Covered California Begins 2021 Renewal and Open Enrollment Period November 1, 2020

With the start of Covered California’s open-enrollment period just a few weeks away, the exchange announced that the renewal process for a record number of enrollees is now underway — with more than 1.5 million Californians eligible to renew their coverage. In addition, the preliminary rate change that Covered California previously announced in August has been revised downward to a new all-time low of 0.5 percent for the 2021 plan year.

“Covered California heads into the upcoming open-enrollment period with more consumers than ever, and we will be doing so with the lowest rate change in our history,” said Peter V. Lee, executive director of Covered California. “California has built on and strengthened the Affordable Care Act, and right now this means that Californians facing a pandemic and recession are finding the security of having access to quality, affordable health care coverage.”

The latest data shows that Covered California had a record 1.5 million enrollees in June of 2020. When compared to historical data, Covered California’s highest enrollment total in October, which is when the renewal process begins, was 1.3 million in 2018. Current enrollees can begin renewing their coverage now, and they have until Dec. 15 to finalize their 2021 plan choice. People who do not actively select a plan for 2021, will be renewed in their current plan, so they do not suffer a gap in coverage.

“During a pandemic and recession, it is no surprise that Covered California is seeing record enrollment, because we are a safety net to help people get quality health care coverage,” Lee said.

New Record-Low Rate Change

Covered California also announced that after the reviews by the California Department of Managed Health Care and the California Department of Insurance, the statewide weighted average rate change was revised downward from 0.6 percent to a new record-low of 0.5 percent.

The lower rate change is the result of reduced rates for Health Net’s EPO and PPO products, which are subject to review the California Department of Insurance, in Contra Costa, El Dorado, Los Angeles, Marin, Mariposa, Merced, Monterey, Napa, Orange, Placer, Riverside, Sacramento, San Benito, San Bernardino, San Diego, San Francisco, San Joaquin, San Mateo, Santa Cruz, Solano, Sonoma, Stanislaus, Tulare and Yolo counties (see Table 1: California Individual Market Rate Changes for 2021 by Rating Region).

Consumers both on and off the exchange benefit from Covered California’s competitive marketplace, which allows them to shop for the best value and benefit from lower increases. In addition, many consumers can save more by shopping and switching to a lower-cost health plan. With the reduction in the statewide average rate change, the average rate change for unsubsidized consumers who shop and switch to the lowest-cost plan in the same metal tier is now -7.4 percent, which means many Californians can get a lower gross premium if they shop and switch. The average rate change varies by region and by an individual’s personal situation.

Nearly nine out of every 10 consumers who enroll through Covered California receive financial help — in the form of federal tax credits, state subsidies, or both — which help make health care more affordable. California’s state-specific enhanced subsidies, which were introduced for the first time in 2020, are benefiting about 590,000 enrollees in Covered California and are available again for both new and renewing members in 2021. 

“The bold policy choices made in California to build on and strengthen the Affordable Care Act have led to a very competitive market that is full of choice for consumers,” Lee said. “Covered California continues to provide stability and lower costs in the face of national uncertainty in health care.”

In 2021, all 11 carriers will continue offering products across the state, and two companies will expand their coverage areas, providing increased competition and consumer choice. Nearly all Californians (99.8 percent) will have two or more choices and over three-quarter of Californians (77 percent) will have four or more choices.

Open enrollment for the upcoming year will begin Nov. 1, 2020, and run through Jan. 31. Open enrollment is the one time of the year where eligible consumers cannot be turned away from coverage for any reason. Covered California will be launching a new ad campaign on Nov. 9 and has budgeted $157 million for marketing, sales and outreach during the current fiscal year — an increase of more than $30 million from last year.

In addition, consumers who need coverage earlier may be eligible for the special-enrollment period that is currently underway. Consumers who experience a qualifying life event, such as: losing their health care coverage, losing their job, suffering a loss of income, moving or being a wildfire victim, could be eligible to sign up for coverage that begins in November or December.

Reporting Your Lost Wage Assistance FEMA Payment in Washington

Beginning September 21st, Employment Security Department will begin processing payments of an additional $300 per week to the state base weekly unemployment benefit approved under the Lost Wages Assistance FEMA payment.

Federal Emergency Management Assistance (FEMA) has approved five weeks of payments, for weeks August 1st – September 5th*. The duration of the benefit is undefined (contingent on weekly federal approval) and recipients receive the payments retroactively for eligible weeks. 

*As of September 14th, 2020, the payments were approved on a weekly basis for that time.

The Lost Wages Assistance FEMA payments is not countable for Washington Apple Health (Medicaid) eligibility but is countable for tax credit and cost-sharing reductions. You should not include the $300 Lost Wages Assistance FEMA payment in your weekly unemployment income amount reported to the Washington Healthplanfinder application.

You may choose to adjust your Qualified Health Plan tax credits by adjusting the amount of tax credits applied to your premium in Washington Healthplanfinder.

If you require assistance, or have any questions, give us a call at 206-258-6820.

Tips on Reporting Self-employment Income to the WA Exchange

Are you self-employed? It is best practice to estimate your self-employment income and expenses for the year based on past earned income, expenses, industry standards and other information. If you filed a federal tax return last year, you could use the Adjusted Gross Income you reported, deduct self-employment expenses, then add or subtract based on how you think your income may change for the current year. 

As always, if you have any questions, do not hesitate to give us a call at 206-258-6820. We are always here for you with free assistance.  

If you are trying to report self-employment income based on prior year taxes:

Adjusted Gross Income – Expenses from Prior Year +/- Anticipated Changes = Current Year Self Employment Income

You should update your estimated annual net income when your business circumstances change. If your earnings are lower, you may be eligible for higher tax credits and Cost Sharing reductions. If your earnings are higher than you reported on your Washington Healthplanfinder application, you could have to pay back some or all of the tax credits you took during the year.

You may report that you are self-employed, and may or may not receive a “wage” or pay stub. Only do this if you do not receive a paycheck from your business (income from a corporation is reported as “earned income”.) Additionally, if you receive dividends from your corporation, this would be considered “other” income.

When you are truly self-employed, follow the guidelines below for how income should be reported. You can report all earned income (through your business), collected from your most current tax return, profit and loss statements, or other income ledgers. Individuals should report their net income, taking into account any allowable business expenses (sometimes called “profit”).

  • If self-employment income is higher than business expenses, report as net income

If business expenses are higher than income, report a net loss

Washington Health Plan Finder Unemployment Income Reminder and CSR Information

As a reminder, the Federal Pandemic Unemployment is countable income for Qualified health plans with tax credits and is not countable income for Washington Apple Health (Medicaid). If you have any questions or need to update your income, Core Columbia Insurance is always here to provide straightforward, up to date answers to all of your questions – give us a call at 206-258-6820.

Cost Sharing Reduction (CSR) Tiers

Changes to income can change eligibility. Much of the recommended Qualified Health Plan shopping are based on eligibility of Cost-Sharing Reduction (CSR) tier per household members seeking coverage. The CSR tiers drives the system to make recommendations for different “Groups”.

What are Cost Sharing Reduction (CSR) Tiers?

Cost Sharing Reductions (CSR) reduce the copay, deductible, and other out-of-pocket costs for individuals and families that are eligible based on many different factors including eligibility for tax credits. These out-of-pocket savings apply only to silver-level Qualified Health Plans. There are no CSRs for platinum, gold, bronze, or catastrophic health plans, and they are not available for Qualified Dental Plans. American Indian/Alaskan Native (AI/AN) customers may be eligible for CSRs on additional Qualified Health Plan types.

Unemployment Compensation, The CARES Act, and Your Eligibility for Marketplace Subsidy in CA and WA

Unemployment Compensation

In the CARES Act, Congress authorized a new federal Pandemic Unemployment Compensation program, which provides an additional $600 in federal benefits per week of weeks of unemployment ending on or before July 31, 2020.

If you had a change in income, you may be eligible or free, or lower cost health insurance. Give Core Columbia Insurance a call in California at 619-259-6905, or in Washington at 206-258-6820. We are always here to provide straight answers, process all necessary changes to your account on your behalf, and ensure you are able to obtain the health coverage you need at the lowest price available.

This type of unemployment income is excluded for purposes of calculating Medicaid eligibility, but included for purposes of determining tax credit eligibility in the Covered California and Washington Health Plan Finder Systems.

  • New and existing clients should not include the additional $600 per week when reporting their unemployment benefit income.
    • This includes households with tax credit enrolled members only.
    • New and existing clients already receiving MediCaid should not report income changes in their application during the COVID-19 emergency.
    • Families who have members on MediCaid, and members receiving tax credits or qualified health plan coverage should continue to report changes in income to see if they qualify for no cost or lower cost care.
  • The Exchanges in CA and WA are working on system updates (planned by end of June) that would allow new and existing clients receiving both tax credits and the additional $600 per week to correctly account for it. More information is forthcoming as additional regulatory options are also explored. Core Columbia Insurance is always here for you, working remotely, to provide straightforward, up to date answers to all of your questions. Give us a call in California at 619-259-6905, or in Washington at 206-258-6820.

Washington Announces Special Enrollment Period in Response to Growing Coronavirus Outbreak

If you are a Washington resident who missed the open enrollment deadline, call Core Columbia today at 206-258-6820 to take advantage of the new special enrollment period and get covered.

In response to the potential growth of Coronavirus (COVID-19) cases, the Washington Health Benefit Exchange (Exchange) today announced a limited-time special enrollment period for qualified individuals who are currently without insurance. This special enrollment period (SEP), that runs through April 8, 2020, will allow uninsured individuals 30 days to enroll in health insurance coverage through Washington Healthplanfinder.

The Exchange may re-evaluate the end date of the special enrollment period if the state of emergency remains in effect after April 8, 2020, so be sure to give Core Columbia a call as soon as possible.

We are closely monitoring the growth of cases in WA, the US, and the world. Below are the three main sources Core Columbia relies on for up to date information.

US Centers of Disease Control: http://www.cdc.gov/coronavirus

Washington State Department of Health (DOH): http://www.doh.wa.gov/coronavirus

DOH daily 2p.m. updates: http://www.doh.wa.gov/Emergencies/Coronavirus

California and Washington – Important 2019 Tax Filing Information

California and Washington clients must file 2019 taxes correctly to remain eligible for premium assistance in 2021. Your APTC (advanced premium tax credit) helps you save on your health insurance premiums. To keep your full tax credit, you’ll need two important forms when you file your return this year. If you have any questions on this form, or the process, give Core Columbia a call at 206-258-6820. We are always here for you with free assistance, and straight answers.

Use your 1095-A to file Form 8962 with your tax return. These two forms will determine the amount of your tax credit. If you file a paper return, you can get Form 8962 here. Using these two forms to file your taxes correctly and on time is very important! If you don’t, you may lose your tax credit, resulting in higher premiums. Don’t forget: the filing deadline for your taxes is April 15!

Do not hesitate to give Core Columbia a call at 206-258-6820 if you are missing your 1095-A. We are always here for you, and can quickly provide a copy for you at no charge.

A Message From Core Columbia About Coronavirus COVID-19

There’s a lot in the news lately about coronavirus COVID-19. Here’s what you need to know to help you understand what it is and how you can protect yourself and the people you care about. 

Core Columbia Insurance is closely monitoring COVID-19 developments and what it means for our customers. Our clinical team is actively monitoring external queries and reports from the Centers for Disease Control and Prevention to help us determine what, if any, action is necessary on our part.

We’re sharing information today to help explain what COVID-19 is all about, how to protect yourself and what to do if you think you might be infected. We also help to answer questions customers are asking about COVID-19 and how it impacts us all.

Employers and members will receive the following message shortly. Please contact Core Columbia Insurance a call in California at 619-259-6905, or in Washington at 206-258-6820 with questions.. We are always here to provide straight answers, and to help you gain access to care. 

About coronavirus COVID-19

What is coronavirus and COVID-19?

Coronavirus is a type of virus that causes mild respiratory illness – an infection of the airways and lungs. COVID-19 is a new strain of coronavirus. It’s part of the same family of coronaviruses that includes the common cold.

What are the symptoms?

The most common early symptoms appear between 2 and 14 days after infection. Symptoms can be mild to severe. They include fever, cough, and shortness of breath.

How does the virus spread?

Like many other viruses, COVID-19 seems to spread from person-to-person through a cough, sneeze, or kiss.

What is the risk?

As of today, the Centers for Disease Control and Prevention (CDC) states that the risk in the U.S. is still low. They will update the status regularly on the CDC website.

Prevention and treatment

How to protect yourself

Frequent handwashing is the most effective way to protect yourself from infection. Other good habits to practice include covering your mouth and nose with a tissue when you cough and sneeze, and cleaning frequently touched items such as phones, keyboards, and doorknobs to help remove germs. Visit the CDC website for more on prevention and treatment.

What to do if you have symptoms

Call your doctor if you develop a fever, have a cough, or have difficulty breathing. And let them know if you’ve been in close contact with a person known to have COVID-19, or if you live in or have recently traveled to an area where the virus has spread. You can also check to see if your plan offers telehealth benefits to see a doctor online. If you think you’re infected, using telehealth helps to prevent spreading a virus.

What your Health Insurance benefits will cover

Your health plan, if ACA compliant, should cover the care you get if you’re diagnosed as having COVID-19, based on your plan’s benefits. It should also cover testing for COVID-19. You’ll likely pay any out-of-pocket expenses your plan requires, unless otherwise determined by state law or regulation. For clarification on your specific plan, give Core Columbia Insurance a call in California at 619-259-6905, or in Washington at 206-258-6820. We are always here to provide straight answers, and to help you gain access to care. 

Sources:

  • Centers for Disease Control and Prevention: About Coronavirus Disease 2019 (COVID-19) (accessed March 2020): cdc.gov/coronavirus/2019-ncov/about/index.html.
  • Centers for Disease Control and Prevention: Frequently Asked Questions and Answers (accessed March 2020): cdc.gov/coronavirus/2019-ncov/faq.html.

Form 1095-A: What You Need to Know to File Your 2019 Taxes in CA or WA

By now you should have received your Form 1095-A.

If you have not received it or are unable to locate it, please give us a call at  619-259-6905 or 206-258-6820 , and we will send you a copy.

Below are some additional tips to help with your 2019 tax needs.
Please disregard this message if you have already received your 1095-A and filed your 2019 taxes.
Why do I need Form 1095-A? 

This form lists the amount of tax credits you received in 2019 to help pay your health insurance monthly premiums. Why do you need it? When you enrolled in your plan, you were asked to estimate your 2019 income, which determined your federal tax credits to help pay for your monthly health insurance premium.

When you complete your taxes this year for 2019, you’ll have to report whether your actual income was different from your estimated income. Since most members received tax credits in advance, you may either owe or be owed money if there’s a difference. 

You will need this form to file your taxes if you had coverage for any part of 2019.
Can I file my 2019 taxes without my 1095-A?

If you are expecting to receive a Form 1095-A, you should wait to file your 2019 income tax return until you receive that form. However, it is not necessary to wait for Forms 1095-B or 1095-C to file. What is the difference between Forms 1095-A, 1095-B and 1095-C? 
Getting the Right Tax Credit or Financial Help

Since you received financial help to make your monthly insurance premium more affordable, you will need to file taxes. The IRS will then compare this financial help, which is officially called Advanced Premium Tax Credits (APTC), you received during 2019 with the financial help that you qualify for based on your actual household income and family size.

Navigating Your Options re: Qualifying Life Events and COBRA

Are you losing your employer sponsored coverage, turning 26 and becoming ineligible to remain on your parents’ insurance, or losing your existing coverage in a divorce? These situations are all qualifying life events, which entitle you to a special enrollment period to select a new health insurance option. You will have many different options, from COBRA, to a subsidized or unsubsidized plan through your state’s health insurance marketplace, to no cost coverage through your state’s MediCaid expansion, depending on your situation. While there are no right or wrong answers on which choice to make going forward, a number of different variables can change what is likely to be the lowest cost option to suit your needs. The one constant is the importance of consulting an expert to discuss your unique situation, and the deadlines involved.  There are many deadlines and restrictions to be aware of, for example, there is a 60 day period after a qualifying event in which you are permitted to enroll in a marketplace or a COBRA plan, and you will become ineligible for a subsidized marketplace plan for a certain amount of time post COBRA enrollment. If you or a family member has recently lost, or is set to lose, health insurance coverage, give us a call at 619-259-6950, or send a quick email to us at info@corecolumbia.com. There are never fees to you (the consumer) for our services. We are always here with free expert advice, to listen to your unique situation and your needs, and enable you to weigh the pros and cons of every available option before making an informed decision in a timely manner.