Important Time for Covered California and Health Insurance

Beginning late last year, California set out to enroll individuals, families and small businesses in health insurance plans through anew program called Covered California. Covered California is the easy-to-use marketplace implementing the federal Patient Protection and Affordable Care Act (ACA) in California.

Through Covered California, individuals and families are able to compare affordable, quality health insurance options and select a plan that best fits their needs and budget. Bylaw, the coverage cannot be dropped or denied due to pre-existing medical conditions or if the policyholder gets sick. Financial assistance is also available to those who qualify to make health coverage more affordable.

In 2014, Covered California successfully enrolled 1.3 million individuals in health insurance plans. Millions of others learned that they qualified for free or low-cost health coverage through Medi-Cal.

Included in those who are receiving coverage are more than 82,000 families, representing 130,105 individuals, who cleared their eligibility status by providing Covered California with proof of legal status. Covered California announced earlier this month that it has been able to clear the citizenship/lawful presence status of the vast majority of individuals who were sent notices seeking verification documents in September, meaning that pre-termination notices have been sent to cases involving only 10,474 people. Covered California noted that the lack of verification does not necessarily mean that the individual is not lawfully present, only that the program does not have documents it needs to verify their status, and continues to review case information. Now, the renewal process for coverage in 2015 is beginning for the millions of individuals who found coverage through Covered California. The first wave of renewal notices began being sent in early October.

Consumers who complete the renewal process will hear from their insurance plans in December and their selected health plan will send a statement reflecting coverage starting January 1, 2015. Consumers who take no action will be renewed into their existing plan. Anyone with Medi-Cal will be contacted directly if they need to take any action. At the same time the renewal process has begun, Covered California is also gearing up for open enrollment, which will begin November 15 and continue through February 15. Open enrollment is the next opportunity for all Californians to benefit from the new federal insurance rules, including the requirement that insurance be offered regardless of health status. Consumers will be able to enroll for health coverage online, by phone or in person with free assistance. In preparation for the renewal and open enrollment process and to ensure a good consumer experience, Covered California unveiled substantial new improvements to facilitate enrollment in coverage for 2015.In a statement from Covered California, Executive Director Peter V. Lee said, “last year, we succeeded in signing up millions of Californians in health coverage through Covered California and Medi-Cal. We learned a great deal in the process, and in this second open enrollment we are building on those lessons using effective and concrete changes. ” To improve customer service and assist those interested in enrolling, Covered California is making improvements, including:

  • n Starting open enrollment with more than double the number of Service Center representatives to dramatically reduce wait times and help consumers enroll.
  • n Additional representatives have been brought on to serve callers in Spanish, Chinese and other languages without the use of interpreters.
  • n Service Center hours have been expanded to accommodate consumers after hours, with representatives now available from8 a.m. to 8 p.m. Monday through Friday and from 8 a.m. to 6 p.m. Saturday. In addition, the Service Center will be open on many Sundays during open enrollment, including every Sunday from Nov.16 through Dec. 15.
  • n The program is ensuring written notices consumers receive are clearer and explanations on the website are better — in both English and Spanish.

With open enrollment beginning soon, consumers can begin the process of shopping for 2015coverage. Using Covered California’s Shop and Compare Tool, consumers can find out if they are eligible for financial assistance and find out how much a health plan will cost them. Those interested in enrolling in health insurance through Covered California will find a range of choices of private health insurance plans offered. For more information about Covered California, please visit