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.

Switch Plans During Open Enrollment?

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Question: Concerning Individual Plans purchased through Covered California: if I sign with a carrier for 2014, can I terminate the plan and switch to the same tier with a different carrier, if the new application is processed prior to 3/31/2014 the end of the open enrollment period? Assume there is no life-changing event, such as the loss of a job, death of a spouse or birth of a child. Am I allowed to terminate and switch because I don’t like the network coverage or I don’t like the carrier’s customer service?

Answer: Yes. One can terminate coverage and buy a new plan during the open enrollment for any reason.

8 Comments

Any word on whether split enrollment will be enabled this year? — i.e. individuals within a family choosing different tier levels of insurance and still computing the subsidy correctly.

Last year they said the software was not capable of handling it. But they couldn’t accommodate it with paper form also. I could choose the different level, but one of us in the family had to pay the full-up cost with no prepaid subsidy. We are hoping at tax time it will all work out. But I give it about 20% probability.

I want to switch plans and can find no information on how to do it. Has anyone found out the procedure?

Connie, my circumstances are exactly the same as yours. Back on October 3rd when I enrolled for CoveredCA, they told me that the Anthem Blue Silver 70 plan that I enrolled in would have Palo Alto Medical Foundation “in network”. Apparently not all of the agreements between providers and insurance plans had been finalized at that time. Only to find-out now that my plan will not allow me to see PAMF Drs. in network. I can’t get through to CCA to pose the question about switching. I’ve also contacted an approved insurance broker and I’m calling Anthem again to confirm no recent changes have been made or will be made to include PAMF in network.

I would appreciate to hear if you have any more information and/or success in switching to Blue Shield EPO Silver plan. Thank you, Bill

I signed up for an Anthem Blue Silver 70 Plan through Covered California only to find out Palo Alto Medical Foundation in SANTA CRUZ did not contract with Anthem Blue Cross for policies applied for through Cover California.

I went directly to the PAMF business office at received this information from their business manager. It is also on their website.

I now want to change to a Blue Shield- Silver 70 EPO plan which is comparable.

Palo Alto Medical Foundation has contracted with Blue Shield EPO plans submitted through Covered California.

Given this information and the fact that Palo Alto Medical Foundation is the dominant provider doctors under their umbrella in Santa Cruz…..HOW DO I CHANGE out of the requested Anthem Blue Silver 70 plan TO THE Blue Shield EPO Silver plan.

Should I start all over with an entirely new application and not pay on the plan I do not want?

There is no part of Covered California’s website, to my knowledge, that addresses this ability to change plans.

Please advise to help myself and others under the same circumstances.

Me, too. Given that the Covered California website gives no direction on this question, knowing it’s possible is useless information without the precise steps to do it. Please advise. Open enrollment is fast ending.

I’m wondering the same thing.

What is the procedure for terminating the existing selected carrier and switching to a different plan? Can’t see any info for how to switch plans.

if I change plans what happens to any deductible and co insurance that might have been paid prior to the change in plans?

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