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Agents . . . Are you dissatisfied with CoveredCA?

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Question: What can agents who are dissatisfied with Covered California service do to be heard by the people who run the agency?

Answer: Max Her replies, "If you, like I, are dissatisfied with the performance of CoveredCA, the Call Center (FOUR hours on hold today pursuant to the notification that four of my clients' documents were not in order and that they are in jeopardy of losing their coverage -- none of which is accurate), $58 payments for Medi-Cal enrollments that have never materialized, and so on, please email me (max.herr@verizon.net) with your complaints and concerns."

"I have decided to fly to Sacramento for the September 18 CoveredCA Board Meeting and will try to find a way to air our grievances with the Board in public session. We are, I believe, not being given the credit we deserve for effecting a significant percentage of both Medi-Cal and QHP enrollments for 2014, nor are we being asked for our input on how to make the system more efficient and accountable, and I believe it's high time to hold Peter V. Lee and the Board accountable to us for a change."

I look forward to hearing from you. I will print your emails and deliver them personally to the Board at the meeting. Ideally, it will be a large stack of paper.


nelse … send me an email and I will give you the email address of someone at CoveredCA who would like to know about this. max.herr@verizon.net

I don’t believe the CovCA people have any xperience with anything ever. That goes along with all the new people at Anthem and Shield CA . I’ve had people not being able to answer my question and just plain state to me, “I don’t know !” When I asked them if I could talk to someone else that does their statement was, “This is a very busy time of year, this is Open Enrollment time, everyone is very busy!” Like this 20 year CA insurance agent doesn’t understand such things as AEP, Open Enrollment! I believe they have been brainwashed with Independent Agent hate …

I had some difficulty accessing the website last week because the “encrypted” emails with my password and userid could not be opened initially. Took about 90 minutes of hassle with Microsoft 360 to get temporary access to the messages in order to get to the extranet website. I was able to download the Excel file and have not revisited the website since then.

I complained about this to CoveredCA … that there is no need for such overkill. An agent’s book of business should simply be accessible within the normal agent login portal. They might change the access in the future, but don’t hold your breath. It’s far from a perfect system but at least we have access to it.

On another note, however, about 45 minutes ago (at almost exactly 4:00pm, while in the process of filling out an online application using the Google Chrome browser (CoveredCA’s preferred browser), I hit the continue button on the tax filing information page and was greeted with an ERROR page (with “Error Number: 0”) and cannot log back into the v.calheers.ca.gov website. All I get is the Error page.

I was able to use Mozilla Firefox to resume and complete the application for the client.

A call to 877-453-9198 along with a 23 minute hold landed me at the ear of a CSR who told me, “We’re not computer people here, you need to take your computer to Best Buy and see if they can fix it.”

LMFAO. That’s exactly the utter lack of support we agents have come to expect from CoveredCA. No access to any IT personnel who might know the fix for this. Clearing the browser cache did not fix the problem, as I would have expected.

Has any agents out there been able to log on to see their book of business at the new http://extranet.coveredca.com/sites/ccAgentPortal ?? I can’t even get to the log on page today .

Just to keep you updated, CoveredCA has not made any effort to “reach out to me” as Exec. Dir. Peter V. Lee told the Board they would.

However, after that meeting, I did have a nice, long coversation with Kirk Wheeler, the new Dir. of Sales, who is very much interested in making sure agents are included in the processes. And I can say this about Kirk: he responds to my emails. And he did incorporate a few of my suggestions in some of his early communications to agents, such as the survey asking how many of us would be interested in joining with CoveredCA and their navigators and application counselors at community outreach events.

Haven’t heard anything new on that front, but he did send me the following information today:

“Medi-Cal payments will start going out the last week of November and will be all caught up by January 1.”

I trust that this is accurate information. I don’t know that CoveredCA can properly track Medi-Cal enrollments between the state and the counties. We’ll have to wait and see how much we get paid.

Thanks for speaking at the last board meeting and delivering the comments and views of agents who speak for themselves. I agree with your opinion of the cozy relationship between CC and CAHU - actually CAHU’s lobbyist. I have watched many hours of CC board meetings over the last 2 years, and Kim Belshe impresses me. Many times she was the sole voice questioning board decisions that ultimately became nightmares - for example the IT systems integration of CC and Medi-Cal.

CAHU has failed us. The members’ money they spent on Sacramento lobbying generally echos the carriers’ agenda. After paying dues for years, I stopped last year.

When I appeared at the CoveredCA Board Meeting a few weeks ago, it was painfully apparent that CAHU is neatly tucked in bed with Peter V. Lee. He uses them to convince the Board that CoveredCA has been dialoguing with agents all along. I’m glad I don’t belong to that organization because they don’t seem to represent agents like me.

At least one member of the Board, Dr. Robert Ross, was “troubled” by the collection of email messages I presented neatly bound to each of the members because he though CoveredCA was conversing with agents.

You can view my remarks to the Board here: http://www.cal-span.org/cgi-bin/archive.php?owner=HBEX&date=2014-09-18&player=jwplayer at 1:47:56-1:50:07 in the timeline, and Dr. Ross’ remarks at 2:20:14-2:21:15.

Following the conclusion of the meeting, another Board member, Kimberly Belshe, came to me and introduced herself to me, thanked me for the document, and said she was looking forward to reading it.

I have yet to hear from Peter Lee, who told the Board that “we will be reaching out to Mr. Herr.”

Just found your post.

Boy, there is so much from Covered California which is so inefficient, and not in compliance, and/or not legal.

Makes me wonder where the heck the CAHUs are. You know, the organizations that are all about the agent?


Yet a joke… to make light…

Now many Covered California reps does it take to screw-up an application.

Answer: just one.


Here’s another…

Now many Nevada Health Link reps does it take to screw up an application?

Answer: same as Covered California.

CSRs who have not idea as to what they are doing has been one of the most challenging things we have to deal in 2014. And it is not only at CC, it is also at carriers as well, particularly Blue Shield.

This situation is unfortunate, and falls squarely on CoveredCA’s inability to manage the far-flung tasks of verifying documents and handling inbound calls. Director Lee acnkowledged to the CoveredCA Board last week that this is a service shortcoming.

There are a couple things that can improve your experience. First, when calling 1-800-300-1506, listen carefully to the initial recorded message. If it says, “Thank you for calling CoveredCA. If this is a medical emergency, hang up and dial 9-1-1.” YOU ARE IN THE QUEUE!! If it says, “Thank you for calling CoveredCA. We are experiencing high call volumes … ” HANG UP and keep redialing until you get the “9-1-1” version. Then grab a good book and plan on spending up to 2 hours on hold.

For agents, you can also call the dedication Pinnacle Agent Service line, where calls are answered much more quickly. Unfortunately, the Pinnacle CSRs are not empowered to make system changes like some of the more experienced CoveredCA CSRs have learned how to do. As a result, a call to Pinnacle is usually less satisfying than it should be.

I have discussed this with Kirk Whelan, the new Director of Sales for CoveredCA, and changes will be occurring (sort of like watching grass grow). But Kirk indicated to me that he is very much interested in dialoging with us agents to make things better. We should all expect to hear from him in various ways going forward. (He’s only been in the position about two months, so he’s still getting his feet wet, and will need some time to begin implementing some of the things he and I discussed).

CC moved some of their Call Center reps over to help out with the residency and citizenship verification backlog about 4 weeks ago. Consequently, they don’t have enough people to answer the consumer line. Currently, 2 out of three callers hang up before their call is answered.

I have been unable to get through to the Covered California consumer line fo a couple of weeks now. Shouldn’t their customer service be improving rather than getting worse?

Max, I know the section “in the application” — I didn’t opt to take the full APTC as it was, but I did take more than I should have in hindsight. What I want to do now is make a change — which should not require a new “application” but rather an opportunity to change options selected originally. I did not see a way to simply make a change to that amount.

By the way, I have a transcript of my chat session with the agent if you think it would be in any way helpful.

Freelancer … there is a section in the application that allows a person to reduce the amount of APTCs applied to premiums. I have used this a couple of times as a recommendation for self-employed persons who might end up the year with more income than expected. If it doesn’t work out that way, then the unused APTCs are refundable when the 2014 federal tax return is filed.

Max, is there a way to change the ATPR without a change to income being reported? Some other Covered Cal. rep told me early on that an income change was the only way that the amounts could be changed— that it couldn’t just be altered because I had changed my mind about what level of subsidy I wanted. The agent who told me that understood that I was talking about reducing the subsidy in the future, not increasing it - as obviously you would want some some sort of income screening if a person wanted to increase their subsidy beyond the amount they had originally qualified for.

Freelancer … I will take your post to Sacramento with me tomorrow (9-18). I don’t think you need to report a change of income at all. What you simply need to do is adjust the amount of APTC you want to receive. You can reduce it all the way to $0 if you want. That’s a far better solution than tinkering with the income. I don’t know why the CSRs did not offer that option to you. Try calling them again (yes, I know, 1-2 hours on hold to get to a CSR).

I didn’t know the online chat function was working. But apparently it wasn’t helpful in your situation.

This certainly sounds like a training issue.

This isn’t an agent issue, but I ran into a problem today with Covered California because I had tried to submit a report online reporting a change of income. I got an error message saying that the system would not accept the change, so I used the online chat to talk to a Covered Cal. representative — she offered to do the change report for me, so I gave her the info. After a very long pause she said that she had bad news, the system wouldn’t accept the change, and the only thing to do was to terminate coverage and reapply, giving me a new policy number. I didn’t want that, so I told her to just cancel the change report. At that time, she said it was impossible to cancel the change report, and I would lose my insurance unless I proceeded to terminate the existing policy and reapply for a new policy, with a new policy number.

Of course that would mean that I’d lose the benefit of whatever dollars have already gone toward this year’s deductible, plus run into issues with outstanding medical bills — so I said no to that. I asked if she had a supervisor who could help sort out and she told me to phone the customer service number and ask to talk to a “lead.”

So I dialed the number and while I was on hold, I went into the Covered Cal. web site and found a link that said “withdraw change request” - I clicked that, and immediately things were set right and — it appears — that I am now restored to the same situation I was in before, with an active policy.

So either the online system is wrong or the customer service rep was giving me potentially disastrous instructions. I’m self-employed, and the only reason I wanted to report a change is that I think I am getting too large a subsidy, and I want to cut off the subsidy payments. In other words, my goal is to stop receiving government money and pay 100% of my own premium, for now. (I’m age 60, so that’s not a trivial amount).

Obviously I can do math and I can just put the money aside and pay IRS any claw back required next April.

But it is frustrating that the system is so confusing and the CC rep’s “assistance” only made things worse. The web site should have a simple interface for seeking adjustments to APTC amounts that is separate and apart from submissions geared to changing existing insurance policies. I probably would have waived the APTC in the first place if I had known it would be so difficult to make changes.

I’m hoping the renewal process will be easier.

The most disturbing thing about the CoveredCA.com website is that they have Not moved uploaded documents (Drivers License and Social Security card) from their website to storage Not accessible from the internet.

As my computer security prof said in 1981, access is EVERYTHING.

We all know that web servers get hacked ALL the time and the longer the documents are accessible via the internet, the greater the chance they will be stolen. They should move them offline immediately.

More agents making comments would be powerful.

There are multiple opportunities to make public comments at the Board meetings. They take public comments after the Executive Director’s summary and after the presentation of other issues before the Board.

Review the agenda for the Covered California Board meeting which is usually released about a week before the meeting. Www.hbex.ca.gov - Board Agenda and Meetings.

Some of the grievances that agents want to address might have more impact if they are considering or discussing certain topics on the agenda.

You can actually make very important and impactful comments in 2 minutes!

While I appreciate the CAHU representative making polite and supportive comments to the Board about agents and brokers, the agent community is virtually nonexistent to the board members.

Calling into the board meetings and adding your comments can also lend weight to the overall argument that agents have been largely ignored on the roll out and continuing operations of CC.

Joey (and others) …

Yes, I am well aware of the procedure at the Board and the two minute allocation to comments. It’s obvious that the reason for that is that the Board has a lot on its plate at each meeting, but they also have virtually no accountability to anyone and want to make it appear that they value public input. It’s the same reason you cannot easily find contact information for anyone at CoveredCA — the objective is obscurity to outsiders.

The real issue is that no one is truly speaking to the Board from our position about what is happening at the agent level, and, as they do with most other things political/governmental, the news media simply report all the pats on the back that Peter V. Lee and others at CoveredCA are constantly giving themselves for the “for the great work” they’re doing. I have seen the representatives of CAHU and others who fail to address the issues we actually face.

The lack of transparency has to end! Why is CoveredCA collecting commissions from insurers for SHOP enrollments but not paying agents? Why did CoveredCA announce in a presentation to the Board in October 2013 that agents would also be paid $58 per new Medi-Cal (household) enrollment like Navigators and CECs, and then send email notices to us CIAs that payments began in June and July, only to send another email in August to say that the Board needed to adopt a policy that would permit agents to be paid and that legal still has to figure out how to include that in our agent contracts — which are due for “renewal” on October 1?

While the Board may not care to hear what I have to say, my goal is to get the news media interested — if any are actually in attendance — and engaged, and to understand that in the real world things are not the bed of roses being portrayed by the Board. When was the last time you saw an insurance agent interviewed on TV/Radio or in a newspaper article about how things are going with CoveredCA? NEVER.

The fact is, our local news media are far more likely to report on issues affecting/related to Healthcare.gov — which has exactly ZERO IMPACT on anyone in California — than they are CoveredCA.

To Max and others that plan to attend a Board Meeting. You only get 2 minutes to present your case/issues. You read your prepared script, and that is it. The Board does not ask questions, and you are not expected to ask direct questions hoping for an answer. If you need more than 2 minutes, than bring more people. If you need 6 minutes, than bring 3 people and break up your comments into 3 sections. Unless there is a chance to schmooze with the Board members after the meeting is over, don’t expect to get any one on one, or other forum, to discuss your issues. 2 minutes, and it is over. If you want to get a better idea how it goes, watch one of the videos of a previous Board meeting. In this link, click on the RECORDING link and fast forward to the questions section. http://board.coveredca.com/meetings/

Legit …

I’m not sure if Office 365 is an acceptable method. You need to log in with a Microsoft “Live” account in order to open the emails. Logging into the “extranet” location shouldn’t be a problem if you have the correct user ID and password (it is case sensitive).

FYI — if you only received an email with a password (mine came more than 3 hours after the initial email with my user ID), here’s the “clue” to your user ID:

Your username: ecoveredca\CC_XXXXXXX

(For example, Joe Smith, Agent License #1H12345 would be typed as “CC_1H12345”)

To access your client list with your user ID and password, Click here: https://extranet.coveredca.com/sites/ccAgentPortal

I just got two encrypted emails with a user name and password to get a list of my Covered CA clients that need to submit proof of lawful presence. After logging in to Office 365… All I get is a message that it’s connecting to extranet.coveredca.com

Marie … The CoveredCA Board has NEVER voted to approve payments to agents for Medi-Cal enrollments. That’s one of the reasons I’m heading to Sacramento next week. I want to know why not!

Kevin Knauss, CIA, and Michael Lujan, President Elect of CAHU, have also been soliciting agent concerns and communicating to the Covered CA Board. They can be contacted via LinkedIn if you want to add some strength to your effort on September 18th.

Since Medi-Cal has 49,000 applications to still approve, the lack of communication between CoveredCA and Medi-Cal and Medi-Cal’s slow process and ignorance, it may be a long time before you get the $58. I wouldn’t be surprised if they are unaware they owe you the $. Good luck!

I have my airfare and rental car reservations! I’m not doing this in an impersonal manner. The Board is going to see my face and hear my voice in person.

The four hours on hold on Saturday were only the tip of the iceberg in this round of pending terminations. It seems that a California Driver License is no longer an acceptable “proof of lawful presence” … for some persons but not for others. [I think this may be connected to the Legislature’s authorization for the issuance of Driver Licenses to illegal immigrants.] No one could tell me with any certainty that all 2015 applicants will have to submit Birth Certificates or Naturalization Certificates, or Alien Registration Cards.

One of the four clients in my list of “problems” is a native, California-born US citizen, whose last name happens to be Hispanic. Despite the fact that his income was “e-verified”, he must now provide evidence of citizenship in order not to have his health insurance terminated.

Despite the assurances on Saturday that all four clients were in order, I had no confidence in that assessment, and called CoveredCA again today (Monday). I spent 50 minutes on hold to get to a CSR and another hour on the phone while all four accounts were checked.

Two accounts were actually resolved with the assistance of “specialists”, and the third one was partially resolved (the husband must still submit a copy of his Naturalization Certificate to replace the Driver License that was acceptable last December, but is not acceptable today).

But it should NEVER have taken 6 hours of my time to get to this point with four clients’ accounts. That’s only part of what the Board is going to hear about from me.

I hope all agents who read these comments take a few moments to send me an email with your concerns and complaints so I can deliver them personally for you to the CoveredCA Board of Directors on Sept 18.

They don’t answer their secured email (mailbox on their server). If they Actually Really wanted to get the work done, they would. Sometimes a phone call is faster and better, but 90% of the time an email is just as good. And with an email nobody has to sit there waiting, which is about as inefficient as you can get.

In addition to driving to Sacramento, you can also call-in to the Board of Directors meeting and give your comments/opinions live.
I called-in in April and complained about the lousy Blue Cross network of doctors, my doctors canceling out of BC’s network mid-year, and the lack of insurance carriers in Alameda county.

Here is a link.


Click on a meeting’s “Agenda” for the number to call, which is 800-230-1096

The call-in was just as effective as attending the meeting. Everyone listens to the call-ins, and as carefully as the attendees making comments.
The Board does not ask questions or give answers to either the call-ins or live questions. You are limited to 2 minutes, which is strictly enforced.

From Covered CA’s Agenda

“For in person (or call-in) comments: Prior to making your comments, please state your name for the record and identify any group or organization you represent. The call-in number for teleconference comments is: (800) 230-1096 Please wait until the operator has introduced you before you make your comments. To request to make a comment during the public comment period, press * 1; you will hear a tone indicating you are in the queue for comment. If you change your mind and do not want to make a comment, press # Assistance is available throughout the teleconference meeting. To request a Specialist: Press * 0 Each person will be limited to two minutes per agenda item.”

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