Covered CA Launches New Enrollment Period, COBRA Updates, Industry News and More!

Covered California Launches New Special Enrollment Period to Run April – December, With Health Plans Now More Affordable Than Ever

Covered California has officially launched a new special-enrollment period to allow Californians to benefit from lower health insurance premiums available through the American Rescue Plan — no matter what their income levels are. This new law will help an estimated 2.5 million Californians, including those without health insurance and people enrolled directly through a health insurance carrier, by injecting $3 billion into the state’s economy.

This new special enrollment period runs from April 12 to December 31, 2021, and many Californians will be able to get a quality, name-brand health plan for as little as $1 per month or richer benefits for less than $100 per month, but only if they sign up for health coverage through Covered California. In addition, consumers who are directly insured through a health insurance company can switch to a Covered California health plan and could save up to $700 per month on their health coverage —  giving them more money to put toward food, housing, their business, retirement, or other needs.

Existing consumers who already have Covered California health plans don’t need to take any action since the savings will be automatically applied to their accounts, and they may see lower monthly health care bills as soon as May 1. Those who currently don’t have health coverage through Covered California can enroll through December 31, 2021 to benefit from this round of new financial help because of the American Rescue Plan. This includes those consumers who currently are insured directly through a health insurer outside of Covered California and are now eligible to get financial assistance for the first time and switch to more affordable plans. 

This week Covered California also launched a new $20 million statewide ad campaign to drive consumer awareness on how they can benefit from the new financial assistance. A new “Shop and Compare” tool is also now available on CoveredCA.com to allow consumers to easily see exactly how they can benefit from the new American Rescue Plan. Consumers just need to enter their ZIP code, household income and the ages of the people in the household to see how low their health care premiums can be and the options in their area for both Covered California and Medi-Cal health plans.

Helpful Tools To Ensure Your Clients a Smooth Transition

Download the documents below to help ensure a smooth transition of your current clients and new potential clients due to changes in subsidies.
Please contact your current clients to ensure when they move from off exchange to exchange plans, you are included in this transaction as the broker of record.

American Rescue Plan FAQ for Certified Enrollers

Program Eligibility by Federal Poverty Level for 2021

DICKERSON INDIVDUAL MARKET

Molina Makes Changes to Payment and Billing Systems for Added Security and Convenience

On 4/26/21, Molina Marketplace will transition all enrollment, premium billing, and payment operations to Wipro Health Plan Services (HPS). HPS is an industry leader in this space, currently supporting over 20% of the ACA market. Molina states that partnering with them will ensure that Molina Marketplace members have a more user friendly experience in paying their monthly premiums.

The transition over to HPS will take place from 4/14 thru 4/25. During this time enrollment changes and payments can be made, however your Molina Marketplace members will not be able to see any updates on their online accounts or through our automated phone system until 4/26.

What’s New?

• All active AutoPay accounts will be transitioned over to HPS with no action needed to be taken by members.

• April’s AutoPay run will still be processed on the 23rd of the month, but will only reflect changes made before 4/14.

• Starting in May, premium payments will be due on the last calendar day of the month.

• Autopay processing will also take place on the last day of the month or the next business day if it falls on a weekend of holiday.

Visit our website for more details and FAQs

DICKERSON INDUSTRY NEWS UPDATES

COBRA ALERT: Get the Latest DOL update on Cobra Premium Assistance

The Department of Labor (DOL) released updated information on the COBRA premium assistance authorized under the American Rescue Plan Act, 2021 (ARPA), the third COVID-19 stimulus bill. With the exception of the model notices, the guidance appears targeted towards impacted workers, leaving many employer-related questions unanswered.

Find a summary on model notices, frequently asked questions and related information here.

BE AWARE:

  • Employers have until May 31, 2021 to send their required General Notice or Notice of Extended Election Period to assistance eligible individuals (AEIs).
  • AEIs must be offered at least a 60-day window within which to elect COBRA coverage, which begins on the date an applicable required notice is provided to the AEI (on or after April 1, 2021).

It is important to find out if your consumers’ incomes have increased, and if so, to report changes prior to April 12!

On April 12, Covered California will automatically begin to redetermine eligibility for most enrolled consumers so that the new financial help available from the American Rescue Plan can be added. However, if households that were slightly over 266% of Federal Poverty Level when they enrolled in coverage for 2021 have dependent children under the age of 18, those children may now be under the new Medi-Cal for Children or CCHIP eligibility thresholds and would be placed in Carry-Forward Status for county review unless any changes in income they’ve experienced are reported before April 12.

The consumers on your list are generally between 266% and 270% of Federal Poverty Level, but please note that this list is not an exhaustive list of all of consumers who may be impacted.

Note: The data for this list was generated on April 6, 2021, so the status and FPL shown for each consumer may have been changed if you or the consumer Reported a Change.

California Once Again Delays Launch Of A Closely Watched Prescription Drug Purchasing Program 

California Department of Health Care Services website says the new Medi-Cal Rx program was scheduled to start on April 1, but has been delayed for the second time this year. No start date was given but update will be provided next month. The website indicates a meeting is scheduled for May 19. Click here for the whole story.

Federal Agency Calls For Higher Medicaid Rebates If Trials Are Delayed 

Medicaid and CHIP Payment and Access Commission, or MACPAC is recommending pharmaceutical companies pay higher Medicaid rebates if they have not completed required trials to confirm the effectiveness of medicines that received accelerated approval. Click here for the whole story.

Biden Seeks $400 Billion to Buttress Long-Term Care

Long-term care options are expensive and often out of reach for seniors and people with disabilities. The president has proposed a massive infusion of federal funding for home and community-based health services that advocates say will go a long way toward helping individuals and families. Click here for the story.