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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.


2015 Auto Renewal?

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On Thursday, HHS announced that most U.S. residents who have health coverage through HealthCare.gov could automatically be enrolled in their existing plan next year, cutting the need to fill out a new coverage application form through the website, the New York Times reports (Pear, New York Times, 6/26).

About 95% of current exchange enrollees could qualify for automatic re-enrollment if they do not change their coverage plans proactively (Radnofsky, Wall Street Journal, 6/26).

While the automatic re-enrollment feature is designed for the federal health insurance exchange, it also could apply to state-run insurance exchanges, officials said. State officials will also have the option to submit an alternative renewal proposal (O’Donnell, USA Today, 6/26).

While the proposed re-enrollment process would be automatic, consumers would be urged to re-evaluate their coverage benefits and needs during the next open enrollment period (HHS release, 6/26). In addition, enrollees would receive information about how to move forward if their incomes or other life circumstances have changed, which could affect their eligibility for future tax credits.

According to Modern Healthcare, HHS drafted the proposed rule with input from the National Association of Insurance Commissioners and other stakeholders. The rule is open for public comment for 30 days, after which HHS will issue a final rule (Demko, Modern Healthcare, 6/26).

3 Comments

Happy Holidays and Happy New Year!

Fred and Phil, nice posts.

It seems that if a CovCal enrollee originally applied using their 2013 AGI as filed on their 2013 tax return, then indeed when financial redetermination comes later this year for 2015 advance tax credit and health plan eligibility, such redetermination process will access the IRS part of the the federal data hub, which will deliver the exact same 2013 enrollee AGI results (2013 still the most recent tax year filing), thereby resulting in determination of the same health plan with the same advance tax credit subsidy as was originally determined and provided for the 2014 initial early or mid-year enrollment.

For those households who/which originally enrolled with 2012 or earlier AGI numbers, where 2013 AGI numbers are in fact different, and as subsequently filed on a 2013 tax return (significantly or moderately so), then it seems redetermination may in fact result to a differing advance tax credit and health plan, relative to this latter-filed 2013 household AGI.

Or will the feds and states just keep the new-year plans and subsidy the same regardless, even if tax-filed 2013 AGI is different than AGI as claimed upon initial enrollment? Seems less likely, but possibly so.

Covered California’s most recent board meeting was on 6/19/2014, and at that time it seemed clear that Covered CA intends to conduct a renewal process very similar to the Federal Marketplace.

The exact details are still being worked out, but you can see a general discussion and timeline for the Covered CA renewal process in this report prepared for the June meeting (on pages 27-30):

http://board.coveredca.com/meetings/2014/6-19/PDFs/PPT%20-%20Executive%20Director%27s%20Report_June%2019,%202014.pdf

Also, for those enrollees who are currently receiving the Advance Premium Tax Credit (and Cost Sharing Reduction if applicable), you may be wondering how the “redetermination” process will be conducted and whether your APTC and CSR will automatically continue in 2015. This federal government memo explains the redetermination process that Covered CA will likely adopt, and as long as you previously authorized Covered CA (on your original application) to obtain updated tax return info AND do not have a significant change in income, your APTC/CSR should automatically continue in 2015:

http://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/2014-0626-Guidance-on-annual-redet-option-2015-FINAL.pdf

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