California Health News

Covered California update removes income assessment for unmarried pregnant women

Covered California

Covered California will implement several changes to their online application program known at CalHEERS on August 1, 2016. One significant change is no longer assessing unmarried pregnant women’s income for determining Medi-Cal eligibility. The previous version automatically determined Medi-Cal eligibility based on a woman’s income and pregnancy status. Because Medi-Cal considers a pregnant woman a household two at a minimum, many women were tracked into Medi-Cal and not eligible for private health insurance with the subsidies.

Covered California changes to online application

The CalHEERS program build is 16.7 is slated to launch August 1st. Other changes include member level plan selection, electronic verification of Medicare enrollment, remote identity proofing updates, non-health benefit services integration, and web browser log in restrictions.

CalHEERS Release Notes – 16.7 Certified Enrollers

CalHEERS Release 16.7 August 1, 2016

CalHEERS, also known as the online application, will be updated to version 16.7 on August 1, 2016. These release notes are intended to inform you of important changes to the functionality of the application.

16.7.1: Member Level Plan Selection for Advanced Premium Tax Credit (APTC) eligible households

APTC eligible consumers may select different plans for each member of the household or custom group members of the household into separate APTC eligible plans. The tax credits will be automatically disbursed across the selected individual plans or custom grouped plans.

16 7 Member Level-Benefit Job Aid FINAL
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Category:2016
Date:July 30, 2016

16.7.2: Electronic verification of Medicare enrollment from the Social Security Administration (SSA)

CalHEERS will utilize electronic verification from the SSA database to determine a consumer’s Medicare eligibility and enrollment status.

16.7.3: Remote Identity Proofing (RIDP)

CalHEERS will feature text changes on the Remote Identity Proofing (RIDP) pages. Users will see changes in description text, as well as the drop down menus to improve clarity and readability of consumer messaging.

16.7.4: Integration of other Non-Health Benefit Services

Consumers with incomes less than or equal to 200% of the Federal Poverty Level will see new messaging and link options on the Additional Benefits Options Page in CalHEERS.

16.7.5: Income Assessment: Unmarried pregnant women, under 21 years old

CalHEERS will no longer assess income when determining eligibility for women who meet all the following conditions:

  1. Pregnant
  2. Unmarried
  3. Under age 21
  4. Living with her parent(s)
  5. Non Tax Filer for the taxable year; or claimed as a tax dependent by parent(s) for the taxable year

16.7.6: CalHEERS web browser log in restrictions

Users will be restricted to one account login per web browser (i.e. Safari, Chrome, Internet Explorer). Users will not have the ability to open a new browser tab or browser window to log-in to their account and view multiple consumer applications.

16 7 Release Notes FINAL
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Date:July 30, 2016
Webinar Sales Update Feature Release 16.7and Other Updates Final
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Category:2016
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Date:August 11, 2016