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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.


Unaffordable Group Coverage?

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Question: My income dropped dramatically as a self employed realtor because my husband had a stroke and I became a full time care giver. My father in law took over our paying our monthly premium of $2,000 per month. He is running out of funds to help us out. Can I apply under special circumstances or do I have to wait for open enrollment. My insurance is through the California Association of Realtors group plan.

Answer: Covered California will recognize that your the group health insurance is unaffordable, i.e your monthly cost exceeds 9.5% of your income. Therefore, you are eligible for Covered California individual coverage with premium assistance. However, to enroll outside of the open enrollment period, you will have to claim that your income change occurred within 60 days of applying. Whether your father-in-law pays or not is not relevant your eligibility.

2 Comments

Fred, You cannot get re-insured at this point. Your only option is to reinstate for your current coverage by paying back premiums. However, your change of income may qualify you for premium assistance going forward. Check your subsidy eligibility here https://www.cahba.com/get-quote/

Due to change income and removing a dependent from my Covered Ca. Plan I cannot keep up with the premiums. They want me to pay $3000.00 plus my premium of $1400/mo. to reinstate my coverage. My wife has cancer and has already missed a treatment. I need assistance to help get re-insured.

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