What is the limit on repayment of excess premium assistance?

If an individual’s income changes, any excess amount that was overpaid in premium assistance would have to be repaid to the federal government as a tax payment. However, there are limits on the excess amounts to repaid and is as follows:

How does the employer defined contribution work in Covered California for Small Business?

The total employee premium for the lowest cost plan in the selected tier is paid by the employer as a percentage contribution. Let’s say that a 10 life group has a $2500 monthly employee premium for the lowest cost plan at the selected metallic level. The employer contribution is 50%. The employer responsibility would be $1250 or 50% of the total employee premium. As we have an age based rating methodology that premium would represent 50% of each employee premium at every age band. So a 65 year old would get more money that a 25 year old but they would each receive a contribution of 50%.

Where can I find SBCs for the Covered California for Small Business plans?

SBCs for the Covered California for Small Business plans can be found here.

I can’t access my Covered California agent portal. Help!

A number of agents have reported that they can’t access their agent portal. Many of them, it turns out, created two accounts for some reason. There can only be one “certified” account per agent/license #. These agents have been trying to access their clients through a non-certified account. Here’s what to do to check if this is the problem that’s impacting you:

Determine if the account is “certified” by looking at the Certification Status screen. See the screenshot in the link here:
https://www.claremontcompanies.com/wp-content/uploads/2014/01/CoveredCA-Agent-Certification-Status-Screenshot.png

If Certification Status indicates “Certified,” then that’s the account you should use and to avoid confusion you should call the service center (1-877-453-9198) and have the other account deleted.

If Certification Status indicates “Eligible”, as in the screen shot, then that account is not valid, but you shouldn’t delete this “Eligible” account until you have confirmed you have a “certified” account.

If you don’t know the username and password for an account, you will need to call the service center to get the username and get a password reset.

Can I update my Covered California agent profile to indicate I only serve employers (i.e. not individuals?)

Yes. To update your profile, simply select ‘Employers’, and de-select ‘Individuals/ Families’ in the ‘Clients served’ section.

My clients with cancelled individual plans have questions about the recently announced eligibility for catastrophic plans. What can I tell them?

See below a link to a recent Covered California FAQ on eligibility for catastrophic (aka minimum coverage) plans.
https://www.coveredca.com/FAQs/FAQ-PDFs/Exemptions_and_Min_Cov_FAQ.pdf

My clients enrolled in Covered California individual plans have questions about access to care starting Jan 1. What can I tell them?

Covered California FAQs.

Will Covered California for Small Business carriers provide prior carrier deductible credit?

Each carrier within Covered California for Small Business has its own policy. Refer to each carrier’s underwriting guidelines for more information.

How does an employer make an Agent-of-Record change in Covered California for Small Business?

The employer group must write a letter to Covered California and state who their current agent is and who they want their new agent to be. The letter should be dated and signed by an employee of the group who is authorized to make the decision. The letter should be mailed to:

Covered California
P.O. Box 7010
Newport Beach, CA 92658

How can clients find out the status of their individual applications?

See below a link to a Covered California Application Status FAQ:
https://www.coveredca.com/FAQs/FAQ-PDFs/Application_Status_FAQ.pdf