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COVID-19 National and Public Health Emergencies Will Terminate May 11, 2023

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While California’s COVID-19 state of emergency ended on February 28, 2023, the national COVID-19 Public Health Emergency is still active and will terminate on May 11, 2023. Consumers impacted by the COVID-19 Public Health Emergency may qualify for Special Enrollment using the “Public Health Emergency” Qualifying Life Event to enroll and make changes to their coverage.

The Department of Labor’s Employee Benefits Security Administration (EBSA) is committed to working with employers and other plan sponsors to ensure a smooth transition as the federal government unwinds some of the policies that have been in place during the COVID-19 public health emergency and National Emergency. To partner with you through this process, the Departments of Labor, Health and Human Services, and the Treasury issued guidance today in an effort to ensure that workers and their families are aware of any changes that may be coming their way:

 

As a reminder, states that administer Medicaid, such as Medi-Cal in California, were prohibited from terminating a beneficiary’s enrollment during the national COVID Public Health Emergency unless they moved out of state, became deceased, or the beneficiary requested a voluntary termination of eligibility. Beginning as of April 1, 2023, the Department of Health Care Services will begin to “unwind” this policy and resume its annual eligibility review process for members enrolled in Medi-Cal, which could possible result in a beneficiary being determined no longer eligible for Medi-Cal.  This would allow eligible individuals to enroll in a qualified health plan and possibly gain eligibility for advanced premium tax credits with a July 1, 2023 effective date.  The other option for members who lose eligibility with Medi-Cal is they could enroll in their employer group plan (if they meet the employer’s eligibility requirements), as this is a qualifying life event.  Please reference Covered California’s Public Health Emergency & Medi-Cal to Marketplace Automatic Enrollment Program Toolkit for additional program information and support materials.

 

If you have any questions or would like more information, please reach out to MNJ Insurance Solutions.

 

This summary is provided for informational purposes only and should not be construed as legal or a recommendation of any kind. While we have attempted to provide current, accurate, and clearly expressed information, this information is provided “as is,” and MNJ Insurance Solutions makes no representations or warranties regarding its accuracy and completeness.

California Individual Mandate Returns in 2020

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Beginning in 2020, California imposes a state individual mandate that requires individuals in California to maintain health coverage or pay a penalty. The California law largely mirrors the federal individual mandate requirement under the Affordable Care Act (ACA) that was effectively eliminated, beginning in 2019.  California’s individual mandate requires most individuals in the state (and their family members) to be covered under minimum essential coverage for each month of the year, beginning in 2020.

Similar to what we saw in the past with the ACA individual mandate, California’s individual mandate penalty is calculated in the same manner. The penalty is the greater of two amounts, the flat dollar amount ($695) or the percentage of income amount (2.5% of income).

For a limited time, you can still sign up through April 30, 2020 but you’ll have to enroll quickly to avoid paying the penalty.

You have until April 30, 2020 to apply if you just learned about the new financial help available to almost 1 million Californians or the new state penalty for not having insurance. You can still apply even if you already have coverage through a company like Kaiser Permanente, Blue Shield, Health Net or any other plan outside of Covered California. After you enroll, your coverage will start the first day of the next month, but April 30th is a firm deadline, unless you have a qualified event/special enrollment period.

Let us know if you have any questions or need help applying for Health Insurance coverage.