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Starting July 1, Covered California for Small Business (CCSB) is offering new Blue Shield plans, providing more options for enrollees. These plans include the Access+ HMO Network with Platinum, Gold, and Silver metal tier options, as well as the Bronze Trio HMO 7000/70. The two most popular Blue Shield High Deductible Health Plans (HDHP), Silver Full PPO Savings 2300/25% and Bronze Full PPO Savings 7000 plans, are also now available.
All of these plans offer benefits such as Wellvolution, Teladoc Mental Health, Nurse Help 24/7, LifeReferrals 24/7, and the Blue Card program for when members are outside of California.Login To Prism
If the couple’s household income for the taxable year is below 138% of the federal poverty level, which it probably will be if they have no income, they may be eligible for Medi-Cal if they also meet the other eligibility requirements.
See pages 8-12 in the Eligibility for Individuals and Families participant guide.
If the couple is eligible for Medi-Cal they will not be able to receive premium assistance or a cost-sharing reduction through Covered California. However, they can buy a Covered California plan at full cost.
Covered California FAQs.
See below a link to a recent Covered California FAQ on eligibility for catastrophic (aka minimum coverage) plans.
See below a link to a Covered California Medicare FAQ:
See below a link to a Covered California Application Status FAQ:
Yes, the employee can decline his employer’s coverage and purchase a Covered California individual plan. Agents should bear in mind:
Plan changes can only be made during open enrollment, or during special enrollment periods after certain qualifying events.
For a list of qualifying events see page 6 of the module: “Eligibility for Individuals and Families” participant guide.
No, not unless they are a U.S. citizen, national or lawfully present.
If the individual enrolls in COBRA coverage and the special-enrollment period lapses, the individual cannot cancel the COBRA coverage and enroll in a Covered California health plan until 1) the COBRA coverage is exhausted, 2) the individual has a different qualifying life event for special enrollment, or 3) the next annual open-enrollment period.
If the individual stops paying the COBRA premium and loses coverage (or if the employer has agreed to pay for a limited time and the individual does not continue the payments), the individual will not be eligible for special enrollment through Covered California. The individual will only qualify for special enrollment if:
If none of these reasons apply, the individual will have to wait until the next Covered California open-enrollment period to cancel the COBRA plan and sign up for a Covered California health insurance plan, unless there is another qualifying life event for special enrollment. It’s also important to know that if the individual decides to drop or forgo COBRA and enroll in a Covered California plan, the individual cannot go back to COBRA.
In order to enroll in a Covered California plan, the individual must reside in California.