Background Information
Covered California sent notices to consumers who are enrolled or pending in a Covered California Health Plan in 2015 to renew for coverage in 2016. These notices explain the renewal process and the importance of retaining health insurance to consumers. Below, find the important information you need to know.
Talking Points
- Update application information online at www.coveredca.com
- No changes? Consumers will be automatically renewed
- Covered California will automatically renew consumer by date listed on notice
- Notice (CalNOD12) includes the following information:
o Case number
o 2015 APTC amount and plan selection
o 2015 attested income
o Referral to carrier notice for 2016 rate that will be sent to consumer
o Instructions to complete the renewal
o Date by which coverage will be auto-renewed if no action is taken
- Reported changes will be effective January 1, 2016
- To report changes for the 2015 benefit year use the “Report a change 2015” link
- Consumers must call Covered California to opt out of renewing their coverage – not available online
Medi-Cal
Remember:
- Modified Adjusted Gross Income (MAGI) Medi-Cal Renewals (“Redeterminations”) are performed every 12 months following the initial eligibility determination for a Medi-Cal case
- Households with MAGI Medi-Cal members may update their application information online (self-serve) or seek assistance from their local county social services office
- Agents, Certified Enrollment Counsels and Certified Enrollment Partners may not make changes to household applications with Medi-Cal members
- The local county social services office sends consumer notices when it is their time to renew their eligibility in Medi-Cal
Important Information
Consent for Verification – Covered California will still renew consumers into their same plan if they have not provided their consent to verify, but without Advanced Premium Tax Credits applied
Consumers in a “pending” status should effectuate their coverage by paying their first bill
Next Steps
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Consumers will also receive the following three notices: Renewal Notice from Health Plan |
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Receive by November 1, 2015 |
Includes the following information:
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| Covered California Eligibility/Welcome Notice (CalNOD01) |
| Receive October 13 – December 5, 2015 |
Includes the following information:
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| Health Plan Invoice |
| Receive December 15, 2015 – January 1, 2016 |
Includes the following information:
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Downloads
2016 Health Benefits Plan Table
Example Renewal Letter
Get ready to renew your health insurance for 2016!
Case Number: 5000005441
October 13, 2015
Dear Sarah Person,
You are getting this letter because, in 2015, you or members of your household qualified to enroll in a Covered California health plan. Your health insurance coverage is coming up for renewal. Renewal for your household is due by November 16, 2015. When you renew your insurance, you will be able to:
- Let Covered California know if any of your application information has change
- Find out if you qualify for a different program
- Find out if your costs have changed
- Change your current health plan
- Get help if you need it!
Note: If someone in your household has Medi-Cal, your county social services agency may contact you for more information. To help them keep Medi-Cal, you will also need to provide any information asked of you from your county social services agency.
You can go online to CoveredCA.com and renew your insurance. For more information on how to renew your insurance now, read the “How do I renew my insurance now?” section. It is important to renew your insurance now to make sure you get the correct amount of premium assistance. Premium assistance is a federal tax credit that helps make health insurance more affordable. When you qualify for premium assistance, there are three ways you can use it:
- Apply all of your tax credits in advance to lower the amount you pay each month
- Take some of the tax credits each month and get the rest at the end of the year
- Wait until the end of the year to apply the credit when you file taxes
The amount of premium assistance depends on your household size, family income, and where you live. If it is used in advance, the tax credit is paid directly to your health plan.
What if I do not renew my insurance?
If you do not renew your insurance, Covered California will automatically re-enroll you or members of your household into your current health plan by December 15, 2015. We will renew your insurance using the most recent household size and income information you gave us.
What will change for you next year?
The amount of premium you pay
The amount you pay for health coverage may change each year. You will receive a letter from your health plan in the fall. The letter will show your new monthly premium amount for 2016 and your 2015 premium assistance amount. After you renew you will get more notices that will include your 2016 premium assistance amount. Make sure to pay your premium directly to your health plan by the due date so your coverage can start on January 1, 2016. Please do not send your payment to Covered California. If you change your plan after December 15, 2015, your coverage start date will change.
For 2015, you chose Bronze 60 PPO. You will receive a letter from Anthem in the fall will show your new monthly premium amount for 2016. Make sure to pay your premium directly to your health plan by the due date so your coverage can start on January 1, 2016. Please do not send your payment to Covered California.
The amount of premium assistance you receive
For 2015, you qualified for up to $0 per month in premium assistance (a tax credit). This amount may change in 2016. This was based on the income that you said your tax household expected to receive in 2015. Your tax household includes all of the people that were listed on your taxes. Our records show that your annual tax household income is $60,000.00 (or $5,000.00 per month). It is important that you let us know if you moved or if your household income or family size has changed.
The level of out-of-pocket savings you qualify for
The level of cost share reduction you qualify for may be different too. Or, you may be newly eligible for a cost share reduction. A cost share reduction lowers the amount you have to pay out-of-pocket when you use your health plan. You can only get these savings if your income qualifies and you choose a silver health plan. With silver cost share reduction, you will save money on co-pays and deductibles.
How do I renew my insurance now?
To renew the insurance for your household before November 16, 2015, follow the three steps below:
Step 1: Log in to your CoveredCA.com account
Step 2: Click the “Continue” button
Step 3: Check your application information
Make sure your information is correct by November 16, 2015 to get the coverage that’s right for you.
If your application information has not changed, confirm your current information by clicking “Continue” until you get to Step 4 (see below).
What if my information has changed?
If your application information has changed, you must report the changes. Click the “Edit” button next to the information you want to change. Changes can affect the amount of premium assistance you receive through Covered California or whether you qualify for free or low-cost Medi-Cal. Report changes including:
- Change in income (employment, self-employment, income tax deductions or other types of income)
- Adding or removing a household member (birth, adoption, marriage, etc.)
- Permanent move out of or within California
- Start receiving health insurance such as through job, Medicare, etc.
- Change in citizenship/immigration status
Once you report your changes, your household may qualify for different programs or health plans available through Covered California. If you agree with the decision that we made when we processed your changes, you can choose your health and/or dental plans by November 16, 2015. You will pay your premium directly to the plan. Pay by the due date so your coverage can start on January 1, 2016. You may contact your insurance plan or wait for them to bill you. Please do not send your payment to Covered California. To report changes, you can also call the Service Center at 1-800-300-1506.
Note: If you or someone in your household has Medi-Cal, report changes to your local county office within 10 days.
Step 4: Shop and pick the best plan for you
Once you confirm your application information, you will be able to stay in your current health plan. If you do not choose a new health plan by November 16, 2015, we will keep you in your current health plan. Or, you can compare rates and shop for a new health plan or enroll in a dental plan. If you’re thinking about changing plans, you may want to check whether the plans you’re looking at have your current doctors or hospitals. At CoveredCA.com, there are links to each health plan provider directory. There you can check to see which doctors are available.
Covered California offers a range of choices of private health insurance plans. You can choose the health plan and level of coverage that best meets your health needs and budget. You can choose to pay a higher monthly cost (called a premium) so that you pay less out of pocket when you need medical care. Or, you can choose to pay a lower monthly cost but pay more out of pocket when you need care.
What if I want to change plans after November 16, 2015?
If you change your mind and want to pick a new plan after November 16, 2015, you still can during the Open Enrollment period. The 2016 Open Enrollment period is from November 01, 2015 to January 31, 2016. Open Enrollment allows you to:
- Change health plans for any reason
- Add new members to your coverage
- Enroll in a dental plan
Please remind your family and friends that the Open Enrollment period is coming and send them to CoveredCA.com.
For Open Enrollment you can:
- Go online to CoveredCA.com and log into your Covered California account
- Call our Customer Service Center at 1-800-300-1506 or (TTY: 1-888-889-4500). Starting now and until the end of Open Enrollment, the Service Center has extended hours.
- Get free help in person from trained Certified Enrollment Counselors and Certified Insurance Agents who can help you. See Need Help? Below.
Need help?
Covered California wants to make renewing your coverage as easy possible. A Covered California Certified Enrollment Counselor or Certified Insurance Agent can help you.
Don’t have an Enrollment Counselor or Agent? To find an Enrollment Counselor or Agent close to your home, go to CoveredCA.com and click Find Help Near You. Or call a Covered California Service Center.
Why is it important to keep your health insurance?
Health insurance helps make sure you get the care you need to keep you healthy. Insurance helps with unplanned emergencies. It protects your peace of mind because you know you’ll have help when you need it.
Starting January 1, 2014, most people must have health insurance. This may be through your employer, coverage you buy for yourself, Medicare, or Medi-Cal. Consumers who don’t have health insurance may have to pay a “shared responsibility fee.”
The “shared responsibility fee” amount is based on how many people are in the household and the household income. The fee goes up each year, to a maximum amount. In 2015, the fee will be 2% of the annual household income or $325 per adult and $162.50 for each child under 18, whichever is greater. For example, a household with 2 adults and 2 children that earns $40,000 in 2015 would pay $325 for each adult and $162.50 for each child. The total fee for this family would be $975. This fee would go up to 2.5% of the yearly household income in 2016 or $695 per adult and $347.50 for each child. If you don’t have health care coverage, you may have to pay any fee you owe when you file your federal taxes at tax time. Remember, if you are uninsured you also pay 100% of your medical costs.
Questions?
If you have created a CoveredCA account, go to www.CoveredCA.com and log in.
Or call the Covered California Service Center at 1-800-300-1506 or 1-888-889-4500 (1-888-TTY-4500).
Starting now and until the end of Open Enrollment, the Service Center has extended hours. Monday through Friday 8 a.m. to 8 p.m. and Saturdays 8 a.m. to 6 p.m. The 2016 Open Enrollment period is from November 01, 2015 to January 31, 2016.