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.

Why Haven't I Heard from Blue Shield?

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Question: We applied on the CoveredCA website on November 1st and still have not received an invoice from Blue Shield. Should we contact Blue Shield directly or what other actions should we take to determine our status. Covered CA website indicates that our enrollment is complete.

Answer: Covered California has yet to install a working data link to the carriers to transfer applications to them. The carriers get a report from CC on the number of applications processed for them, but CC has yet to send application one. So in your case, Blue Shield does not know that you have applied, much less be in a position to confirm your coverage and send you an invoice. This will get resolved eventually, but it’s a huge bottleneck, particularly because so many paper applications have been submitted.

43 Comments

I submitted my application on 9/30. Policy is dated to go live 11/1 but I haven’t heard anything. I called and my application wasn’t in their database. After about 15-20mins the woman on the line found my application which was never sent to where it needed to go, so it was sitting in limbo. She took my number and said she will call me back later this week after everything is processed.

I kept procrastinating calling hoping I would hear something because there is nothing I hate on earth more than wasting time on hold. I would advise just to make the call. Only took 20mins of time and most of it was her searching for my application.

I have been waiting for months and have not received anything alright M a diabetic I have high blood pressure I am I have a disability with my knees I have high cholesterol and I am dying they said I was too poor for Calvert California refer me to medi-cal stayed on line for hours somebody got got on phone and said someone would call me nothing happened this is a big mess Obama care is a joke

I signed up for Blue Shield through Covered California in January 2014. I paid that first months premium. My second payment is not due by the end of this month, yet I have not received any packets or information regarding my benefits. Not even an ID card for me to keep in my wallet. I tried creating an account with the website for CC Blue Shield of California, and it does not show any active member under my info. I am very confused and frustrated. Does anyone have any insight on here before I sit on hold calling the 800 number for the help desk with this company??

I thought I was all set in Nov,I got no paperwork for insurence so I was ready for Jan ,nothing so I had to do it all over I NEEDEd pre exsisting and scripts benefit .now i am having trouble with logging in to the sight

WTH…. OMG, For 4 months I have been waiting patiently. I finally received a package from Blue Shield, but instead of the $68.74 monthly premium I got quoted in CoveredCA website, I get 8 times higher $536.78. Can they do that?

I enrolled in the Blue Shield Silver PPO through Covered California at the end of December. After enrolling, I had trouble paying my first month’s premium and found this website very helpful in solving that problem. After paying, I decided to dump my Anthem Blue Cross PPO plan which covers hardly anything and cost $346.00 per month. The Blue Shield plan offered by Covered California provides a subsidy since I am on a fixed income and am self employed. After paying my first month’s premium, I went online to Blue Shield’s website to check and see if my doctor was in the provider directory. All three of my doctors were listed at the time. Now one of my doctors is not listed in the provider directory when I sign in under my plan. I checked to see if my doctor was listed in the Blue Shield’s provider directory under a guest and without signing in. He is listed. Why is my doctor listed under the Blue Shield’s provider directory when you check online as guest without signing in? Why is my doctor not listed now when I sign in and check the provider directory under my plan? Why was my doctor listed in December and not today as of 2/8/13? Obama lied when he said, “If you like your health plan you can keep it.”, and when he said, “If you like your doctor, you can keep it.”

Also, I received a packet from Blue Cross today in the mail. Inside the packet, I am being informed my premium for the plan I dumped is going up from $343.00 per month to $429.00 per month effective April 1, 2014. They sent this because I am on the 30 day grace period for not paying my premium. I switched to Blue Shield.

Kat, you are not the only person having trouble getting the summary of benefits or evidence of coverage from Kaiser. I think everyone who is making the transition from an old individual Kaiser policy to a new Kaiser policy effective 1/1/14 is experiencing the same wait. (My situation is slightly different - I switched from an individual Kaiser policy for 2013 to a Covered California Kaiser policy for 2014.)

If every service rep confirms your Platinum plan coverage effective 1/1/14, then you should be OK. There’s no reason to believe that the clerk or nurse who schedules or checks you in for your next appointment will access a different system - they should also identify you as a Platinum member.

But if you want to play safe, bring along documentation of your new plan to your next appointment. If the person checking you in misidentifies your plan, show them your paperwork and ask to pay correct amount and request to be billed for the incorrect balance. By the time you get the bill, you should have the evidence of coverage in hand to have the bill for the incorrect balance reversed and cancelled.

If you haven’t already done so, go to kp.org and instead of logging on, just click on the “Shop Our Plans” link. Locate the platinum plan you purchased and print out the details of your plan (including co-pays, deductibles, etc.). That printout will have to serve as your temporary summary of benefits until you get the paper copy from Kaiser. If you bring in all this info along with the premium bill which identifies your new plan, you should be OK for any disputes that may arise when you check in for your next appointment.

Received letter October 2, 2013 that Kaiser was cancelling my plan because it didn’t meet the ACA requirements effective 12/31/2013. Enrolled with Kaiser directly October 15, 2013 for the Platinum Plan over the phone. Received bill for January premium December 1, 2013. Paid premium with Kaiser over the phone 12/15/2013. Have received no evidence of coverage or welcome letter for my new plan as of yet. Today is 1/12/2014. I have called Kaiser at least 2 or 3 times a week since November 15, 2013 asking when will I receive my evidence of coverage, summary of benefits and welcome letter. They said they sent it out. They said they didn’t send it out. They said that there was a bug in the system and my info didn’t get mailed out. I have asked them repeatedly to send me anything for proof of coverage …called Member Services…spoken to different people on different days. They all show that I am enrolled in their system effective 1/1/14 but are unable to mail anything out to me. They tell me they will but then when I call back they say it never went out. When I sign into my Kaiser account on kp.org it shows I have no benefits. But it shows that I have paid my 1/1/14 premium on 12/15/2014. I am 6 months pregnant and don’t know what to do at this point because even going down to Kaiser Member Service Department at my local Kaiser doesn’t do any good they tell me the same thing. We will send it out. I never get anything. What is going to happen if I have to go to my next appointment next week. Are they going to show that I am enrolled in Platinum Plan or are they going to show me enrolled in my old plan. It makes no sense why they can’t mail out my packet. Any advice would be greatly appreciated. Thank you

Finally yesterday I received an invoice from Kaiser Permanente for the initial payment for the new plan. Paid it online today and it was confirmed.

Tried to call Kaiser to make sure that my old and more expensive plan with Kaiser gets cancelled, but cannot get through due to heavy call volume.

At least things seem to finally be moving in the right direction.

Applied through CoveredCA on 10/26 and was immediately notified of acceptance/enrollment. I chose Blue Shield as provider and was advised I would receive Welcome packet, etc., by 11/15. Didn’t happen. Received letter from CoveredCA on 12/2 advising me to choose plan (already did that in October). Called them with questions and they apologized saying the mailing was in error and that they had that info and all was progressing. Called CoveredCA again on 12/9 to inquire as to status. Was informed my application was denied due to citizenship issues??? Born and raised in Sacramento so don’t know what the issue was. Apparently the CoveredCA application assistant checked the incorrect box on my application! Was told the only way to fix the error was to cancel the original application and start over. So two calls and 3+ hours later the second application was submitted and enrollment was confirmed. On 12/12, I spoke to Blue Shield who confirmed acceptance of everything and I paid the first month’s premium over the phone at the time. Received confirmation number., etc. in was told I. Would receive a Welcome kit and ID card in 7-10 business days. On 12/26 I received two letters from Blue Shield. The first was a statement reflecting January billing, total payment posted 12/12, zero balance due. The second was a statement reflecting January billing, no payment posted, balance due no later than 12/21. Two different cases. I called Blue Shield. They verified they had posted payment to the wrong case and they had to correct everything in their system before they could process my application. Subsequently, I spent another 2+ hours on the phone with Blue Shield on 1/2 and 2 hours with CoveredCA on 1/3 and I have gotten nowhere. CoveredCA says “it’s all on Blue Shield”. My Blue Shield “agent” cannot help because their system does not allow her to resolve this issue on my behalf. Right now, the Blue Shield toll free number “recognizes” my phone number and name but they have no evidence of coverage for anyone at my address—and I live alone. I am 63 years old and, for the first time in my life I’m afraid I have no health insurance, even though I’ve followed all the rules and started this process 3 months ago.

I applied in October and chose Blue CROSS. Everything went so well and so smoothly. Totally seamless. Now just recently I got a letter from Blue SHIELD. Not a bill. I called Blue Shield’s number today and I got the usual, “high call volume” spiel. I decided to wait while a number rang over 30 times then went to a busy signal. I tried to call the number again and now all I get is busy signal immediately. Covered California is impossible to get through. i call one number and it refers me to two other numbers that bounce me back and forth between the two numbers. - call this number, call this number.Live chat - forget it-, phone calls, etc. NOTHING WORKS. I’ve tried every phone number, website, you name it and I’ve tried it!

Frustrating!!!! I completed my enrollment on December 10, 2013, to date still have not received anything from Blueshieldca to make my payment. I tried to go to the website http:/service.healthplan.com/blueshieldca/binder to register but the system doesn’t have me on file!!! I can’t get through their line for help either.

Help….take my payment already!!!

Well it was a challenge but the 12/23/13 I got someone from Blue Shield to take my pmt from my cc, however she could not give me my member number as it would not update until 1/1/14…so now I am racking the system to see if I can find my member number. I will feel I have completed everything if I just get the number.

I applied for and completed coverage through covered CA. I have not received a bill or invoice for payment . I called the service number at covered ca. and they gave me the number to make a payment over the phone .888-256 3650 . I called the number and could not make a payment .The phone number listed your website which I accessed to make a payment and I still can’t seem to make one . What should I do next ? Thanks Joe

Just called Kaiser and was told that December enrollments are not processed yet.

So after 4 weeks of calling coveredca and kaiser because I have not received anything from Kaiser, who says im not in their system, A manager at Kaiser said it may have not been transmitted even though coveredca says it was transmitted in early November. If you have not received of or heard anything from Kaiser, you may want top withdraw and re-enroll. I have spent over 23 hrs on the phone talking to the highest levels of management with both entities and nobody could tell me anything, ridiculous. I withdrew my enrollment today and submitted a new one with Kaiser, I am not confident that I will received anything in time. They also say you need to make a payment yet Kaiser would not take a payment because I was not in their system, even though i am a current kaiser member whose existing policy terminates Dec 31.

Here is some important information about what happens AFTER you pay your first premium.

Your health plan cannot simply send out your enrollment package and ID cards immediately upon payment. They have to transmit a report of your payment to Covered CA and then WAIT for a final verification of enrollment from Covered CA. It is only at this point that your plan can mail your enrollment materials, and they must do so within 10 business days.

In my case, I paid my first premium on 11/29 and Kaiser did not receive final verification of my enrollment until 12/10. (I’m not saying that it will always take Covered CA 11 days to send out final verification - Covered CA may not have been ready to handle payments as early as November, so maybe the first batch of payments experienced an unusually long turnaround time.) Kaiser then has until 12/24 to drop my enrollment package in the mail. SO I MAY GET MY ID CARD AS LATE AS ONE MONTH AFTER PAYMENT OF MY PREMIUM. People who paid in December may definitely have to wait until well into January to get their cards.

Now, a service rep at your plan may tell you that your ID card is being sent right away. Either that person is wrong OR perhaps your plan is sending you a temporary ID or a printed enrollment sheet in advance of the actual ID card. You’ll know when you get the real enrollment package when you get a mailing with ALL of these required inclusions:

a. Welcome letter;

b. Enrollee ID card (NOTE: This is supposed to be a card bearing some Covered CA wording or logo, so that would seem to mean that people who already have coverage with the same insurer and already have an ID card must be issued a NEW co-branded card, even if they are keeping the same medical record number);

c. Summary of Benefits and Coverage;

d. Pharmacy benefit information;

e. Nurse advice line information

You can get health care starting 1/1/14 even if you have not yet received your ID card - AS LONG as you pay your first premium by 1/6/14. The health plan contracts carry language stating “Contractor shall promptly coordinate and ensure access to medical services for Enrollees who have not received ID cards but are eligible for services.” It may take an exasperating call to your plan to get this service, but you should prevail. However, for those eligible for CSR (cost sharing reduction), you should also make sure in this call that you will be charged the correct, lower co-payment. (If you pay $45 for a doctor visit in early January that should have only cost $3, good luck ever getting that $42 back.)

I enrolled through covered ca with Kaiser back in early November and have yet to hear from anybody. I have not received a invoice, Kaiser says they don’t have me in the system. The deadline for enrollment is coming quick, covered ca say’s they sent the data, what a mess. I call daily and Kaiser keeps telling me they don’t have the data. I have spoken to several managers, have had 3 way calls with Kaiser and covered ca and nobody know what’s going on. This is a mess and I am not not confidant that I will be enrolled, I am a currant Kaiser member, and my current plan expires in 13 days.

I too have yet to receive my packet from Blueshield of Ca. Etc. Cards…does blueshield outsource the printing of the packets and cards to some company in India ? I spoke with a blueshield rep by the name of ZAR…when she told me the packet and ID cards have been mailed she could not tell me what date or where the packet and ID cards are mailed from….how BIZ-ZAR is that !!!!! I did make my first payment to Blueshield and its been over a week since I wad told the cards and packet had been mailed……hummmmm .

I have semi-enrolled in Covered CA online on Dec-15-2013 since I haven not heard anything from them with my paper application that was sent on Nov-30-2013.

After making a correction in the Income section, the software would not allow me to Save&Exit. After press Submit, the application can not proceed to Eligibility section.

It seems that there are some bugs in the software, I reported a crash when clicked on View Submitted Application (Summary->Eligibility->View Submitted Application) prior to hitting the Changes page road block.

I’d appreciate it if anyone has any insightful info on my issue. Thanks in advance.

Jim Marsh - The same thing happened to me but I never got a call since CoveredCA did not have my phone number. However, You CAN pay your bill by going to this website: service.healthplan.com/blueshieldca/binder

You can register using your case #. I was allowed to pay mine by CC. Hope this helps.

If anyone knows how to go back into my application and re-enter my phone number please let me know. I know I can go back in and make changes but I don’t want to go through the entire income verification process again just to add a phone number.

I applied for covered on Nov. 28, 2013 and was accepted for one of the Blue Shield Plans. I received confirmation by US mail that I had been accepted and given a case number. Several days later I received a phone message on voice mail that I had until Jan 6, 2014 to make my first payment. I called the number provided (855-836-9705) and asked how to make my first payment. The Blue Shield representative said that the recording was wrong and I had only until Dec 26, 2013 and the only way to make a payment is to give them my checking account number. I explained that I didn’t have a checking account but I would mail them a money order or a cashiers check. The representative told me that would be impossible as they didn’t have a mailing address nor a physical office location where I could pay in person. When I asked for a invoice or bill to be mailed to me he said that he could not send a bill until he received the first payment. This is a catch 22 situation, I can’t pay my bill until I get an invoice and I can’t get an invoice until I pay my bill. I think this defeats the spirit of the ACA bill to help people that need Health Insurance.

Got the invoice in mail today from Kaiser which I paid using credit card.

I will follow up in a few days to check with Kaiser in a few days to see if they have me in the system to enable me to select primary care physician.

I submitted through Covered CA for a Kaiser plan way back in October, but then nothing happened. No paperwork, no confirmation or request to pay premiums by Kaiser. Finally I got a bill from Kaiser for my old plan (I was already a member with Kaiser)

After a few hours on the phone with Covered CA staff with conflicting information (every time I had to call back another person had something different to say - from “you need to cancel and call us back in January” to “you can pay your premiums through the Covered CA website” (which you can’t - to “you haven’t picked a plan yet (which I had)” - to “you don’t make enough money” to “you make too much money to qualify” ). After plenty of that nonsense, I finally spoke to Kaiser and got this information.

As a current Kaiser member I still got an invoice for my old plan (pre Healthcare reform) my application for the new plan through Covered CA is in their system and they will send me an invoice shortly.

Once I receive that invoice and make arrangements to pay the premium I should contact Kaiser again to cancel my old plan. If I don’t cancel the old plan I will have double coverage until I do.

I just signed up and chose my plan and hit check out. Now it just says your application is complete with the Eligibility box in green with no check in it, and the last box that says enrollment is all white. Is that normal, it did give me a case # and application #. It also said I have until March to verify income. Is this normal? DO I have to wait for the enrollment box to become checked now?

My application with Covered California has been complete for a while. However, I was unable to make payment by clicking on “make payment now”.

After reading other comments, I called Kaiser to see if they had received my info. from CC. The menu prompt asked for my medical record number, which I did not have as I am a new enrollee. When I did not respond, it asked me if I wanted to use SS#. Upon using the SS# the first time, the automated telephone system indicated there was no match and asked me to enter SS# again. After the second failure using SS#, the system connected me to a live agent who was able to confirm that I was enrolled in the system and an invoice had been mailed out on Dec. 4.

The agent explained that the reason I was not able to pay on the site was because Kaiser had to generate the invoice first.

Yes, thanks for the help. I was able to find on the Cov ered Care website (and also according to the letter Covered CA sent) that I’ve been accepted. Their website indicates my next step will be receiving an invoice from Anthem. Since everyone days this is where the bottleneck of delay is, I’m a bit concerned I won’t hear from them on time. Many thanks for this forum; it has been very helpful.

Progress. I called Blue Shield today and someone could see my application in their system with the correct monthly payment after subsidy. Had been calling regularly for two months without them having received anything from Covered California. Hopefully this means they’ll be sending me the welcome packet soon.

Update: I went back through the Covered California website and after clicking on the application process, I finally found a link that stated the next step will be that I’ll hear directly from Anthem. It did take awhile to find this link, however. And the link didn’t work by clicking on it, I had to input the URL to Anthem, then I received the info. The info I first got from the Covererd CA site, stating that I was approved and should now choose a plan was incorrect, because I had already chosen a plan, and that was noted when I was able to access the Anthem site.

Making the payment in not the problem. Receiving an invoice is the bottleneck.

Covered CA has extended the deadline for payment of the January 2014 premium from December 26 to January 5. So people who are rightfully concerned about not receiving their billing in time have at least 10 more days of breathing space to make the required first payment to activate their 2014 policy.

Now, if you log on to your Covered CA account, you can still find screens that will display the warning that you must pay the first premium by 12/26. This is business as usual - Covered CA is very slow to correct and update erroneously generated messages on various screens. But I trust that as more panicky people call their hotline, they will eventually fix the screens and otherwise get the word out that there are an additional 10 days to pay that first premium (though I would advise people to pay by 12/26 just to play safe).

JR Deaver - If you click at on the Summary box at CoveredCA, doesn’t it show what plan you signed up for ? Even better is Summary box, THEN the Enrollment box. Before 8am today the website is fast.

The website says my application is complete. The summary page says my enrollment in pending. Under both subsidy categories it indicates I need to upload documents. On the eligibility page I uploaded my prior years taxes (and it finally went through). Now when I click upload documents it either does nothing or says I already submitted docs (which are there when I go to manage verifications). There is nothing in the verification response box. I have no secure messages. I have never heard from Covered California about anything (I found the document request page by accident). The dates on the eligibility page keep changing and saying I have to submit documents by the next day. It doesn’t specify any documents except my proof of income. I can’t tell if I need to do more, or if I am enrolled (even though it just says pending). I can’t get through in online chat or by phone although I have tried many times. Do I just wait and hope to hear something? Sometime?

Perhaps this is the best place to ask my question as it’s related to this post. I was approved by Covered California for a subsidy, and told I should now log on to their site and select a health plan. But I already did that (I selected Anthem Silver)during the initial application process. When I log on now, the only way to select a plan is to start the application process all over again and I’m afraid that Covered CA will look on this as a duplication of my original application. Should I call Anthem directly? Thank you for any advice.

Signed up for Blueshield here on 10/26. Havent heard a peep either. BlueShield knows nothing about me, CoveredCA says I’m all done. To add insult to my situation today got a mailer from BlueShield urging me to sign up to see if I’m eligible from tax credits… I think I’m just going to extend my current insurance with BlueShield till April and let them figure this mess out.

Albert, sorry to hear you’re still waiting for your Kaiser billing for January 2014. I was in the same position as you (a current Kaiser individual policy holder who went on the exchange to get the lower subsidized premium) and I can assure you that they eventually mailed the January bill to me.

As I said below, I enrolled on 10/23 and got my bill in the mail on 11/29. But that does NOT mean that it takes 37 days from enrollment to get your bill. When I spoke with Covered CA on 11/15, they indicated that NO carrier had sent out billing notices yet. She said it made no difference whether someone filed on 10/1 or 10/23, no one had been mailed anything. That tells me that all of the first batch of enrollees (from 10/1 to whatever the cutoff date was) was sent in one transmission to whichever carriers were ready to receive. Presumably, once a carrier (such as Kaiser) confirmed that it was able to process the data, then it could tell Covered CA to continue transmitting data. So October enrollees had the longest wait for their billing, while more recent Kaiser enrollees should have a shorter wait.

Here is some general advice for Kaiser enrollees who haven’t gotten their January billing yet. Call Member Services at 1-800-464-4000, and if at some point you are asked to press 1 to ask about health care reform, press 1 (otherwise, just find a way to talk to a live rep and say that you want to ask about enrolling under the new health care law). That takes you to a special unit who will know about Covered CA. Tell them what date you enrolled at Covered CA and ask them to check to see if they have received your enrollment data yet and whether they have sent your January billing yet. They will then put you on hold for around 3 to 5 minutes while they check with some processing office in the Central time zone (presumably that Texas office from which my bill was mailed). That office not only can verify your enrollment but also keeps track of the date of mailing of the premium notice. If they don’t have your enrollment data yet, ask what the processing time is between enrollment at Covered CA and receipt by Kaiser. Hopefully you will be reassured by whatever info they can give.

One other note to current Kaiser members who have enrolled on Covered CA for 2014 - Kaiser has a process in place (as hopefully all other carriers would) to identify current members in the incoming Covered CA data. Once they receive your January payment, Kaiser will cancel your existing policy effective at the end of the year so that you will only have the new policy in effect in 2014. Supposedly you will keep the same member number but I don’t have evidence of that yet. One thing I did note was that for my December premium, the billing on my credit card did not show “Kaiser Dues” as it usually does but instead showed a billing by phone by “CSC” (which stands for Kaiser’s California Service Center). It seems that once a current member is identified as a Covered CA enrollee, then your record is isolated for special processing while you make the transition.

I learned something very important today. When calling Blue Shield for information about where you are in their system, ask to be connected to department HPS. HPS stands for Health Plan Services.

From an April 3, 2013, news release:

“HealthPlan Services(HPS), the nation’s leading technology, sales, retention and administrative services provider for the insurance and managed care markets, announced today that Blue Shield of California will utilize its Go-To-Exchange platform to streamline participation in the Covered California Exchange.

Included in the Go-To-Exchange platform are:

ExchangeLink, a software platform that will be used to connect Blue Shield customers to Covered California, the state-sponsored public health exchange, and

ServiceLink, which provides in-force administration, member billing, tax credit/subsidy collection, premium reconciliation and customer service. Blue Shield will leverage ServiceLink to ensure administrative functions are streamlined and high-quality customer service is provided to its members.

“We are delighted to partner with Blue Shield of California through this initiative to ensure their members receive the highest quality service as they make critical health plan decisions,” said Jeff Bak, President and CEO of HPS.

If I don’t get satisfaction within the next two weeks, I’m calling HPS directly in Tampa at 877-300-9488 and ask to speak to Jeff Bak. Every day, 5 times a day if need be.

It is not that complicated, close to thirty years ago I used transmit data between computers over phones lines.

If there was one thing I learned, it was take care of the easy customers first. They are quicker to get done so there are more happy customers sooner.

CoveredCA certainly can put the online applicants relevant data on a stick drive and walk it over to BlueShield. From what I have read about the Feds problem with “834 EDI transmission form”, it is just a text file. What a days worth of CoveredCA online data for BlueShield would be One Meg or something. Make it a Gig if you want, but the online data is still very small and there is No Excuse for BlueShield not having it and processing it and sending out notices of coverage. No Excuse.

I applied 10/17, and uploaded my verification of income docs 11/14. I assumed that if they were uploaded, then they would be seen and attended to. What else would one expect?

Yesterday I spoke to a Covered CA rep to see where things were at. Apparently you’ve got to get a phone rep to open your doc, see that it looks correct, and then that rep will pass it along to some other dept that can make a determination about eligibility. If you don’t make that call, it seems the uploaded doc will just sit there, unseen and unworked on.

Incredible, right? If you’ve been asked for any sort of documentation from Covered CA, better to be safe than sorry and include this as your last step. And my experience is just don’t ask any rep that answers the phone to do it. Some reps sound like they know what they’re doing, and some sound like they just got hired that day. If they sound ignorant concerning the process, hang up and try again.

Phil, you stated that “Covered California has yet to install a working data link to the carriers to transfer applications to them.”

I just want to make sure that people do not get the impression that ALL carriers have not received applications. I enrolled on 10/23 and chose Kaiser as my carrier. When I did not get my premium billing within a month, I called Kaiser on 11/22 and they confirmed that they had my 2014 enrollment info (plan level and subsidized premium amount) but had not sent out notices yet. Then on 11/25, in reply to an email, Kaiser told me “At this time, Covered California has advised mailings will be going out on November 26, 2013.” The wording confused me since I thought that Kaiser would be sending out the notices themselves.

On 11/29, I received my billing from Kaiser, which listed the correct plan level and subsidized premium. The letter was dated 11/21 and postmarked from a Kaiser facility in Texas on 11/25. So it appeared that the notice was ready to go but that they needed some type of go-ahead from Covered CA (most likely confirmation that the link for payment notification was working). I paid my premium after-hours on 11/29, which probably missed the cutoff for Friday processing. My understanding from talking with Kaiser is that they have 3 business days to transmit notice of premium payment (hence the cutoff date for paying January premiums is 12/26). As of last night, there was nothing on my Covered CA account to indicate I had paid the premium, but it had not been 3 full business days since Monday so I’m not worried (yet).

It’s not quite the same as having my health plan ID card or Evidence of Coverage in my hands, but at least I have evidence that my carrier has identified me as a 2014 enrollee and has confirmed receipt of my payment.

I too applied on Covered Ca in Nov. The eligibility was confirmed and a plan with Kaiser was selected. I was told via the secured mail on Covered Ca and by snail mail that the carrier would contact me about paying the premium by 12-26-13 for coverage starting on 1-1-14. I’ve heard nothing else from anybody. I’m a current Kaiser member paying for an individual policy that I can’t afford so have great interest in finding out what’s going on. I called Kaiser customer service today and after checking my record, It was determined that they’ve had no contact from Covered Ca. regarding new coverage. This is really bad and Kaiser expects to be paid their initial binder payment by 12-26-13? Thanks to Phil’s answer I now know why Kaiser hasn’t received anything. Kaiser’s customer service rep didn’t know why except to say they’ve received nothing. No data link to the carriers and the website has been running for 2 months and the software has been worked on for how long before that? Not only is there no data link, it seems customers and carriers aren’t in the loop about what is and isn’t going on.

I am in exactly the same position only I applied even earlier than you. I have called Blue Shield and they informed me that they expect to receive applications by end of this week and send invoices by 12/22. The invoice must be paid by end of the month in order to have insurance on 1-1-14. I have little confidence that this will happen but am hopeful. If they are backed up now how are they going to handle the onslaught in the next 3 weeks??? I selected a plan based on affordability and subsidies certainly played a role in that selection. If I can not be certain from Covered Ca that I will receive that level of subsidy I will need to select a new plan. Covered CA has asked me for the same data twice now. I am a bit frustrated as to why covered ca can not verify with certainty what subsidies I am qualified for and explain how I can expect to have coverage starting 1-1-14. No one seems to know the process and have a timeline.

The disconnect between CovCA and insurance carriers is just another manifestation of what a SNAFU the even smoother running than the multi state exchange is.

Maybe those that are getting insurance for the first time will be thrilled and patient to know that as long as CovCA shows they have gone through all the steps including enrollment in a health plan-all is good for 1-1-14 effective date of coverage. But those who have always carried insurance but have received cancellation notices/mapping to new ACA compliant plans and have gone thru CovCA because they may qualify for premium subsidies- and may in some cases be going through treatment for chronic diseases or cancer treatment: these clients are nervous and anxiety ridden- and rightfully so- about billings from teh carriers they are yet to receive to “bind” 1-1-2014 coverage. Their notification from CovCA at conclusion of processing is that their premiums must be paid by Dec 26th 2013 ( or whatever date per client). How can they if the carriers are not even in the informed loop on this??!!

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