December 30, 2016 Covered California Agent Alert
Incorrect Tax Credit Sent To Health Plans
During the 2017 renewal process the incorrect Advanced Premium Tax Credit (APTC) amount was sent to the health plan for some consumers. The eligibility determination and notice the consumer received from Covered California displayed the correct APTC amount. However, because the incorrect APTC was sent to the health plans, they invoiced the consumers with overstated APTC and understated premiums owed.
To correct this issue Covered California has systematically updated the incorrect APTC amounts with the health plans. Consumers have been re-enrolled in a plan with the correct APTC for January 1, 2017. Consumers do not have to report a change or make any updates to their application.
Covered California will be reaching out directly to these affected consumers via phone, email, and a mailed notice next week to advise them of the issue. The communications will include a dedicated hotline consumers can call to receive additional information.
Additionally, consumers will receive an invoice from their health plan reflecting the correct amount of APTC and premium for the month of February. It is at the health plan’s discretion to collect the difference for the January invoice, as well as how the difference may be billed.
Agents, who have been identified as having clients for whom the incorrect APTC was sent to the carriers, will be receiving an alert email from Covered California. This communication is intended to ensure that agents are informed of this issue, along with consumers, and are able to assist them in contacting Covered California for customer service support.
Please Note: Agents should refer any affected consumers with questions regarding this matter to the email communication they will receive from Covered California next week.