Covered CA Update 1-26-14

Here is an update we sent to our Covered CA clients on 1/26/14.  Many of you will find this helpful as several items have come up over the last couple of weeks:

1.  Payments:  The final dates to make payments for January 1st coverage have changed frequently because health plans were unable to issue billing statements in a timely fashion.  The deadlines for January payments have been regularly updated on our blog:  If you enrolled before 12/28/13, you should have already received a billing statement.  If you enrolled after that date, you may or may not have a statement yet.

If you DON’T have a billing statement, please contact your health plan for information on how to pay.  Here is a link to the Covered CA “How to Pay” page.

2.  Letters from Covered CA:  Most of you have received letters from Covered CA regarding your eligibility.  These letters were generated after you submitted your application, but were not mailed until recently.  As a result, the letters contain outdated information that is causing concern among our clients.

~  Proof of Income/Proof of Residency/legal status – Many of you were asked to submit proof of income or residency or legal status to verify your eligibility for the tax credit or cost sharing reductions.  If you have already uploaded AND submitted your information, you can ignore the request in the written letter. 

A few people uploaded the documents to the website but did not hit the “Submit” button at the bottom of the page.  If you’re not sure whether you completed this process, log in to your account and click on “Manage Verification” on the right hand side menu. Once there, make sure your verification history shows as Status – “Submitted” and that your documents are listed in the “Documents Uploaded” section. 

If you need help to submit requested documents, visit our blog post: Covered California – Uploading Documents

~ Covered CA could not verify your Social Security Number:  According to Covered CA, if you enrolled before 12/28/13, you enrolled before Covered CA was fully integrated with the federal systems required for income/SSN verification.  For this reason, MOST of our clients are being told that their SSN could not be verified.  In addition, many who enrolled after 12/28/13 have also received this notation on their letters.  Covered CA has told us that clients need not worry about this because now the systems are integrated and SSNs will automatically be verified.  However, we are leery of this advice and are encouraging all of our clients to fax or upload a copy of the Social Security Card for each family member.  The problem is, there is not an easy way to upload this documentation.  As a result, many customers are choosing to fax the cards with a copy of the Covered CA letter.  Either way, we encourage you to complete this process to be certain you have complied with Covered CA’s eligibility verification.

~ Proof of Minimum Essential Coverage – Some of our applicants were told to submit proof of “Minimum Essential Coverage”.  This is a poorly named requirement, because it relates to other coverage that you or your family members may have had before enrolling in Covered CA.  In order to confirm your eligibility, you may be asked to provide proof that you have dis-enrolled in other coverage – for example Medi-Cal or other group coverage.  Covered CA has told us that even if a family member was dis-enrolled from Medi-Cal several years ago, you may have to provide a document from your local Medi-Cal office to confirm that you or your family members are not currently enrolled.  If you have had a C.A.R. health plan or other group coverage, you should upload your termination letter that confirms the date your coverage terminated. 

3. ID Cards and Policy Documents:  You may not have received your new ID cards or policy documents.  Don’t feel alone in that regard!  Most of our clients HAVE NOT received this important information.  Health plans report that they are working 7 days a week to get caught up on sending this information to you.  In the meantime, if you need care, you may be asked to pay for services and then submit a claim.  It is important to note that if you enrolled for a January 1st date, and have paid your premium, then your health plan will be responsible for claims from January 1st forward.  We have put some information on our blog page to help you if you need care before you receive your ID card or ID numbers.  Visit our “What to do now…” post and our “Prescription Drug Benefits and your new 2014 health plan” post for more information.

4.  Cancellation of your prior coverage:  If you have paid for your new Covered CA plan, you should cancel your old health plan.  This process is not automatic, so if you have not taken action to cancel your prior plan, you should do so now. 

If you were covered on a C.A.R. health plan, and have not already done so, you will need to submit a termination form (see below) to request cancellation.  If you have already paid your January premiums or February premiums, we will refund your health plan premiums to you when your termination is processed.  Your requested termination date should be the date your new Covered CA coverage begins.  Please fax the completed forms to: (707) 939-8450 or scan/email to:

ABC Termination Form

KP_Terminate Coverage