Category Archives: Health Insurance

March 31st Affordable Care Enrollment Deadline

It was reported in an article February 24, 2014 by the Los Angeles Times that California’s enrollment website for Obamacare coverage was restored Monday after a five-day outage due to software problems.

The online troubles frustrated many consumers, enrollment counselors and insurance agents who wanted to use the Covered California website. The state had been signing up more than 7,000 people per day, on average, in February.

The online enrollment system went down late Wednesday and the state continued to work on it throughout the weekend.

In a statement, Covered California attributed the website problem “to a software malfunction that occurred during a planned maintenance update on Sunday, Feb. 16.”

Regardless of the online glitches, it was also reported that more than 1.7 million Californians have signed up for health coverage since Oct. 1, according to the state’s insurance exchange.

“This shows how strongly Californians are stepping up to take advantage of the Covered California opportunity,’ Peter Lee, the exchange’s executive director, said at a news conference Wednesday.
Another 877,000 Californians were determined to be likely eligible for coverage under the health care law’s expansion of Medi-Cal, the state’s health program for the poor.

Over the last month, the numbers of enrollees in private plans jumped by 203,072, while the number of Medi-Cal enrollees increased by 293,000.

“At least 626,210 of those who selected private plans are eligible for federal tax subsidies,” Lee said. “Covered California does not know how many of those who have signed up for plans were previously uninsured.”

With the March 31st open enrollment deadline rapidly approaching, it is important to contact Jeremy now at (310) 486-7620.


The deadline for open enrollment for Medicare is DECEMBER 7 2013. The deadline for enrolling in Covered California to ensure January 1 2014 effective date is DECEMBER 15th 2013. Open enrollment for Covered California (Obamacare) continues through March 31st 2014 but you are not assured of coverage as of January 1st. It is not too late to realize coverage January 1, 2014, do not delay – call Jeremy at (310) 486-7625 asap.


WASHINGTON November 13, 2013– Top congressional Democrats on Sunday stood by President Obama and the flawed rollout of the government’s healthcare website, expressing confidence the problems would be fixed and the issue would not drag down the party in next year’s mid-term elections.
“I don’t think you can tell what will happen next year, but I will tell you this — Democrats stand tall in support of the Affordable Care Act,” House Minority Leader Nancy Pelosi (D-San Francisco) said on NBC’s “Meet the Press.”
Pelosi downplayed the defection of 39 House Democrats on Friday who voted to help pass a Republican bill, opposed by the White House, to address the millions of people facing cancellation of their health insurance policies. The bill, which passed 261-157, would allow insurers to continue selling individual policies that do not meet new federal standards under the law.
The number of Democrats who defied President Obama and House Democratic leaders on the vote was about the same as those who have joined with Republicans on other bills to alter the healthcare law, Pelosi said. On one such vote in July, to delay the employer mandate in the law, 35 Democrats joined with Republicans.
“No matter how much Congresswoman Pelosi tries to spin this, this is a mess,” Sen. Kelly Ayotte (R-N.H.) said on “Meet the Press.” “My constituents are very unhappy with the notices they’re receiving and higher premiums.”
Obama tried to address the problem of policy cancellations last week even as administration officials scrambled to try to get the website running correctly by the end of the month. On Thursday, Obama gave insurance companies permission to renew policies that were to be canceled for not meeting the law’s new standards that require, for example, coverage for prescription drugs, hospitalization and maternity care.
But companies do not have to renew the policies and would need permission from state regulators to do so.
“Keep in mind, it is a suggestion. It is not a ruling, and it certainly is not a law,” Ben Nelson, chief executive of the National Assn. of Insurance Commissioners, said on “Fox News Sunday.” A former Democratic senator, Nelson said insurance commissioners are concerned Obama’s proposal could disrupt the healthcare market and lead to higher premiums.
Insurance industry officials have the same concerns. They met with Obama at the White House on Friday and are working with the administration to try to address the issue of policy cancellations, said Karen Ignagni, president of America’s Health Insurance Plans, an industry trade group.
“We have the same goals. We’re going to work together to try to get people into affordable coverage,” she said on “Fox News Sunday.” “We have work to do, there is no question. But we have an interest in doing it together and working together on that.”

Blue Shield of CA extends Policies

According to the LA Times, November 5, 2013, California Insurance Commissioner Dave Jones says the state health exchange “made a bad decision” by requiring its participating insurers to cancel coverage by Dec. 31 for hundreds of thousands of consumers.
“I don’t think it was necessary,” Jones said in an interview. “I think people should be given the opportunity to stay in their current plans for another year.”
On Tuesday, Jones discussed a settlement with Blue Shield of California that will buy some more time for about 80,000 policyholders whose policies are being terminated.
Blue Shield of California agreed to let those policyholders extend their current coverage until March 31 to resolve regulators’ claims it didn’t give customers ample warning about the changes.
“This is important because it will allow people with current plans more time to shop and it resolves a defect we discovered,” Jones said.
But Blue Shield said “the changing deadlines may confuse customers and lead some people to pay a deductible twice in one year after they enroll in a new plan for 2014.”
In recent weeks, insurance companies across the country have notified policyholders that their existing coverage will expire because it doesn’t meet all the standards of the Affordable Care Act.
Consumers are guaranteed new health insurance next year regardless of their medical history and many will see rates drop thanks to federal premium subsidies.
But some people will pay more, have fewer health plan options and possibly lose access to their regular doctors and hospitals as medical networks shrink.
“I’m not convinced it would have been fatal to the risk pool,” said Jones, a Democrat who has strongly backed the implementation of the healthcare law. “The Dec. 31 cutoff for individual policies in California didn’t have to happen.”

Business Insurance Solutions in 2014

CaliforniaChoice announced on October 22, 2013 the introduction of a small-group “Business Solutions Suite” designed to provide small businesses and their employees with a host of additional products and services at no additional cost. CaliforniaChoice is one of the nations most successful small-group private health insurance exchanges.

“When it comes to purchasing health insurance, employers today are choosing between a government option, a single carrier or a private exchange,” said Ron Goldstein, president and CEO of CHOICE Administrators, which operates CaliforniaChoice. “Our new Business Solutions Suite includes products and services employers want and need; and we’re able to offer them at absolutely no additional cost to the employer, which enhances the overall value of our program.”
CaliforniaChoice’s Business Solutions Suite will be available January 1, 2014.

The Business Solutions Suite is comprised of three levels, based on the number of employees in a small business. Each level includes discount dental, voluntary vision, discount hearing programs, a pharmacy prescription card, a premium-only plan, access to an online human resources support center, Cal Perks employee discount programs, payroll discounts, and Cal-COBRA billing support. Businesses with more than 15 employees also have access to a flexible spending account, and those with 20 or more employees receive federal COBRA billing support.

CaliforniaChoice offers a wide selection of benefit plans – ranging from platinum metal tier benefits (the richest benefits) to gold, silver and bronze – through Aetna, Anthem Blue Cross, Health Net, Kaiser Permanente, Sharp Health Plan and Western Health Advantage. CaliforniaChoice also offers both full and limited provider networks within each metal tier of benefits, which gives employees more flexibility when it comes to selecting the right coverage. The program also includes a host of optional benefits including dental, vision, chiropractic, life and payroll services.

For more information, call Jeremy at (310) 486-7625 to discuss the most effective options for your small business.

Successful Applications on Covered California

In an article by Chad Terhune October 9, 2013, the LA Times reported that 29,000 people had successfully applied for coverage with Covered California the preceding week.
Covered California released the data earlier than planned to counter “misinformation” and reports about widespread glitches preventing people from signing up.
“This continued drumbeat of doubters and misinformation made us say, ‘Let’s put this out,'” Lee said. Pointing to persistent Republican efforts in Washington to defund or delay Obamacare as a federal government shutdown drags on, Lee said that “you can’t derail something when it has already left the station. We are going very strong.”
California’s enrollment efforts are significant because of its size and strong political backing for the Affordable Care Act. California is one of 14 states running their own insurance exchange; the federal government is operating the marketplace in the 36 other states.
“This is a good start, but the pace of enrollment will have to accelerate for California to meet its goals,” said Gerald Kominski, director of the UCLA Center for Health Policy Research. “I hope they have eliminated the glitches.”
In California, 16,311 households had completed the application process through Saturday the 5th, representing 28,699 people. Consumers had started an additional 27,305 applications that are still pending while they consider their options and keep shopping.
“This blew the socks off anything we expected,” Lee said.
Lee acknowledged that the state website has been slow and “clunky” in the first week, but he said computer upgrades are making it “faster every day.” He also said service-center employees were answering calls within five minutes by the end of last week, down from 30 minutes beforehand.
Experts say the real test for California and other exchanges will come in November and early December when websites, call centers and enrollment counselors come under even greater pressure. Enrollment in exchanges nationwide runs through March 31. But consumers must sign up by Dec. 15 if they want coverage in effect by Jan. 1.

Penalties for Not having Health Coverage

People who are required to have health insurance but choose not to buy it will have to pay a penalty when filing their taxes.

Pay the greater of…

Year —- Percentage of family income — Set dollar amount

2014 — 1% — $95 per adult and $47.50 per child
(up to $285 for a family)

2015 — 2% — $325 per adult and $162.50 per child
(up to $975 for a family)

2016 — 2.5% — $695 per adult and $347.50 per child
and beyond (up to $2,085 for a family)

People who are exempt from the requirement are those who:
• would have to pay more than eight percent of their income for health insurance
• have incomes below the threshold required for filing taxes
• qualify for religious exemptions

Also exempt are:
• undocumented immigrants
• people who are incarcerated
• members of Native American tribes

Open Enrollment – Affordable Health Care Exchange

Reasons to Use An Agent for the Exchange
Open enrollment for the Affordable Health Care Exchange begins October 1, 2013 for effective coverage January 1, 2014. The Exchange can be confusing so let us guide you through the decision and application process. All agents are required to complete hours of training to prepare to aid you in deciding whether the exchange is right for you and to help you navigate the application process.
Small business owners will be directed to Certified Agents. In order to ensure that you have personalized service throughout the length of your coverage, Covered California is referring applicants to Licensed Agents.
Call Jeremy at (310) 486-7625 to have your questions answered and your particular insurance needs met.

Out of Pocket Protection – Affordable Health Care

It has recently been reported that a little-noticed rule on the U.S. Department of Labors’ website since February would allow many group health plans to maintain separate out-of-pocket limits for medical and prescription drug coverage for 2014.

But according to a report in the Sacramento Business Journal, California may be in the lead on health care reform again. The Assembly Health Committee passed legislation in August to implement consumer protections in the Affordable Care Act against high out-of-pocket costs.

Senate Bill 639 by Sen. Ed Hernandez would implement key protections to provide a one-year delay for some plans if passed by the Legislature this year and signed by the Governor, despite a decision by the Obama administration.

““With this bill, California can once again not just implement the federal law, but improve upon it so our patients get these benefits as soon as possible,”” Anthony Wright, executive director of Health Access, said in a news release.

“This bill ensures that no California consumer in individual or small group coverage has to wait to get these important consumer protections.”

SB 639 would limit annual out-of-pocket costs to $6,350 per individual.

“”California has been implementing other pieces of the legislation early and should be in a place to go ahead on this,”” Wright said. “It is possible the question is moot in California because benefits and out-of-pocket costs are already set by Covered California for 2014,” he added.

Agents Recommended for Business Policies in Insurance Exchange

Covered California announced in a recent seminar that it does not have the capacity to oversee and manage group policies within the exchange. Representatives from Covered CA are strongly recommending that small and large group policy holders continue to utilize the expertise of licensed agents to select, manage and explain the details of the new policies in and out of the Affordable Care Exchange.
Small business options in the Exchange will include the Four Metal plans offered in the individual arena. Group coverage will be offered with Blue Shield, Health Net and Kaiser. Businesses with less than 25 employees are eligible for Premium Assistance (tax credits.) All of the resultant changes with the Affordable Care Act necessitate working with a trained, licensed agent. For more information, call Jeremy at (310) 486-7625.