Medical Coverage

Health Insurance Marketplace Updates

Time is running out to buy your 2014 health insurance policy! Open Enrollment for individual health plans ends on March 31st. If you fail to enroll in a qualified health plan by March 31, 2014, you may have to pay a penalty on your 2014 federal taxes. Contact RealCare, the e California Association of REALTORS’® exclusively endorsed insurance broker, to discuss your health insurance options. Most of our web page visitors are affiliated with the California Association of REALTORS®. As a C.A.R. member, you have several options available to you for health insurance. Each is outlined below. If you are not a C.A.R. member, you will not be able to enroll in the C.A.R. group health plan, but you are eligible for Options 2 & 3, the individual and Covered California plans.

OPTION 1: C.A.R. Group Health Plans

The C.A.R. Group Health Plans Open Enrollment begins April 1st.  Updated plan and rate information will be posted on April 1st. Some people can still join the plan outside of the Open Enrollment, but be aware that plans and rates will change on June 1st.

  • If you are a NEW C.A.R. member, you have a 60 day window to enroll for coverage.  The new member enrollment period begins on the day you join C.A.R. and ends on the 60th day of membership.
  • If you are an existing C.A.R. member, but have experienced a qualifying event, you can join the C.A.R. group plan within 30 days of your qualifying event.
  • Here are links to the C.A.R. Health Plan pages, where you will find rates, benefits and enrollment forms:

OPTION 2:  Individual and Family Plans

Individual and Family Plans (IFP) have an Open Enrollment that runs until March 31, 2014.  All IFP plans are guaranteed issue – no one can be turned down due to medical conditions or history.  If you were on an individual plan in 2013, it is likely that your plan has changed to a new 2014 plan.  It’s also possible that your plan terminated on 12/31/13.  If you have not made a new plan selection, you may not be covered for 2014. The new plans must comply with the Affordable Care Act (ACA) guidelines for benefit structure, rating procedures and taxes.  The 2014 plans are very different from 2013 plans in many ways. If you are applying for a new individual health plan for 2014, you MUST check your new plan’s provider list to be sure that your doctors and hospitals will be available to you in 2014. The 2014 networks for most individual plans are smaller than they were for 2013 and there is no guarantee that your doctor or hospital will be available to you next year just because they are this year. Below are links to look up your providers from the main individual health insurance carriers in 2014. (Kaiser is excluded as their network as not changed.) IMPORTANT! When searching, you may be asked to select a plan. Be sure to select a plan or network that matches the 2014 Individual and Family policies.

To compare the costs and benefits for the new 2014 individual plans, visit our Individual and Family Plans Quoting Page to enter your data and see the plans and rates available in your area.

OPTION 3:  Covered California

Covered California is the name of the new individual plan marketplace that provides Advance Premium Tax Credit and Cost Sharing Reduction to those who qualify through income guidelines.  Under the ACA, the only way to get the Advance Premium Tax Credit or Cost Sharing Reduction is to apply for coverage through the California marketplace, Covered California. If you qualify for the tax credit or cost sharing reduction, you must apply through Covered California.  If you won’t qualify, then there is no reason to apply through this new system.  All the plans available in Covered California are also available through the Individual and Family plans directly.

Not Yet Applied?

If you have not yet applied for coverage, and would like coverage through Covered California, please follow these STEP BY STEP instructions to create your account, choose us as your agent, and apply online. If you don’t know whether you’ll qualify for the tax credit or cost sharing reductions, go to the Covered California Shop & Compare tool to find out.  If you’ll qualify, follow the STEP BY STEP instructions.

THE NEXT AVAILABLE APPLICATION CUTOFF & EFFECTIVE DATES FOR COVERAGE THROUGH COVERED CALIFORNIA ARE:

Effective Date Application Must Be Submitted & a Health Plan Selected By
3/1/14 2/15/14
4/1/14 3/15/14
5/1/14 3/31/14

Already Applied But Need To Check Status?

The best way to check your application status is to log in and view your account.  If your application is completed and a plan has been selected, then you will see a “progress line” with all boxes checked, from “Summary” to “Enrollment.”  You will be able to step through and review each section by clicking on the section at the top (with the check mark) and then clicking on each module on the left hand sidebar.  If you click on “Summary” you will be able to see which health plan you selected; whether you are enrolled; or if enrollment is still pending. Also, follow these tips:

  • If you are ever “lost” in the account, just click on the Covered California logo to go back to the original Home screen.
  • When you click on “Summary” you can view your household members, current enrollment summary and the plan you’ve chosen.
  • Click on the “Eligibility” checkbox to view whether details of your eligibility and determine whether you are required to provide additional documentation such as proof of income or legal residence.
  • If the system shows that your eligibility is conditional pending proof of income or other documentation, click on “Submit Documents” to view the acceptable documentation to provide. To get the latest information on Covered California, visit our blog at www.realcarecar.com/blog

To get the latest information on Covered California, visit our blog at www.realcarecar.com/blog