The clocks have changed, the World Series has ended, the election is over. Before everyone’s attention gets consumed by the holidays, there’s one other major event on everyone’s to-do list: health care sign-ups.
In this year’s second round of the Affordable Care Act, the open enrollment season for health care coverage starts on Saturday. That may be news to lots of folks. According to a recent Kaiser Family Foundation survey, 89 percent of the nation’s uninsured were unaware that they can begin signing up for health care in November.
In California, the state’s official health care exchange is Covered California, which has ramped up its hiring, beefed up its computer systems and extended its walk-in storefronts statewide, trying to entice more of the state’s estimated 3.2 million uninsured to get on board. (For those who get health care coverage through their employer, November is also the traditional month to re-up health care policies.)
From deadlines to dental care, there are some don’t-miss aspects of this year’s Covered California sign-ups. Here’s a look:
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Less time, more penalties
First off, the sign-up season this year is cut in half. Last year, during the inaugural rollout of the Affordable Care Act, consumers had six months to sign up. This year, it’s just a three-month window, from Saturday through Feb. 15, 2015.
“You’ve only got three months this time. That’s a pretty significant change. That deadline’s going to come up real quick,” said Roy Kennedy, Covered California spokesman.
And, as part of the federal rules, the IRS tax penalties for those who don’t have health coverage increase every year. (Some individuals are exempt from tax penalties, including those who are low-income, tribal members, incarcerated or of certain religious faiths.)
In 2015, the tax penalty rises to $325 per adult, plus $162.50 per child (or a family maximum of $975). The tax penalties are intended as an incentive to encourage people to get signed up for Affordable Care Act coverage.
Get free help
Last year, Covered California’s rollout was plagued by jammed phone lines and balky computer pages that generated complaints by frustrated consumers, as well as from the enrollment counselors and insurance agents trying to sign up clients. This time around, it’s spent millions and doubled its staffing to make the system easier to access.
“It was a problem this year. We don’t want people frustrated by long waits,” said Kennedy. This season, he said, Covered California will have more than 1,300 staffers answering phones at four call centers in Concord, Rancho Cordova, south Sacramento and Fresno. Last year, there were 709.
Covered California also added 150 bilingual staffers, compared with 55 last year, at its call centers, who can answer questions in multiple languages including Spanish, Turkish, Hmong, Mandarin, Vietnamese and Russian.
For walk-in help, there are more than 200 storefronts in community clinics and shopping malls statewide, from Florin Towne Centre in Sacramento to the Baldwin Hills Crenshaw Mall in Los Angeles.
As for its computer system, Covered California says it spent $22.6 million this year to increase the server capacity. “We’ve expanded the pipe, so to speak, so people will experience speedier page loads and have an easier time signing up during peak periods,” Kennedy said.
New dental care
For 2015, pediatric dental care is embedded in all Covered California policies for children up to age 19.
Adults, whose dental care is not automatically provided, can purchase separate policies later in 2015. In most counties, there will be six dental carriers to choose from. Premiums vary, based on county, family size and other factors.
Grab the opportunity
In California, the race to enrollment starts this week. Overall, the state’s goal is to have 1.7 million people signed up when enrollment ends on Feb. 15.
“People who are happy with what they’ve got, keep those plans. But if their situation changed – they moved or plan on moving – they might want to shop around and pick a different plan,” said Kennedy. Noting that premium rates have changed, either up or down, in various counties, he urged consumers to use the rate comparison tool on Covered California’s website. Just as last year, consumers can choose among three tiers of coverage.
“We have a tougher job this year,” trying to reach the long-term uninsured, said Kennedy. “There’s a lot of people still without coverage who we want to reach. We’re ready to sink our teeth into it.”
Call The Bee’s Claudia Buck at (916) 321-1968 or read her Personal Finance columns at sacbee.com/claudiabuck.
Covered California sign-ups
Open enrollment: Nov. 15 through Feb. 15, 2015
To get help: Visit the state’s website, www.coveredca.com. Use it to search – by ZIP code or by desired languages – for some 28,000 certified insurance agents and enrollment counselors who can answer questions and walk you through the sign-up process. Also listed: more than 200 community locations statewide where consumers can get walk-in help.
By phone: Call (800) 300-1506 weekdays, 8 a.m. to 8 p.m.; Saturdays, 8 a.m. to 5 p.m.; and most Sundays from Nov. 16 through Dec. 14.