Washington Cascade Care OE 2021

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Starting Nov. 1, Washingtonians seeking health coverage have more options this year along with financial assistance. New for 2021 will be Cascade Care offerings that enable consumers to shop, choose, and save from more options in all counties.

“As more Washingtonians are impacted by the Coronavirus pandemic, having health coverage is crucial during these difficult times” said Exchange Chief Executive Officer, Pam MacEwan. “We encourage all Washingtonians who are seeking health coverage to shop during open enrollment and find plans for how they’re living.”

New this year, Cascade Care plans offer high value, standard benefits. Cascade Care is expanding access, choice, and value for Washingtonians at a time when they need it most. These plans offer deductibles that are on average $1,000 less than other plans, and cover more services prior to meeting a deductible, including primary care visits, mental health services, and generic drugs. Most customers will see that average premium costs and deductibles of Exchange plans are lower than previous years, including eight counties where a Cascade Care plans – either Cascade or Cascade Select – is the lowest-cost silver plan.

“With new plans available, we encourage customers to shop around for the best health plan that fits their needs,” adds MacEwan. “For example, many renewing customers can switch to the lowest cost plan in their same metal tier and save money, and many customers can save more than $50 a month by shopping.”

For those seeking coverage starting January 1, customers need to enroll in a plan by December 15. Those who enroll after that deadline and before January 15 will have a coverage start date of February 1. give us a call today to enroll.

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.

Washington Healthplanfinder Urges Uninsured to Act Fast to Meet Friday, May 8 Deadline

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In response to the Coronavirus (COVID-19) pandemic, Washington Health Benefit Exchange (Exchange) today is urging individuals who did not secure health insurance for 2020 to sign up for coverage by 5:30 p.m. on Friday, May 8, the deadline of the limited-time special enrollment period (SEP) through Washington Healthplanfinder for coverage beginning May 1, 2020.“Now is the time to sign up for health coverage if you are currently uninsured,” said Exchange Chief Executive Officer Pam MacEwan, “There are many resources available to help individuals understand their options and secure health coverage before the special enrollment period ends.” Individuals who need help signing up for coverage through Washington Healthplanfinder should contact Core Columbia Insurance at 206-258-6820 as soon as possible to meet the enrollment deadline.

Over 19,500 customers have signed up for coverage since the Exchange announced a special enrollment period in response to the Coronavirus (COVID-19) pandemic. This includes 7,000 uninsured Washington residents who have come in through the COVID-19 special enrollment period, and 12,500 additional customers who have come in through a qualifying life event.

“An unprecedented number of people in our state are losing their employer sponsored health coverage. Those Washingtonians will continue to have free and low-cost coverage options available to them through Washington Healthplanfinder,” said Chief Marketing Officer Michael Marchand. Additional qualifying life events that may open a special enrollment period include:Marriage, birth of a child, or move within the state, Purchased coverage through a health sharing ministry that has received a cease and desist order from the Washington office of Insurance Commissioner for fraudulent activity or Purchased full price coverage outside the Exchange marketplace, who due to a change in income could now benefit from federal subsidies available exclusively through Washington Healthplanfinder. In some cases, individuals may qualify for free or low-cost coverage through Washington Apple Health (Medicaid) that is available year-round.

Coverage You Can Count On
Insurance companies providing coverage through Washington Healthplanfinder have agreed to cover cost sharing related to the testing and treatment of COVID-19.

Contact your health insurance provider directly for more information about:How COVID-19 impacts your coverage, Telehealth, appointments, payment options, grace periods, or other benefits related to COVID-19.

Washington Income Reporting and Your CARES Act Federal Stimulus Payments

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In response to the COVID-19 public health crisis, Congress passed the CARES Act which includes a federal stimulus payment. The amount most individuals will receive is a one-time payment of $1200 individual/$2400 joint filer/$500 per child. Core Columbia Insurance is here to answer any questions you may have about how this benefit impacts your eligibility for Healthplanfinder coverage.

The one-time federal stimulus payment (also referred to as the “Recovery Rebate” by the media or “Economic Impact Payment” by the IRS) is not considered income for purposes of Apple Health or APTC/CSR eligibility. At this time, Core Columbia and the Exchange advise clients to not report this as income in their application.

The federal stimulus payment (referred to as the Recovery Rebate or Economic Impact Payment) is not income for purposes of applying for health and dental coverage through Washington Healthplanfinder. You do not need to report any check or payment amount you receive from the federal government in your application.

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 at 206-258-6820.

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.

WASHINGTON – Emergency Order Issued in Response to Coronavirus

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For clarification on your specific plan, give Core Columbia Insurance a call at 206-258-6820. We are always here to provide straight answers, and to help you gain access to care.

Insurance Commissioner Mike Kreidler issued an emergency order to Washington state health insurers requiring them to waive copays and deductibles for any consumer requiring testing for coronavirus (COVID-19).

Insurers also must:

  • Allow a one-time early refill for prescription drugs
  • Suspend any prior authorization requirement for treatment or testing of COVID-19

In addition, if an insurer does not have enough medical providers in its network to provide testing or treatment for COVID-19, it must allow enrollees to be treated by another provider within a reasonable distance at no additional cost.

The order is effective immediately and applies to all state-regulated health insurance plans and short-term limited duration medical plans until May 4, 2020.

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.