"Getting Over the Finish Line”
Covered California — Consumers’ interest in Covered California has been remarkable! Through the efforts of County Eligibility Workers, Certified Insurance Agents, Service Center Representatives, Certified Enrollment Counselors and Plan-Based Enrollers, Covered California supported over 400,000 individuals to get ready for the final step with their enrollment process and to pay their initial premium to start their coverage. This occurred within the first 3 months of Open Enrollment.
Covered California is committed in helping the enrollment of consumers who need affordable, high quality health insurance. The following describes our approach in getting consumers enrolled with a January 1, 2014 effective date of coverage. These approaches are being implemented to help consumers who made good faith attempts to complete their enrollment process on time.
Consumer started an application before December 23rd. But, did not complete the enrollment process until after December 23rd.
- Covered California’s service channels will continue to assist consumers to “get over the finish line” to help them receive an January 1st effective date of coverage.
- In order to keep the January 1st effective date of coverage, all service channels can continue to key in applications when consumers contact us to complete the application and plan enrollment process. Applications keyed into CalHEERS by 6:00 p.m. on December 28th may receive the January 1st effective date.
- A job aid will be distributed to explain the manual work around process to keep the January 1st effective date under these circumstances.
- Any completed application submitted after December 28th after 6:00 p.m. will continue to be accepted. However, the consumer will receive a February 1st effective date.
General Agents and Certified Insurance Agents who were unable to key in applications into the CalHEERS system by December 23rd will receive an extension to enter in the applications.
- Covered California will keep the January 1st effective date for applications that are submitted into CalHEERS from General Agents and Certified Insurance Agents. In order to keep the January 1st effective date, the application must be completed with a plan enrollment by December 28th (by 6:00 p.m.).
- Any completed on-line application submitted after December 28th after 6:00 p.m. will continue to be accepted. However, the consumer will receive a February 1st effective date.
Mailed or faxed paper applications received by December 24th.
- Any completed faxed or mailed applications received by Covered California with plan enrollment on December 24thwill continue to receive the January 1st effective date.
- Any completed mailed or faxed applications received after December 24th will continue to be accepted. However, the consumer will receive a February 1st effective date.
Reminders to consumers to pay their premiums.
Covered California will encourage consumers to proactively reach out to their selected health plans to pay their initial premium. Both e-mails and notices will be sent to consumers whose enrollment information has already been submitted to the health plans. We will remind consumers that they must pay their premiums by the January 6th payment due date.
If a consumer disagrees with the eligibility decision and effective date.
As a reminder – in the event a consumer disagrees with any eligibility decision, they can appeal the eligibility determination.
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