Covered California has released a variety of documents to support agents and enrollers with assisting consumers with 1095-A questions. Included in the files are the letter of 1095-A notification being sent to consumer, a quick reference chart, and a job aid on where to find a consumer’s 1095-A online.
Cigna Medicare Advantage Plans receive sanction from CMS
The Centers for Medicare and Medicaid Services (CMS) issued an immediate suspension of enrollment and marketing activities for Cigna-HealthSpring Medicare Advantage plans on January 21, 2016. The immediate intermediate sanctions against enrollment and marketing activities to Cigna, HealthSpring, and Bravo Health Medicare Advantage plans sold in the states of Alabama, Arizona, Tennessee, Georgia, Pennsylvania, South Carolina, North Carolina, and Florida. The CMS sanctions were imposed on Medicare Advantage medical plan which include prescription drug coverage also known as MA-PDs.
Health Net Covered California missing enrollments
Health Net is continuing to reach out to our Individual & Family Plan (IFP) members who do not appear in Covered California’s files. This effort began in December when we first learned of the data mismatch from Covered California.
Some qualifying events eliminated for Special Enrollment Periods
Elimination of several unnecessary special enrollment periods, clarifies the definitions of other special enrollment periods, and provides stronger enforcement so that special enrollment periods serve the purpose for which they are intended and do not provide unintended loopholes.
Employees to receive 1095-C for employer health insurance coverage
Employers with 50 or more full-time employees, including full-time equivalent employees, in the previous year use Form 1095-C, Employer-Provided Health Insurance Offer and Coverage, to report the information required about offers of health coverage and enrollment in health coverage for their employees. Form 1095-C is used to report information about each employee.
1095-B Form for the IRS and tax return
Form 1095-B, Health Coverage, is used to report certain information to the IRS and to taxpayers about individuals who are covered by minimum essential coverage and therefore aren’t liable for the individual shared responsibility payment.
Cigna to require proof of identity, residency and payment for health insurance
Cigna has announced they will be sending letters out to individuals newly enrolled in their health plans in 2016. The letters requesting verification of identity, residency, and premium payment will be sent to Cigna Individual and Family health plan enrollments regardless of whether the plan was purchased either through a Market Place Exchange or off-exchange directly from Cigna. If Cigna doesn’t receive the requested information within 45 days the health insurance may be cancelled.
Health Net California PPO plans to require proof of residency
Effective immediately, Health Net has implemented required proof of California permanent residency for IFP PPO policies. Applications for IFP PPO policies will now require the attached Proof of Permanent Residency form to be completed prior to proceeding with the enrollment process.
Legislation to stop surprise medical bills from out of network providers
Have you been hit with a surprise medical bill? Did you follow your insurance company’s rules by picking a hospital, lab, or outpatient facility that is in your plan’s network to keep costs low? But then did you end up getting a huge surprise medical bill from specialists, labs, or others who are not in your plan’s network—providers you didn’t choose, may have never met, and had no control over?
Covered California Small Business Plans Expand to 100 Employees
The definition of a small business in California has expanded to include groups with 1-100 full-time equivalent (FTE) employees. Second, the Affordable Care Act (ACA) employer mandate now requires businesses with at least 50 full-time equivalent employees to provide health coverage for their employees and dependents or face a tax penalty.
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