Tag Archives: Special Enrollment

3 Actions To Keep Affordable Health Coverage- Private Insurance

The previous articles covered Part I and Part II, and this final segment describes the 3rd of 3 Actions To Keep Affordable Health Coverage- Private Insurance. [Small Employers should read about huge penalties beginning August 2015]

  • Going directly to the insurance carrier (Kaiser Permanente, Anthem Blue Cross, Blue Shield of California, Cigna, HealthNet and others) is easier than going through Covered California and the prices are virtually identical under California law.
  • In our opinion, the only reason one would choose the Covered California exchange (Part II of story) over your 3rd option (private insurance) is the likelihood of receiving a subsidy or Advance Premium Tax Credt. Otherwise, CoveredCA is not worth the hassle, due to the burden of providing tax forms, proof of California residency, employment information etc.
  • Deadlines: Regardless of your choice among the 3 Actions To Keep Affordable Health Coverage, the 60 day limit applies.

    Time is of the essence to find or keep affordable health coverage while looking for a new job, and you must take action fast. Read more about Special Events here or request assistance.  

    Need Temporary Health Insurance?   CLICK TO QUOTE

In conclusion of this 3-part article, the easiest part of this process is choosing a plan, and the hardest is getting the triggering loss of coverage form to the carrier (the specific document and method vary by health plan). Don’t risk losing your effective date, use a competent broker who is licensed and certified to help you compare your options under all 3 alternatives above, and will help you submit a properly completed application to the health plan of your choice!

Certified Insurance Agents are a free service to consumers under the ACA and California law. However, the best certified agents will also help you compare your private insurance (PPO, HMO) options vs. your CoveredCA options.  Find a local office of one of these broker-agents, in order to keep affordable health coverage while looking for a job.

Click to return to Part I or Part II of this article.

3 Actions To Keep Affordable Health Coverage- CoveredCA

While Federal or Cal-COBRA is the conservative choice (as discussed in Part I of this article), the negative aspects are “higher costs.”  This is true because Federal COBRA administrators add 2% to the premium and Cal-COBRA administrators add 10%. If finding a low cost health plan is your priority, your 2nd action to keep affordable health coverage- CoveredCA should be requesting information from Covered California [Small Employers should read about huge penalties beginning August 2015]

  • Covered California provides access to most private health plans e.g. Kaiser Permanante, Anthem Blue Cross, Blue Shield of California, HealthNet EPO and PPO plans and some regional providers as well (although availability varies among each of California’s counties- check here for assistance): extra caution is advised, because you must complete and submit your application prior to the desired 1st of the month coverage start date to avoid a gap in coverage, and the 60 Day Limit also applies.

Warning:  failure to enroll within the special event 60-day period will not only incur a possible IRS tax penalty, but will consequently lock you out of the U.S. health insurance market until the following open enrollment period i.e. January 1st!  (This is a lessor known problem with the Affordable Care Act).

Need Temporary Health Insurance?   CLICK TO QUOTE

 

Yet there are other reasons to skip CoveredCA and go directly to a private carrier.  Read more about the 3rd of 3 Actions to keep affordable health coverage while looking for a job in Part III of this article.

Return to Part I of this article or proceed to Part III or request assistance now.

3 Actions To Keep Affordable Health Coverage While Looking For A New Job

Time is of the essence to find or keep affordable health coverage while looking for a new job, and you must take action fast. In this three-part series, here are 3 important steps to find or keep affordable health coverage under the Affordable Care Act:

  1. If all else fails, use CAL-COBRA or Federal COBRA as a backstop, although it may not be the lowest price option: Warning, there is a maximum 60 Day Time Limit To Respond or you could lose your COBRA rights and eligibility;

Failure to enroll within the special 60-day period will not only incur a possible IRS tax penalty, but will consequently lock you out of the U.S. health insurance market until the following open enrollment period i.e. January 1st!  (This is a lessor known problem with the Affordable Care Act).  Read more about Special Events here or request assistance.

If you cannot afford the high cost of COBRA premiums, and really want the most affordable health coverage, then CoveredCA, the Covered California health exchange market may work better for you. Read about the pro’s and con’s of CoveredCA in Part II of this series, or proceed to Part III, “Private Insurance” options.

 

 

Proceed to Part II of this article or skip to Part III.

SEP Qualifying Event Rule- How It Works

The Qualifying Event rule is complicated and confusing, moreover, the definition of qualifying event varies between private insurers and Covered California.

The SEP Qualifying Event Rule- How It Works in a 2 Minute Video

Questions About Special Qualifying Events?  Get Local Assistance

Time is of the essence during your qualifying event period (60 days). Yet some situations don’t qualify for special event consideration e.g. missing a COBRA premium payment.  Either way, time is of the essence, consult with a Certified Agent as soon as possible.  The ideal advisor is also an independent agent/broker:

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

Obamacare is Not Easy! ………………… Cake Pop?

An independent Certified Agent is knowledgable about private market health plans and Covered California plans.

An independent Certified Agent is also able to place you with temporary health insurance until the next regular Open Enrollment season begins.

“Special Enrollment” flyer from Covered California

Qualifying Event

List of Covered California Qualifying Life Events

Lost or will soon lose my health insurance
Examples:

  • You lose Medi-Cal coverage.
  • You lose your employer-sponsored coverage.
  • Your COBRA coverage is exhausted. Note: Not paying your COBRA premium is not considered loss of coverage.
  • You are no longer eligible for student health coverage.
  • You turn 26 years old and are no longer eligible for a family plan.
  • You turn 19 years old and are no longer eligible for a child-only plan.

Read the entire list of Qualifying Life Events at Covered California or view Kaiser Permanente’s sample triggering loss of coverage form.  If you have lost your health coverage within the last 60 days, then read this article first.

Find Local Assistance for your Qualifying Event

You can find independent local assistance in San Jose, Santa Clara and the San Francisco bay area or via telephone, throughout Northern and Southern California.

Eventbrite - Shopping For Obamacare And Better Covered California Insurance

 

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