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.

CC Application Pending?

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Question: I submitted my prior year taxes, which do not reflect current income (had some stock sales) but I appended an explanation in the comments. My verification is “pending”. However, it says all documents must be submitted by 12/23 and I don’t know if they need anything else since they have not reviewed it or contacted me. Is it okay to just wait and see what happens for APTC and CSR as long as I attempted to provide supporting documents?

Answer: If your application is “pending” it’s because it’s not complete, not because of verification issues. Login and see what you need to do to complete it. If you need help call one of the agents in our Find-a-Pro Directory. It’s not because they don’t like your verification efforts. I can safely say that the documents you’ve submitted so far won’t be looked at for some time. You actually have 90 days from the date of your application to submit verification documents and you can be covered in the meantime.

4 Comments

Phil responded: “If your application is “pending” it’s because it’s not complete”. I beg to disagree.

I have submitted some 35 COMPLETE applications which include all necessary documents as requested. I don’t believe anyone at CoveredCA is looking at any of those applications. If they were, those applications which remain in limbo would not continue to be “pending”.

I spent over 45 min on hold with CoveredCA yesterday morning waiting to talk with someone about this. When my call was answered, the “agent” had no clue what I was talking about, only that she was really getting tired of telling agents that the SHOP has the answers to these questions. Funny thing is, I told her, after spending nearly the same amount of time on hold waiting for someone from SHOP to take my call, I was told, “We only hav information about group enrollments, you have to call Sacramento.”

So we have the left and right hands which do not communicate with one another pushing the buck back and forth across the table.

I sent an email complaining about this to Sarah Soto-Taylor the Deputy Director of Community Relations for CoveredCA (and the person who has said we will be paid for our Medi-Cal applicants), and she wrote “I sincerely apologize” in response to my complaint that no one has any answers. Then she asked for my phone number. So far, she hasn’t called either. So much for Community Relations.

Maybe you’ll have better luck. Write to her at: Sarah.Soto-Taylor@covered.ca.gov

This was my experience. The pending status didn’t change to completed until I got on the phone with Covered CA and the rep then “verified” my uploaded documents. Verification in this context does NOT mean make any determination about anything. It means the rep: (1) is able to open the docs on their system, very elementary but necessary (2) see that my docs were germane to the matter, that my “proofs” were of the list of expected forms of documentation (3) then passes the docs along on their side electronically to the next step in the queue by changing a status or checking a box or something.

After that process on the phone, my status on the Progress Bar on my homepage changed from pending to completed.

I believe, based on what I was told on the phone that day, that until you do this you will stay pending. Forever. No one will just come along and open your uploaded documents and begin working on them. Unbelievable, right?

All of my clients show as “pending” according to CoveredCA because they have yet to pay their first premium, not because the application isn’t complete. Their applications are complete and most now appear in the carriers’ systems. Some have received an invoice for the first month’s premium. Hopefully their status on the CoveredCA website will change to “enrolled” once they’ve made that initial premium payment.

I don’t think the application is pending, as I paid blue shield today and receive a paper bill as well. But next to the tax document on the manage verification page, it says pending under status. Not sure what that means.

also, I noticed on the paper document blue shield sent that they referred me to a web page for my plan but it’s not the right plan. I’ll try calling them to find out whether there’s an error on their end (I signed up for silver 87 epo and they said to go to the webpage for their enhanced PPO page and it also said it was for families).

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