Covered California and ACA related questions from consumers, employers and agents are answered by Phil Daigle with the best information available at the time. Archived entries may no longer be accurate as the ACA and Covered California knowledge-base is evolving quickly. TO REQUEST A PERSONAL RESPONSE INCLUDE EMAIL ADDRESS.

What is the Income Verifications Deadline?

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Question: I have completed my enrollment process (on the exchange) and designated an agent and picked a plan/carrier. My question has to do with submitting income verification. The CC website says, “You can use this page to submit electronic copy of the required verification documents in order to insure eligibility… Please submit all required verification documents within 30 days.” This has me worried. Do you think the 30 day stipulation is just boilerplate and does not have to be taken seriously at this time? When I asked a Covered CA person about this, they put me on hold, tracked down a supervisor, and came back and told me that what was required would be spelled out in the Notice of Action correspondence I’d be receiving from Covered CA “sometime in November”. Should I be more proactive than just sit back and wait?

Answer: Sit back and wait a while. You actually have 90 days to meet the income verification requirement in California.

10 Comments

We had the same experience as Dina. We were waiting for an email but after one week still haven’t received anything. We logged in and saw 1 new message in the Secure Mailbox. We uploaded our proof of income (scanned copy of 2012 tax form) a few days AFTER submitting our application (we kept getting an error when trying to upload the proof documents online). Our Secure Mailbox letter said that we are qualified for 90 days but that we still need to provide proof of income. I’m not sure what would be better more reliable proof than the federal tax form so I’m wondering if a) they sent this notification letter without having seen our uploaded documents or b) we didn’t submit the correct portion of our tax form. Does anyone know what is the correct tax form to submit? We sent in 2 pages of the 1040, from line 1 (including our names, SSN, address) all the way through line 77 and our tax preparer’s signature.

The original question referred to a “Notice of Action” that enrollees would receive “sometime in November” re: proof of income. Since I specified that I wanted all future contact to be done by email, I’ve been waiting for that email and never got it.

Yesterday I logged onto my Covered CA account again and lo and behold, I noticed that there was one item in my “Secure Mailbox”. I opened it and there was the formal request for proof of income, including the reason for the request, examples of the types of acceptable proof and instructions on how to submit it, and my appeal rights. It was dated November 13.

Covered CA never indicated at the time of enrollment that I needed to check for mail on their website. It’s astounding that they would use this means of communication instead of simply using regular email (do they really expect enrollees to continually log on to their website in order to receive their notices in a timely manner?). Anyway, to access your website mail, go to Covered CA, click the “Start Here” button, click “Log In” at the top, and then enter your username and password as a returning user. Once logged on, you will see the “Secure Mailbox” link at the top.

By the way, Andy referred to “high net worth low income retirees”, a population that can have quite a challenge in submitting proof of income since investment income such as dividends, business income, capital gains and mutual fund distributions can be received sporadically throughout the year (and much of it possibly coming in December). Initially I was going to explain why I knew my 2013/2014 income would be lower than 2012 (with a few supporting account statements), but really didn’t feel comfortable sacrificing personal info such as account numbers and investment holdings. I also wasn’t sure how an affidavit would go over without supporting documentation. Here’s what I decided to do: One of the types of acceptable proof is “Previous year Federal income tax form”. If I wait until the beginning of January to submit proof, then 2013 becomes a “previous year”, and I can then submit copies of both my 2012 and 2013 tax forms (just the 1040 should suffice - no need to let them see your Schedules B, C etc.). Of course it will take some work to check all your accounts for year-end totals instead of waiting for 1099’s, but I’ve always done this on January 1 or 2 without any problems. I will explain every change of income in detail and also explain that I will manage my income in the same manner in 2014 so that I will continue at the same income level. This may be a bit more work but is far more discrete than sending in a bunch of bank or brokerage statements, or income and expense receipts from your business.

Yes, we used their own account and they completed it in my office with our assistance. I assumed this was the only way we could do it because that’s the only way I found to do it. Anytime during the application process at the top they select “Find an Agent”. Once you are found, they click on your name. That is what attaches you to the application and then they will show up on your dashboard and you will have to “accept” them as a client. My question for Phil or anyone out there is are we allowed to enroll them online with their own account and then sign for them as do the certified enrollers do when subscribers are calling into to the hotline to get enrolled?? I’m assuming so because surely professional, certified agents who have gone through more background checks and scrutiny and have been helping clients for years would be on the same level playing field as others especially given that the goal is to get California covered but would sure love a confirmation about this. If not, can they complete a paper application, submit it to us and then we enter it on their behalf and then do the electronic signature for them with their permission?? Please someone confirm this for me. Thank you!

Then how were you able to enroll your client? Clicking on their name was supposed to start the application process by the agent. Did you enroll them through their own account? To my understanding, they need to be enrolled through our dashboard in order to designate us as their agents.

Yes, once they have been entered and show up on my dashboard as active individuals I get that same message when I click on actions. I’m assuming actions is where it’d list what documents we need to submit, yes??

Dina, when you clicked the client’s name who delegated you in your account, did their secure info show up? Every agent that I talk to says “Oracle Access Manager Operation Error” message shows up which means an access to the secure info is denied. How did you work around this issue? Thanks.

How do we find the application ID and case ID off of those applications submitted online?

While I appreciate Phil’s advice, I’ve decided I’m going to be proactive and jump the gun on providing supporting docs. There’s a 10% leeway on the difference between your 2012 reported income and your attestation of income for 2014. At least at the Fed level - States may have room to tweak both that number and the sample size they decide to poll on those who fail the parameter. The Fed was saying they were going for 100% sample size - but that was before the meltdown.

Cover letter should include Application ID, Case ID, and last 4 digits of the SS#. Better make a clear decisive argument supporting 2013 income and then follow through to 2014 income. I’m also considering drawing up an Affadavit to include with the package. I’m going to mail rather than fax.

Agents, your high net worth low income retirees younger than 65, who were paying a fortune for individual plans and are looking to benefit from Covered CA, will need to seriously document any large income drops. Better start prepping them now.

I just completed my first online enrollment for a client! Yeah! It wouldn’t work on my newer version of Internet Explorer that I have on my new laptop but I tried the older version on my assistant’s computer and it worked! 1) The client had to agree to file 2014 tax return by 4/15/2015. Many people file extensions…what will happen IF they don’t file it by then? 2) For this client that I just signed up…the system didn’t ask us for their tax return. What will happen next? Will they receive a contact from Covered CA with instructions about how to get it to them? Can I get those instructions so I could just forward it along for them? Could we just do it while their in my office completing the application?

Does that mean that all applications are considered eligible and conditionality is waived during that 90 day period - as in, granted by default and possibly rescinded later?

Or some are allowed in? Or none - denied by default?

The answer and the timing is important, obviously. I can’t afford to go one day without coverage. That will be the day I fracture my leg in 10 different places necessitating $100,000 worth of treatment. I’ve lived through this scenario before - not like this, but close. ACL surgery, $12,000.

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