More information & Detail

It’s unbelievable how much of this website is dedicated to explaining how ACA/Obamacare/Covered CA works!

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• ACA Health Care Reform – Obamacare Introduction
  • 10 Essential Mandatory Benefits + CA Benefits
    • Cancer – Coverage under ACA Obamacare, Medi Cal & Medicare
    • Maternity – Reproductive Health – Infertility
    • Mental Health Parity Essential Benefit
      • Autism – Essential Benefits & Health Coverage
      • Resources – Mental Health – Conservatorship – FSP
        • Care Courts
        • Organizing, Hoarding, & Cluttering
      • Therapist Provider Finder Medicare Mental Health
    • Pre-Existing Conditions – ACA No more!
    • Preventative Care – Wellness Visit – Medicare
      • Corona Virus – COVID 19 How does Insurance Cover it? – Relief Programs
      • Social Determinants of Health Togetherness – Loneliness
      • Tennis – For Health
      • Weight & Nutrition
  • Metal Levels – Platinum, Gold, Bronze – Silver & Enhanced
    • Enhanced Silver 94, 87, 73 Cost-sharing reductions House v Price
    • Grand Fathered Plans What does that mean?
    • HSA Health Savings Accounts
    • OOP -Out of Pocket Maximum – Participating or Not? Deductibles & Co- Pays
      • Negotiated Rates – Balance Billing? Transparency No Surprises no index
    • Provider Finder – no index
      • Cedar’s Sinai – Thipa – Optum – UCLA – stanford Insurance Plans Accepted
      • International Travel Insurance
        • California HMO & PPO Coverage Out of State & Country
      • Narrow Lists? Fewer MD’s than before? Mirrored Plans?
        • Continuity of Care same doctor even if no longer in network
        • Emergency Room treatment for uninsured patients
          • Medical Debt Covered CA Debt Cancellation
  • MLR 80% Medical Loss Ratio – Actuarial Value Minimum Payout
    • CA Insurance Rate Regulation
      • Financial Impact of Health Care Reform on Premiums no index
      • Premium increases? Why are they always going up?
  • Special & Open Enrollment Periods Covered CA & Direct with Broker
    • Material Violation – Special Enrollment
  • Trump Great American Health Plan
• MAGI – Modified Adjusted Gross Income – Line 11
  • APTC Advance Premium Tax Credit – Subsidies ARPA
    • 8962 Premium Tax Credit Reconciliation APTC Instructions
      • 1095 A, B & C & FTB 3895 Covered CA Statement of Subsidy & Proof of Coverage
    • Age 65 – Can you get Tax Credits Subsidies Covered CA?
    • Employer Coverage available? Updated rules – Family Glitch
    • Mandate Penalty California Individual & Family
      • Health Sharing Ministries – Not Protected by Insurance Guarantees
  • MAGI Income Chart – Line 11 1040 Covered CA
  • Report a Change – How & When – Especially Income Create Account
    • Covered CA Broker – Agent Appointment No extra charge
    • Fudging the Income or Deductions?
      • Last Minute Application? When does coverage start? Competent Adults no index
    • Proof of Income & Identity – Accepted Documents
  • Table of Contents -Income, Deductions & Expenses for MAGI no index
    • Alimony – From a Divorce Settlement taxable
      • Child Support – Adoption – Tax Credit – Enter Military
      • Married – Must File Jointly, Single, etc? Filing Status?
    • Capital Gains, Sale of Home & Dividends
      • Rental Income? MAGI? Home Mortgage Interest – Tenant Rights
    • Clergy – Housing Allowance? Covered CA MAGI Income
    • Educational Credits – Student Loan Interest no index
    • Gambling Income & Losses – Other Income Line 21

• Appeal & Grievances?
  • Medical Necessity – reasonable and necessary Independent Medical Review
    • Knee and Hip Replacement Medical Necessity
    • Prior Authorization
  • Understand Insurance Policies EOC Evidence of Coverage
    • Fraud, Scams, Waste & Abuse Risk Adjustment
• Contact Us, Zoom, Disclosures & License Info
  • 17 Reasons to use Steve Shorr Insurance
    • Biography – Steve Shorr
      • Lt. Paul S. Shorr US Army – Korea
        • Coronel Mickey Markus no index
      • Web Design no index
    • Purchase Tutoring, Research & Education
    • Testimonials – “Yelp” “Google” Reviews
      • Older Testimonials no index
  • Set a Meeting – Zoom, Skype or Phone
    • Meeting – Expectations – Terms of Service
      • Privacy Statement no index
    • Visitor Agreement
• Covered CA Introduction – Coverage? Tax Subsidies?
  • ACA Health Care Reform – Obamacare Introduction
    • 10 Essential Mandatory Benefits + CA Benefits
      • Cancer – Coverage under ACA Obamacare, Medi Cal & Medicare
      • Maternity – Reproductive Health – Infertility
      • Mental Health Parity Essential Benefit
        • Autism – Essential Benefits & Health Coverage
        • Resources – Mental Health – Conservatorship – FSP
          • Care Courts
          • Organizing, Hoarding, & Cluttering
        • Therapist Provider Finder Medicare Mental Health
      • Pre-Existing Conditions – ACA No more!
      • Preventative Care – Wellness Visit – Medicare
        • Corona Virus – COVID 19 How does Insurance Cover it? – Relief Programs
        • Social Determinants of Health Togetherness – Loneliness
        • Tennis – For Health
        • Weight & Nutrition
    • Metal Levels – Platinum, Gold, Bronze – Silver & Enhanced
      • Enhanced Silver 94, 87, 73 Cost-sharing reductions House v Price
      • Grand Fathered Plans What does that mean?
      • HSA Health Savings Accounts
      • OOP -Out of Pocket Maximum – Participating or Not? Deductibles & Co- Pays
        • Negotiated Rates – Balance Billing? Transparency No Surprises no index
      • Provider Finder – no index
        • Cedar’s Sinai – Thipa – Optum – UCLA – stanford Insurance Plans Accepted
        • International Travel Insurance
          • California HMO & PPO Coverage Out of State & Country
        • Narrow Lists? Fewer MD’s than before? Mirrored Plans?
          • Continuity of Care same doctor even if no longer in network
          • Emergency Room treatment for uninsured patients
            • Medical Debt Covered CA Debt Cancellation
    • MLR 80% Medical Loss Ratio – Actuarial Value Minimum Payout
      • CA Insurance Rate Regulation
        • Financial Impact of Health Care Reform on Premiums no index
        • Premium increases? Why are they always going up?
    • Special & Open Enrollment Periods Covered CA & Direct with Broker
      • Material Violation – Special Enrollment
    • Trump Great American Health Plan
  • MAGI – Modified Adjusted Gross Income – Line 11
    • APTC Advance Premium Tax Credit – Subsidies ARPA
      • 8962 Premium Tax Credit Reconciliation APTC Instructions
        • 1095 A, B & C & FTB 3895 Covered CA Statement of Subsidy & Proof of Coverage
      • Age 65 – Can you get Tax Credits Subsidies Covered CA?
      • Employer Coverage available? Updated rules – Family Glitch
      • Mandate Penalty California Individual & Family
        • Health Sharing Ministries – Not Protected by Insurance Guarantees
    • MAGI Income Chart – Line 11 1040 Covered CA
    • Report a Change – How & When – Especially Income Create Account
      • Covered CA Broker – Agent Appointment No extra charge
      • Fudging the Income or Deductions?
        • Last Minute Application? When does coverage start? Competent Adults no index
      • Proof of Income & Identity – Accepted Documents
    • Table of Contents -Income, Deductions & Expenses for MAGI no index
      • Alimony – From a Divorce Settlement taxable
        • Child Support – Adoption – Tax Credit – Enter Military
        • Married – Must File Jointly, Single, etc? Filing Status?
      • Capital Gains, Sale of Home & Dividends
        • Rental Income? MAGI? Home Mortgage Interest – Tenant Rights
      • Clergy – Housing Allowance? Covered CA MAGI Income
      • Educational Credits – Student Loan Interest no index
      • Gambling Income & Losses – Other Income Line 21
• Employer Small Group Health Plans – Introduction
  • Carriers – Companies Employer Group ni
    • Aetna Employer Group Plan Coverage
    • Blue Cross – Anthem – Employer Health Plans
      • Administrative, Renewal & Wellness Tools
    • California Choice – Multiple Companies ONE Bill
    • Employer Group Blue Shield –
    • Health Net Employer Small Group
    • Kaiser Permanente – New Enrollment – Administrative
    • Oscar – CIGNA + Oscar
    • Quotes Employer Group – California – Instantly
    • Sharp Health Plan
    • SHOP – Covered CA for Small Business
    • Sutter Employer Health Plans 2022
    • UnitedHealthcare Small Employer Sales & Enrollment
      • Administration & Wellness
  • COBRA & California Cal-COBRA 36 months total coverage
  • EmployER Definition – Health Care Reform
    • EmployEE Definition
      • 1099 Independent Contractor vs Employee & Other Defintions
      • 90 Day Maximum Waiting Period?
        • Late Enrollee – Triggers – Qualifying Events
      • Dependent Definition – Up to Age 26 – Add newborn baby
        • Registered Domestic Partners – Spousal Health Coverage? no index
  • Participation & Premium Contribution Requirements
    • Employer Group Association Plans – Trump’s Executive Order – CA prohibition no index
    • Management Carve Outs – §2716 – Similarly Situated
      • Common Ownership – Affiliated Companies – Corporations no index
  • Tax Credits Small Business §45 R
    • IRC §106 – 162 Health Insurance Deduction for Employers & Employees
      • Schedule C – Self-Employment Income – Hobby? Office in home?
    • Section §105 -HRA Health Reimbursement & ICHRA
    • Section 125 – POP Plan Employee Contributions are Tax Deductible
• Individual & Family Health Insurance CA
  • Companies – Carriers no index
    • Aetna Individual & Family
    • Blue Cross – Anthem Individual
    • Blue Shield Family Plans PPO & HMO Trio
    • Health Net Individual Information & Enroll
    • Kaiser Permanente – Enrollment – Pay Premium ONLINE
    • LA Care – Medi Cal & Covered CA
    • Molina Health Care no index
    • Sharp Health Plan – Employer & Family
    • Sutter Health Insurance Individual & Employer Plans
    • Western Health Advantage Individual & Small Group
  • Dental & Vision for Adults and Children
    • Dental – Vision Medicare limited
    • Dental Implants – Denti Cal – Coverage?
• Life, Disability, Long Term Care & Retirement
  • Benefits of Retirement Planning & Effect on MAGI Income
    • Annuities & MAGI Income Taxation Exemption
      • Trump Savings Account for Children
      • TSA-Teacher Retirement Plans – Tax Sheltered Annuities
    • Business – Employer Sponsored Retirement Plans
      • CalSavers Mandate vs Private Pension Plan
      • Selling and Valuation of an Insurance Practice? no index
      • SEP – Simplified Employee Pension
    • IRA – Individual Retirement Account Tax Deductible & Roth
    • Social Security – Retirement Benefits – Survivors – When?
      • Social Security Benefits MAGI Covered CA Income Subsidies
  • Disability Income – Pay Check Protection
    • SDI State Disability Insurance – MAGI Income Taxable? COVID
      • Unemployment Compensation – Can’t find job – Corona Pandemic – Family Leave- Free Silver 94
  • Estate Planning
    • Estate & Gift Taxes
      • Gift Income? Covered CA MAGI? Taxable?
    • Living Trust – Bank Accounts?
      • Executor – Successor Trustee – What are the duties?
      • Sample – Example California Will – Where does your stuff go? Health Care Directive
        • Probate California
        • Will Contests – Disinherit a child no index
      • Special Needs Trust
  • Life Insurance – Instant Quotes – Universal – Key Man Life
    • Find a lost or missing Life Insurance policy – Pension – Bank Accounts
      • Life Settlements – Sell your unwanted policy
    • Rated – Surcharged Policies Pre Existing Conditions
      • Final Expense – Almost Guaranteed Issue
  • Long Term Care Nursing & Home Health Care
    • Medi Cal – Long Term Care & Nursing Home Estate Recovery – Strategic Planning
      • Cal AIM – Board & Care – Medi Cal no index
• Medi-Cal – MAGI Income Eligibility Criteria
  • Aged and Disabled Federal Poverty Level Program
    • Share of Cost – Eliminate with Dental, Vision Medi Gap Insurance Premiums
      • FAQ’s Share of Cost
      • How to upload documents to BenefitsCal.com
      • How to use medical expenses to lower share of cost
      • Medi Gap to lower share of cost Medi Cal IHSS
      • Worksheets Medi Cal Share of Cost?
    • SSI – Supplemental Security Benefits – Automatic Medi Cal – SSDI
      • DAC Disabled Adult Child – Keep Medi Cal – Retirement – Pickle
        • Disabled Adult Children – over 26 – stay on parents insurance
  • Dual Coverage?
• Medicare Part A Hospital & B Doctor Visits Enroll ONLINE
  • Enrollment Tools and Decisions for Medicare Table of Contents
    • Medicare enrollment, if covered by Employer Plan? Retiring?
    • ONLINE Account for Medicare & Social Security
    • Part A Hospital – when it’s not Free – 40 quarters
      • Medicare Funding – Medicare for All no index
    • VA compared to Medicare A, B, C, D & Medi Gap
  • MAPD Medicare Advantage Plans – Part C General Info all companies
    • Advantages – Disadvantages of Dual SNP Medi Cal & Medicare
    • Anthem Blue Cross Select HMO MediBlue Plus & SNP
    • Blue Shield 65 Plus – Inspire HMO 2025
    • Enrollment Dates for MAPD – Medicare Advantage & Part D Rx
      • Marketing Rules – Best Plan no index
        • Medicare Star Ratings
        • SOA Scope of Appointment
      • Residency – CA, USA – Covered CA & Medicare
        • Lawfully Present – Immigration Status
        • Premium – Rating Factors – 19 Geographic Regions no index
    • MAPD UnitedHealthCare
      • U Card UnitedHealthcare no index
    • SCAN MAPD Medicare Advantage
    • SNP Special Needs Plans Medicare Advantage
  • Medi Gap – Supplement Plans
    • Anthem Blue Cross
    • Blue Shield – Medi-Gap – Any Medicare Provider
    • Guaranteed Acceptance – Medi-Gap – Supplemental Plans
      • Medicare Assignment – Find MD’s
      • Plan G High Deductible – Saves Premium
      • Price Advantage of Plan G compared to Plan F
    • Health Net Medi Gap
    • UnitedHealthCare – Medi Gap
  • Part D Rx Prescriptions no index
    • High Income Surcharge IRMAA Parts D Rx & B Doctor Visits
    • Part D Rx Late Enrollment LEP Penalty Appeals
    • Shop & Compare Tools Part D Rx
      • Part D Rx Low Income Subsidy – LIS – Extra Help
        • Prescriptions Drugs – Rx – Including under 65 ACA no index
  • zCoverage for Specific Disease or Questions FAQ’s no index
    • Demential & Alzheimers Medicare & ACA/ObamaCare coverage
    • Diabetes – Prevention & Coverage under Medicare & ACA
    • Durable Medical Equipment, Chiropractic, Physical Therapy
    • End Stage Renal – Kidney Failure – ESRD
    • Hearing Aids Insurance Coverage
    • Hospice Coverage – Medicare
    • Skilled Nursing SNF & Home Health What Medicare Pays
• Site Map Health Reform Quotes.com

Links & Resources

coveredca.com/lets-talk-health

• Wikipedia on Individually purchased Health Insurance
• VIDEO Introduction to ACA/Obamacare Individual Health Plans for those coming from an Employer Plan

Historical

• For example, there are no more short term plans in CA   ^{SB 910 Hernandez 2018}.  ^§10123.61. ^{LA times} *  ^{KFF News July 2023} * 
  • There is has been… legislation for short term plans on a National Level Read More NAFIA , BUT CA regulations don’t allow them at all.  Read more Insure Me Kevin.com *
• Everything you need to know about 2024 ACA Open Enrollment
•