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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.

Discontinuing CovCA to Go Direct With Insurance Co?

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Question: After having so many problems with Blue Shield through CovCA, I have decided to just go direct with BS during open enrollment for 1/1/2015. Can I just apply directly to BS now and when confirmed I have coverage starting 1/1/15- terminate participation in CovCA/BS eff 12/31/14?

Answer: Yes, you can do that, but the carriers are not immune from screw-ups themselves. The safest way not to create problems for yourself is to do nothing. That way your coverage will renew without changes.


Contact me for the email address of someone near the top of the food chain at CoveredCA. Can’t guarantee anything, but he may be able to help.

My wife & I tried to change plans in early Jan, and instead of that happening, our current coverage was cancelled. We were told that at least we’d be enrolled starting Feb 1, but it was setup only for me. However on Friday someone at CoveredCA messed up my account, and even though I was enrolled and paid for Feb 1, that has also been cancelled. So again we are both left uninsured.

No one at CoveredCA seems to be able to actually DO anything. They keep creating tickets, but nothing good ever happens.

Is there any secret way of getting to someone who can actually fix this for us?

Leaving CoveredCA for the same plan off the exchange probably won’t change your experience with Blue Shield, unless the problem originates with the doctor’s office. Some office personnel did not recognize the fact that a Blue Shield member card with the CoveredCA logo was no different than any other Blue Shield card. That’s a training issue between the insurance company and their providers.

For the two others who expressed some major challenges, I would recommend that you join the CoveredCA Board Meeting live stream webinar on 11/20 beginning about noon or so. Use the call in feature to get into the speakers’ queue and then let the Board know that Exec Director Peter Lee hides this kind of information from the Board.

Join the webinar here: http://www.cal-span.org/State_Webcast/?agency=hbex&captioned=true&player=http://www.ustream.tv/embed/19351214%3fwmode=direct%26showtitle=false&captioningURL=https://www.streamtext.net/player%3fevent=IHaveADream%26header=false%26chat=false%26footer=false%26controls=false%26bgc=000&fgc=ff0

I cancelled my Covered California coverage through Blue Cross SEVEN months ago. I NEVER accessed medical care or services under the plan. I was told by BOTH Covered California & Blue Cross that I would be able to receive reimbursement for the premium I paid because I cancelled within 25 days of the plan activation. I have made MULTIPLE phone calls to both Covered California & Blue Cross over the past SEVEN months in an effort to resolve this issue & get my money back.I’ve been told by BOTH that it takes 3-5 days to process a reimbursement claim & 2-3 weeks before I’d receive it. SEVEN MONTHS LATER I STILL HAVEN’T GOTTEN ANYTHING. Covered California blames Anthem Blue Cross, CLAIMING that they have already submitted what Anthem needs(as of 6/23/14, so they say) & Anthem blames Covered California CLAIMING they haven’t received the appropriate information yet (as of 11/16/14 the last information they received was 7/22/14). I’ve been told by Covered California that I can file a complaint/grievance BUT that it won’t guarantee anything. The only contact number for Covered California is to their application processing representatives who can only document the MULTIPLE phone calls I’ve made; there is no way to contact the escalation team who are the ONLY people at Covered California with the power to expedite the process. Anthem can’t reimburse me until Covered California submits the appropriate information. I understand this is the flagship year for Covered California & that there are still kinks in the system; however, it seems more than unreasonable that in SEVEN MONTHS this has not been resolved. I am beyond frustrated. There doesn’t seem to be any contact information regarding anyone at the State level whom I can contact to help me since my efforts in dealing with Covered California have not brought forth ANY results. I really need help with this matter. Do you have any ideas or information that can help me? PLEASE?

Carriers are rampant with screw-ups! I have been in this business for almost 40 years and have never seen such lack of follow-through, mis-information ( lies!) and absolutely no accountability.Blue Shield has been the worst offender. Embarrasing as an agent. Interesting to me is that when calling in as a broker need to identify self with broker # or SSN but CSRs are rarely willing to provide their contact information. If you get lucky enough to have a CSR give you their last name or initial and their extension nbr- good luck ever getting back to them. The *00 # goes to several call centers and therefore providing any way of getting back in touch with same CSR is futile,The CSRs will make Call Ref#s on a case but still- every call involves them taking time to read through a file and all the Call Refs #s and usually me trying to summarize and make note of what was the last thing that was NOT done properly. I have a case submitted as SEP for 10/1 eff date that is still not rectified after I kid you not probably 15 calls and as many or more emails. And this was a direct to carrier/OFF Exchg case. Broker Reps and so called case resolution “escalators” are fairly worthless. Until all are held responsible for following through to get cases issued, ID cards sent, broker paid commission, etc. (EVERY case I wrote w/ BS this year both ON and OFF Excg I had to call in on to get commissions straightened out) SCREW UP might as well be part of their name!

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