Open Enrollment and Special Enrollment

Covered California has said they will allow extended enrollment through 2/22/15 for certain scenarios.

To take advantage of the extra time, they must have been, and be, working with a certified insurance agent, enrollment counselor or county eligibility worker.

After this Open Enrollment window closes, only Qualifying Events (or Special Enrollment Periods) allow consumers to change plans or enroll in a new plan.

EXAMPLE OF QUALIFYING LIFE EVENTS FOR SPECIAL ENROLLMENT:

  • Getting married or entering into a domestic partnership.
  • Having a child or adopting a child, receiving a child into foster care, or placing a child in adoption or in a foster home.
  • Change in place of residency, which allows a consumer to gain access to new Covered California health insurance plans. This includes moving to California from another state. This also applies to individuals who are released from jail or prison.
  • Losing health coverage. For example, consumers are no longer eligible for Medi-Cal, or they lose health coverage through their job.
  • Income changes so much that a consumer becomes newly eligible or ineligible for help paying for their insurance. For example, if a consumer is already getting help paying for their insurance premium, and their income goes down, they may be able to get extra help.
  • Becoming citizens, national or lawfully present individuals. This event applies only to people who were not previously citizens, nationals or lawfully present.
  • The consumer’s enrollment was wrong, due to the misconduct or misrepresentation of their health insurance company, Covered California or a non-Covered California entity (such as a Certified Enrollment Counselor).
  • Being a member of a federally recognized American Indian or Alaska Native tribe. A consumer in this category may enroll in health insurance or change health insurance plan once a month even if the open enrollment period is over.
  • Covered California can also determine, on a case-by-case basis, that the consumer experienced an exceptional circumstance, which could allow for a special enrollment period.

Eligible consumers with a low income, who qualify, can apply for Medi-Cal anytime throughout the year.

For more information, you can view the Covered California link below.  To enroll in a plan and explore your options, contact Steve Downey, or any Covered California Certified Insurance Agent.

http://www.coveredca.com/individuals-and-families/getting-covered/special-enrollment/

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Covered CA Notice sent to (some) Clients

From COVERED CA:

Notices with Incorrect Open Enrollment Dates

In the past two weeks, about 11,000 Denial of Coverage notices were generated and sent to consumers with the incorrect Open Enrollment dates for the Individual Marketplace. These notices were sent to consumers that applied outside of Covered California’s Open Enrollment period.  Although the dates indicated were correct at the time the notices were sent, a change in the law resulted in a change to the Open Enrollment period indicated.

The incorrect dates on the notice were October 15, 2014 through December 7, 2014. The 2015 Open Enrollment period is November 15, 2014 to February 15, 2015.

Please [be aware if you were] affected by this notice [and take note of] the new Open Enrollment dates. Be sure to also check whether [you] qualify for Covered California’s Special Enrollment Period.

If eligible, you can call [today for questions about enrolling in this special enrollment period].

[If you] are not eligible for Covered California’s Special Enrollment Period, [you] can apply during Open Enrollment this fall for coverage beginning January 1, 2015.

Apply by Monday 3-31-14, Open Enrollment will be OVER

 
Enrollees Who Want to Beat March 31 Deadline Rush Should Sign Up Now
 
SACRAMENTO, Calif. — Covered California™ today confirmed its March 31 deadline for open enrollment in an exchange health insurance plan and announced its policies for completing an application for health care coverage.
 
With five days left to enroll in a Covered California health insurance plan, the exchange is urging consumers to sign up before the deadline if they want to get affordable health care coverage and avoid a tax penalty.
 
“If you haven’t applied yet, do it now,” said Covered California Executive Director Peter V. Lee. “We are concerned that high numbers of people will come to our doors at the last minute and won’t be able to get enrolled in time. If that happens, consumers face a penalty for not getting insurance, and they may miss out on the peace of mind that comes with coverage.”
 
Covered California also clarified the process for completing applications for health coverage in 2014.
 
“Covered California is not extending its deadline for applying for a health plan,” Lee said. “However, we’re committed to helping all those who started an online application to cross the finish line.”
 
Individuals who start an online application by 11:59 p.m. on March 31, 2014, will have until 11:59 p.m. on April 15, 2014, to complete their application and select a plan. To start an application, the consumer must take at least the following steps:
 
  • Create an online account.
  • Fill out all required information on the “Apply for Benefits” page and click “Continue.” The page contains two required fields (see application screen images online athttp://news.coveredca.com/p/blog-page_26.html).
  • After clicking on “Continue,” individuals will be taken to the “Consent for Verification” page, where they need to click on “Save & Exit” or “Continue.”
  • They must return to their online account no later than April 15 to complete the application and select a plan. 
Covered California reminds consumers that they must make their first premium payment to the health insurance company by the due date to avoid the tax penalty.
 
Paper applications must be postmarked by March 31, 2014, to meet the open-enrollment deadline for 2014 Covered California plans. To guarantee coverage beginning May 1, 2014, however, consumers are encouraged to enroll online.
 
After the end of open enrollment on March 31, consumers may be eligible for Covered California’s special enrollment period, which can be triggered by one of several “qualifying life events,” as defined under the Affordable Care Act. Some of those qualifying events are:
 
  • Getting married.
  • Having a baby or adopting a child.
  • Permanently moving to a new area that has different health plan options.
  •  Losing other health care coverage that is considered minimum essential coverage.
  • A change in income that would affect an enrollee’s eligibility for financial assistance.
 
Low-cost or no-cost coverage through Medi-Cal is also available to consumers year-round, and they can check their eligibility and sign up on the Covered California website, through its Service Center or with the help of assisters.
 
Covered California also operates its Small Business Health Options Program (SHOP) year-round for businesses with 50 employees or fewer.
 
Covered California’s next open enrollment, for 2015 coverage, will begin in fall 2014, likely mid-November.