[quote=SK in CV][quote=bearishgurl]They have their OWN interpretation of the ACA. The bottom line is, you sign up on Covered CA for a non-MediCal plan and accept a subsidy to help pay the premiums (no matter how small), there are a whole lotta of strings attached to that. In short, CC owns your a$$. Not only MUST you file your tax returns on time and NOT file any extensions (as with ALL healthplan exchanges across the country) but your plan’s carrier has absolutely NO SAY whatsoever in whether they get to keep you as a customer the entire 12 months … or not. [/quote]
You can’t continue too make shit up without being called on it. Nobody is bound to accept subsidies. Anyone can pay full price for their insurance and never share any tax info. Furthermore, even if subscribers do accept subsidies, their tax returns must be timely filed. That means including extensions. You’re just wrong on this. You have no idea what you’re talking about. I have no idea what that last part of the last sentence means about carriers having no say in whether they keep you. They do. Insureds contracts are with the carrier. And only with the carrier.
Additionally, if someone wants to get a premium tax credit and doesn’t want to share tax information with the exchange, whether it’s California or any other state, they don’t have to. Ever. They do have to pay 100% of their premiums up front, and then take the tax credit on their tax return.[/quote]SK, I’m not going to beleaguer this point any longer with you but healthplans don’t have any say on whether they can keep exchange enrollees, or not. They have absolutely no control on whether they will be allowed to accept exchange enrollees future premiums within the same plan year … or not. In CA, the carriers have no control whether their planholders are dropped by CC or Medi-Cal and no control as to the start and end date of a customer’s plans. This is because the planholder is actually a customer of CC and not the plan itself. When a CC enrollee is dropped from their plan by CC or Medi-Cal, it takes 4-9 months for them to receive a refund from their carrier of their premiums paid for all the time they paid a premium but weren’t covered, IF they receive any refund at all. Most of these cases have to go through the appeals process because the carrier argues that the planholder was dropped through no fault of their own. And a lot of “gypped former CC planholders” don’t have the time, energy or expertise to appeal.
I truly believe that you may have studied the (voluminous) ACA during the time it was passed into law. But my last post described how CC does business in a very rudimentary fashion. There is much, much more.
You live in AZ, right? Perhaps you may be unfamiliar with how CC operates because you have never enrolled with CC yourself, have never assisted anyone enrolling with CC and with their various problems with CC subsequent to that enrollment because you don’t live in CA.
I can see here that you cannot possibly put yourself into another person’s shoes who has been repeatedly dumped from their (health exchange) plan after making timely, automatic premium payments every month and can’t fathom that this is actually happening. But it does happen very frequently in CA. The traditional “grace period” of yore means absolutely nothing to CC, Medi-Cal or the exchange carriers.
Thank you for posting your last paragraph. I am going to independently verify it with CA experts in the field. If it is true and there are no other plans to choose from in SD County this fall, I will renew my exchange plan for 2017 and drop my request to receive an APTC up front every month and pay my premiums upfront in 2017. I wouldn’t mind at all to just let the IRS refund me any excess premium paid out of my pocket using whatever formula they use and will encourage others to do the same. That’s what I thought WAS going to happen when I first signed up on the exchange in late 2013. I had no idea at that time that CC and the county would constantly be in my business and repeatedly canceling my plan and neither did anyone I assisted with enrolling and renewing on CC. None of us want to continue with the uncertainly of being repeatedly dropped from our healthplans behind our backs and/or force-placed into Medi-Cal. We all want SB33 to get signed into law by the governor this year but we have no control over whether this happens or not.
