plans click this link.

Got questions? Request free consumer assistance from Certified Insurance Agents, below:

https://coveragecalifornia.eventbrite.com/

 

Affordable Care Act “ACA Tax” Beats Up California Employers

New Health Insurer Tax, Exchange Tax, Transitional Reinsurance Tax, and Risk Adjustment Tax

The name for each ACA Tax begs the question: “Why are Employers paying for these taxes?”  The public perception, at least in California, is the ACA Tax is a health insurer tax, right?  Effective October 28, 2014, Blue Shield of California notified all small business customers that this ACA Tax is being passed through to employer group plans:

“Today we are mailing a letter to all of our small business customers renewing from February to December 2014 to notify them of the upcoming 2014 taxes and how they will impact their dues and/or premiums.” [Blue Shield of California letter to policyholder, October 28, 2013]

California Marketplace

The Affordable Care Act hits California employers hard

ACA Tax (Part I):

“Beginning on January 1, 2014 the health insurer tax and transitional reinsurance tax will be added to your base medical rate and you will see the increase on your bill.”

  • Health Insurer Tax – est.  1.3% of premium
  • Transitional Reinsurance Tax – est. 2.3% of premium

In addition to this ACA tax cost, two additional Affordable Care Act taxes will be added effective with your 2014 group anniversary date, and will become part of the group premium rate:

ACA Tax (Part II)

  • Exchange Tax – est. .2% of premium
  • Risk Adjustment Tax – est. .02% of premium 

For a big picture look at the effect of the Affordable Care Act in California, read our related story.

For additional employer requirements under the Affordable Care Act legislation click here.  For rate comparisons of new group health plans, click here.  For non-group e.g. individual family plans click this link.

Got questions? Frustrated with the Affordable Care Act?  Life’s too short to waste time with all this:  Request free consumer assistance from Certified Insurance Agents, below:

https://coveragecalifornia.eventbrite.com/