March 10th deadline for Covered California Conditional Eligibility verification

Conditional Eligibility Notice Sent to Consumers with Jan 1 Coverage Start Date

Consumers began to receive a Covered California notice February 2016 as a reminder that they need to provide documents to prove they are eligible to continue their health insurance and/or financial assistance through Covered California. The first round of this conditional eligibility notice was sent to those consumers with a coverage start date of January 1, 2016.

Download -> Verification Document Inconsistency Notice

Consumers will need to submit valid documentation for one or more of the following reasons:

• U.S. Citizen/National or non-citizen with a lawfully present status
• Income
• Social Security Number (SSN)
• Incarceration Status
• American Indian/Alaska Native Status

Within the notice, documents required per family member are indicated by a check box. If boxes are not checked, no documentation is required for that category. 

Updated documentation from these consumers must be received by March 10, 2016.

The consumer can upload, fax, or mail their documentation. More than one document may be required.

If the consumer does not provide the documentation by March 10, 2016, Covered California may be required to cancel their health insurance coverage, their Advanced Premium Tax Credit (APTC), and/or Cost Sharing Reductions. Consumers may be required to reconcile any APTC with the Internal Revenue Service (IRS) when they file their taxes in 2017.

2016 Conditional Eligibility Quick Guide

Consumers began to receive a Covered California notice February 2016 as a reminder that they need to provide documents to prove they are eligible to continue their health insurance and/or financial assistance through Covered California. The first batch of the notice includes those consumers with a coverage start date of January 1, 2016.

The notice will be mailed in the following languages: English, Spanish, Chinese, Korea, and Vietnamese.

Consumers will need to submit valid documentation for one or more of the following reasons:

1. US Citizen/National or non-citizen with lawful presence status
2. Income
3. Social Security Number
4. Incarceration Status
5. American Indian/Alaska Native Status

Documents required per family member will be indicated with a check box on the appropriate category.

• If the box is not checked, no documentation is required for that category.
• The notice indicates which documentation each household member is required to provide.

Download -> Accepted Documentation for Covered California Conditional Eligibility

• Updated documentation for these consumers must be received by March 10, 2016.
• The consumer can upload, fax, or mail their documentation. More than one document may be required.
• If the consumer does not provide the documentation by March 10, 2016, Covered California may be required to cancel their health insurance or cancel their Advanced Premium Tax Credit (APTC) or Cost Sharing Reductions. Consumers may be required to reconcile any APTC with the Internal Revenue Service (IRS) when they file their taxes in 2017.
• If their health insurance is canceled, they may also have to pay a tax penalty for the duration they remain uninsured and do not qualify for an exemption.
• Remind consumers: The documents provided are confidential and will only be used to determine eligibility for health insurance programs. The documents are not used for immigration enforcement purposes.
• If documentation has already provided, no action is needed. Covered California will contact them if additional information is needed. Households with Medi-Cal eligible members should contact a County Eligibility Worker to verify the submitted documentation.
• Advise consumer to not submit original documents, but legible copies only. A cover page is included to fill out if the consumer is faxing or mailing their documentation.