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Open Enrollment for Covered California

You can lead a horse to water…..and we all know the rest. That is a bit of what Covered California, the individual health insurance market place is experiencing these days.

A recent Press Release from Covered California announced that an estimate 32,000 people in Chico and Redding can benefit from subsidies provided by the American Rescue Plan (ARP). There are so many provisions of this act that I expect most peoples’ eyes glaze over at the mention of it.

If you have individual health insurance coverage, not provided by an employer, you really should pay attention. At the very least, contact your agent or go to www.coveredca.com and click on the “shop and compare” button to get an estimate of your premiums You will need to know your approximate taxable income for 2021 to obtain the most accurate results.

Income for this purpose is (MAGI) Modified Adjusted Gross income. There are several links to help you calculate this including: https://laborcenter.berkeley.edu/modified-adjusted-gross-income-under-the-affordable-care-act/.

In the past it has been primarily your earned income, interest, pensions, unemployment plus you must also include non-taxable social security benefits and tax-exempt interest. Certain Native Americans payments may be excluded.

Covid relief packages have added a new decision tree to the mix for what is or is not included.

There are different rules for coverage under the Covered CA Exchange and Medi-Cal and CHIP (Children’s Health Insurance Program). For the Exchange, coverage you might be be surprised to know that the following payments do NOT count toward income for subsidy purposes: Recovery Rebates (one-time payments for individuals) and Workers Compensation payments.

For Medi-Cal, the Supplemental Unemployment insurance (additional $300 weekly) will not be included in the calculation.

Inputting income, ages and zip codes, “Shop and Compare” can give you an estimate of what your insurance would cost. One tip, use the full “Shop and Compare” button located in the top right corner of the home page. Don’t use the “Get your estimate” pink button. Once this is updated for the Unemployment information it will be more valuable.

The trick is that your insurance MUST be purchased through the Exchange to qualify for subsidies. If you have individual coverage outside the Exchange, you will not get any premium help.

The good news is that there is an open enrollment period that will allow those who apply and qualify by June 30 to have insurance effective 7/1/2020! This is a far cry from when we had to answer 50 health questions and wait for the insurer to get doctor records to see if we would be granted insurance.

Covered CA estimates that there are 11,000 people in Chico and Redding that do not have insurance and could qualify. Additionally there are 2500 who have insurance with directly with the carriers that may qualify. Within the state, they estimate 680,000 people in the state have plans that would cost them $1 monthly on the Exchange.

Covered CA announced that under the ARP, any Californian who received unemployment insurance benefits in 2021 is eligible for the $1 monthly high deductible plans. Apparently, this is regardless of other income. They expect to be able to implement system changes that will allow the estimator to calculate this benefit sometime this month. In the interim, one can contact Covered CA directly at 800-300-1506.

Consumers need to be aware that these plans are very similar or even identical to the plans they have purchased off the Exchange. The plans are not inferior. In fact, if one qualified for Advanced Silver, they are getting better benefits than is available outside the Exchange.

A single 50 year-old living in Redding with $50,000 of income would receive about $517 in subsidy giving a net premium of $113 for a Bronze Plan from Anthem. That $6000 annualized premium savings could cover most of the $7000 deductible, if coverage was provided through the Exchange. If income and family size are doubled to $100,000 for a family of two, the savings is $1017 monthly with a net premium of $243.23!

The trick to getting this help is to purchase individual coverage through the Exchange. There are three main ways to obtain coverage:

1) Contact a Covered CA agents in our area

2) Call Covered CA at 800-300-1506 to enroll.

3) Go to www.coveredca.com and enroll directly. Be careful to go to the direct site, otherwise you may inadvertently be directed to a marketing website.

I recommend enrolling before June 30th as the sites often crash on the last day of an enrollment period. Might as well take advantage of “free” money!

Margaret R. Beck

Margaret Beck CLU, ChFC, CEBS started her insurance practice in Redding in 1978. She is the founder of Affiliated Benefit Services where businesses and individuals are assisted in choosing proper products, compliance with complex benefit laws and claims issues once coverage is placed.

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