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Covered California Q&A

Covered California and Obamacare 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 Covered California and Obamacare knowledge-base is evolving quickly. TO REQUEST A PERSONAL RESPONSE INCLUDE EMAIL ADDRESS.


COBRA Cancellation a Qualifying Event?

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Question: I am currently on Cal COBRA and it will go until July 2014. The plan renews in May 2014. At that point I expect the rates to go up, would that be considered a qualifying event that would allow me to enroll at that time? Are the qualifying events off and on the exchange the same?

Answer: You can keep COBRA coverage until it expires in July and would then qualify for a Special Enrollment Period extending 60 days from that date. If you drop COBRA coverage between April and June you will have to wait until the next open enrollment period starting October 15, 2014 to enroll in an individual health plan either in-exchange or off-exchange..

4 Comments

Where does one file a complaint about a portion of the Affordable Care Act? I would like our voice to be heard on an aspect of the law that is bad policy. We have a client that was on vacation when his COBRA prism was due. He made the payment a few days late. Hence, his family of five was cancelled. He is now penalized for being late on a policy he has had for years. He cannot get an ACA plan until Open Enrollment, and, to add insult to injury, he will pay a whopping penalty for 2015. He is essentially penalized for not buying what he cannot buy!!! Where does one go to have our voice heard on some of the parts of this law that do not make sense. The government has extended a new special enrollment to those who had no insurance last year just so they do not get penalized this year, yet this family is not granted the same extension. They made one slight error and results in loss of coverage and no way to correct it. This is not right!!!!!

Steve,

Qualifying event rules are in play during open enrollment. The enrollment deadlines (eg Jan 15th) do not apply. If an applicant is losing coverage at the end of January, they can get approved now for a Feb 1st effective date.

I have a few people who are enrolling now, but have a qualifying event, like COBRA termination or loss of Medi-Cal.

It’s my understanding that as long as one applies by the end of the month, they can get coverage for the 1st and not have to do it by the 15th.

I’m told that during open enrollment, there are no qualifying events.

Max, do you have a citation, pro or con on this? It doesn’t make sense that someone has to go a month without coverage, because it’s open enrollment

HHS rules permit a person to terminate COBRA continuation at any time and enroll in a Qualified Health Plan within 30 days of termination. You could enroll in a QHP beginning on Oct 1, 2013, continue your group coverage under Cal-COBRA until December 31, and your new QHP coverage would begin on January 1, 2014.

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