About Open Enrollment

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Open enrollment is the period of time during which individuals and families can enroll in or make changes to their health insurance coverage. In the United States, open enrollment typically takes place annually, although some states have their own open enrollment periods that differ from the federal timeline. Below is a bit more background on how open enrollment works in the Washington Health Plan Finder and Covered California systems.

The Washington Health Plan Finder is the state’s online health insurance marketplace, where individuals and families can compare and enroll in health insurance plans. Open enrollment in the Washington Health Plan Finder typically takes place from November 1st to December 15th each year. During this time, individuals and families can enroll in a new health insurance plan or make changes to their existing coverage. It is important to note that outside of open enrollment, individuals and families may only be able to make changes to their health insurance coverage if they experience a qualifying life event, such as getting married or having a baby.

Covered California is California’s online health insurance marketplace, where individuals and families can compare and enroll in health insurance plans. Open enrollment in Covered California typically takes place from November 1st to January 31st each year. Like in the Washington Health Plan Finder, during this time individuals and families can enroll in a new health insurance plan or make changes to their existing coverage. It is important to note that Covered California has a special enrollment period for individuals and families who experience a qualifying life event, such as losing their health insurance coverage or getting married.

If you are in Washington or California and are considering enrolling in health insurance coverage or making changes to your existing coverage, it is important to keep in mind the open enrollment period for the Washington Health Plan Finder or Covered California. These open enrollment periods provide a critical opportunity to enroll in or make changes to your health insurance coverage, and missing the deadline could mean having to wait until the next open enrollment period to make any changes. It is also important to carefully consider your health insurance needs and compare plans to find the coverage that best fits your needs and budget.

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

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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.

2021 California Health Insurance Rate Changes Announced

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Covered California announced today that the average rate change for the 2021 individual market will be 0.6 percent. This marks a record-low for the second consecutive year and follows California’s efforts to build on, and go beyond, the Affordable Care Act!

The rate change was driven lower by California’s affordability initiatives, the state subsidy program and state individual mandate penalty, which were designed to improve affordability and encourage enrollment.

All 11 of Covered California’s health plans will be returning for 2021, and two plans will be expanding their coverage areas. As a result, 88 percent of Californians will be able to choose from three carriers or more and 99.8 percent of consumers will have two or more choices.

As always, if you have questions, give us a call at (619) 259-6905. We are here to help.

Covered California Expanding Special Enrollment Period for 2020 in Response to COVID-19 Emergency

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Effective March 20, 2020, anyone uninsured and eligible to enroll in health care coverage through Covered California can sign up through the end of June. The Department of Health Care Services announced new steps to help those eligible for Medi-Cal sign up easily and get immediate coverage.

The moves come amid widespread disruption in the lives and livelihoods of Californians as public health officials seek to reduce the spread of COVID-19. All medically necessary screening and testing for COVID-19 are free of charge, and all health plans available through Medi-Cal and Covered California offer telehealth options. These actions build on increased state subsidies and the implementation of a state penalty, both of which took effect in January 2020.

If you would like to enroll, or have any questions about your options, give Core Columbia a call at 619-259-6905. We are working remotely and ready to take your call.

A Message From Core Columbia About Coronavirus COVID-19

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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

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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.