Covered California to launch second enrollment campaign Saturday

The Covered California health exchange is gearing up for Saturday’s start to the second enrollment period under national health reform.

The exchange hopes to build on what was learned from last year’s campaign in California, which surpassed all other states. Officials expect 500,000 residents will sign up for health insurance from Saturday through Feb. 15, pushing the state’s two-year enrollment figure to 1.7 million.

Applicants can’t be rejected by insurers and may be eligible for subsidies to lower their monthly premiums. “We will need to work harder to enroll those who are still uninsured,” said Covered California Executive Director Peter Lee, who is on a 21-city bus tour promoting the program. “We want to get the word out to Californians not to gamble with their health by going without insurance.”

Federal law requires individuals to have health coverage or pay a tax penalty. As the state’s health benefits exchange, Covered California offers insurance plans for families and adults ages 18 to 64.

Covered California is making an effort to improve the enrollment experience for consumers by:

▪ Doubling its customer service staff to reduce wait times for consumers over the phone. Service center hours will increase and more bilingual staffers will be available.

▪ Updating the Covered California website with easier ways to find coverage options.

▪ Building a 28,000-member team of certified insurance agents, county workers and enrollment counselors to assist consumers in their communities. Applicants can connect with brokers or certified enrollers by searching under “Find Local Help” at www.coveredca.com.

▪ Adding 200-plus storefront locations that will be open evenings and weekends to assist working people in many communities.

Four insurers offer health plans through the exchange in Stanislaus, San Joaquin and Merced counties: Anthem Blue Cross, Kaiser Permanente, Blue Cross of California and Health Net. There are four types of health plans – bronze, silver, gold and platinum – covering 60percent to 90percent of medical costs.

An individual with annual income of $16,105 to $46,680, and a four-member family earning $32,913 to $95,400, may be eligible for tax credits to help pay for insurance.

For a 40-year-old adult, the 2015 premiums for silver plans (covering 70percent of medical bills) are about $288 per month for the Anthem plan, $319 for Kaiser, $345 for Blue Shield and $402 for Health Net.

A 60-year-old consumer will pay more for the same coverage: $612 for Anthem, $676 for Kaiser, $732 for Blue Shield and $855 for Health Net.

About 90percent of Valley residents in the first enrollment campaign were granted subsidies, based on income, that reduced their premiums to as low as $20 a month. Starting Jan.1, a 40-year-old resident earning $17,505 a year is expected to pay $29 monthly for Anthem silver coverage, $58 for Kaiser, $84 for Blue Shield and $141 for Health Net.

For a family of four earning $50,000 a year, the “Shop and Compare” function of Covered California’s website quoted silver premiums of $216 a month for Anthem, $277 for Kaiser, $329 for Blue Shield and $445 for Health Net.

The exchange also has an insurance marketplace, called SHOP, for small businesses with one to 50 employees who average 30 or more work hours per week.

In addition, the Affordable Care Act broadened eligibility for the Medi-Cal program. Those benefits are now available to single adults earning less than $16,105 a year or a family of four with income of less than $32,913 a year.

This year’s expansion of Medi-Cal resulted in an application backlog affecting hundreds of thousands of low-income residents statewide. Stanislaus County’s Community Services Agency was able to work through its share of unprocessed applications, said Kristie Santos, assistant director of the agency’s StanWorks division.

The county is working out issues with a state enrollment system and has some duplicated applications to clean up, Santos said. As of July1, more than 43,000 county residents were enrolled through the Medi-Cal expansion.

The Community Services Agency operates a regional call center to assist Medi-Cal applicants from Stanislaus County, as well as Marin and Napa counties. People can apply for Medi-Cal year-round, but starting Saturday, Covered California will refer callers to the county center if they meet the criteria.

“People can come to our offices and sign up for Covered California insurance and don’t have to go through their call centers,” Santos added.

Starting Saturday, people can apply for health insurance at www.coveredca.com or by calling Covered California at (800) 300-1506. To apply for the Medi-Cal program, Stanislaus County residents may call (877) 652-0734 or apply in person during regular hours at the Community Services Agency, 251 E. Hackett Road in south Modesto.

This story was originally published November 11, 2014 at 4:01 PM with the headline "Covered California to launch second enrollment campaign Saturday."