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.

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.

Reporting Your Lost Wage Assistance FEMA Payment in Washington

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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

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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

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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.

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.

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.