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.

California Extends Special-Enrollment Deadline to Give Consumers More Time to Sign Up for Health Care Coverage During COVID-19 Pandemic

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Covered California announced on Tuesday that it would be giving consumers more time to sign up for health care coverage during the COVID-19 pandemic by extending the current special-enrollment deadline through the end of July. 
If you would like to enroll, or have any questions about your options, give Core Columbia a call at 619-259-6905.

“Covered California is committed to helping people get access to the health care they need, and while California is reopening parts of the state, there is still a lot of uncertainty out there due to the pandemic,” said Peter V. Lee, executive director of Covered California. “We want to make sure that people have a path to coverage, whether it is through Covered California or Medi-Cal, and giving people more time to sign up is the right thing to do.”

Every year, Covered California provides eligible consumers the opportunity to sign up for health care coverage outside of the traditional open-enrollment period if they experience a qualifying life event. These can include events like losing your health insurance, moving, getting married or having a baby.  

 People who sign up will have access to private health insurance plans with monthly premiums that may be lowered due to federal and new state financial help that became effective in 2020. After selecting a plan, their coverage would begin on the first day of the following month — meaning individuals losing job-based coverage would not face a gap in coverage.

The latest data from California’s Employment Development Department shows that 6.3 million unemployment claims have been processed in the state since the pandemic started.

“We know that when people lose their jobs, they often lose the health care coverage that was protecting them and their families,” Lee said. “While Californians who lose coverage can always sign up outside of open enrollment, we want to make sure even those who have lost work and did not have insurance have access to the health care in the middle of a pandemic.”

Medi-Cal and Off-Exchange Coverage

In addition, consumers who sign up may find out that they are eligible for no-cost or low-cost coverage through Medi-Cal, which they can enroll in online. Those eligible for Medi-Cal can have coverage that is immediately effective.

California has suspended Medi-Cal renewal reviews through the end of the public health emergency, ensuring that those already enrolled can continue their coverage and freeing up resources to quickly process new enrollments. The Department of Health Care Services (DHCS) also received expanded authority to expedite enrollment for seniors and other vulnerable populations, expand the use of telehealth and take other steps to make it easier to access care.

If you would like to enroll, or have any questions about your options, give Core Columbia a call at 619-259-6905.

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

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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.

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.