California Issuers May Push Off-Exchange Enrollees Toward Exchange

October 8, 2019

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Source: ThinkAdvisor

Managers of Covered California say participating health plans will be encouraging off-exchange enrollees who qualify for exchange subsidies to switch to exchange coverage.

“Issuer-to-consumer outreach includes renewal packages highlighting the state subsidy, referral to the agent of record, and direction to to check subsidy eligibility,” according to a meeting slidedeck posted by Peter Lee, Covered California’s executive director, on the Covered California’s board website.

Issuers and Covered California are working with agents to increase consumer awareness of subsidies, Lee says in the slidedeck.

“Commission rates are being reviewed on a plan-by-plan basis to assure agents are paid for the effort of moving consumers from off-exchange to Covered California,” Lee says.

Covered California is California’s state-based Affordable Care Act (ACA) public exchange program. It has helped 1.5 million state residents sign up for coverage this year.

An ACA public exchange uses federal premium tax credit subsidy money to help consumers who earn up to 400% of the federal poverty level to pay for coverage from private health coverage issuers.

California recently added a state subsidy that will make subsidies available to residents earning up to 600% of the federal poverty level.

That means premium subsidies will be available to one-person California households with annual income of up to almost $75,000, and four-person households with annual income up to about $155,000.


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