A 90 day conditional eligibility notice means that you get coverage for 90 days even though Covered CA hasn’t verified that you qualify. As long as you send the proofs that are being asked for, everything is fine! There is NOTHING to worry about! Just comply. If you have trouble with compliance, email us.
Clients need to submit valid documentation for one or more of the following reasons:
- U.S. Citizen/National or non-citizen with a lawfully present status
- Income (MAGI Line 37*) Insure Me Kevin.com 2.19.2016
- Social Security Number (SSN)
- Incarceration Status – Insure Me Kevin.com
- American Indian/Alaska Native Status
Look for this sentence in the letter that you get from Covered CA.
We need your proof within 90 days. If we get a response and you prove your citizenship by the due date above, you will keep your insurance through Covered California.
Here’s the biggest lesson I learned in one year of law school. Read everything 3 times and when you think you understand it, read it again.
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Letter of Understanding for Late Applications
Some Insurance Companies #kaiserform for example have a form that must be signed when
applications are sent in late to avoid any misunderstanding.
In order for your group, ___________to be considered for late enrollment for a/an _________effective date, both customer and broker will need to sign this letter of understanding.
Complete group eligibility and enrollment documentation must be submitted. This letter and/or group submission do not guarantee approval, but rather consideration for a/an _____effective date.
Please note the following potential liabilities of a late enrollment:
Customer is responsible for the full month’s premium – no proration or refunds
Effective date of coverage will not be changed to a future date
Potential impacts to members:
Members will not have member ID cards, nor be active in systems, including medical facilities, until enrollment is complete and processed, which could take 7- 10 business days beyond submission
Members may be billed or asked to pay at point of service. Kaiser Form *
Realistic Drop Dead Deadline Date?
What if you apply on March 30th for an April 1st effective date and you don’t get ID cards till April 24th,
do you have to pay April premium?
What about trying to collect on claims paid out of pocket?
I learned the word SNAFU Situation Normal, All Fouled Up in the dorm, when I attended San Diego State in the early 70's and earned a degree in Insurance. In all that time, I've never been able to use the word in a sentence, until last 10.1.2013, when Covered CA.com, Health Care.Gov nor the Insurance Company Websites or my own Quote Engine that I pay around $250/month for were supposed to launch, but did not do it properly.
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We recently had a parent call and enroll his daughter in Covered CA with subsidies. The daughter now has found a “rule” that states that she should have always been in Medi-Cal as her child’s Social Security Survivor Benefits do not count, for MAGI Income. We don’t need the grief, look at the Long Story she wrote us…
So, unless you have authority, we can’t help you, unless the child is on the Zoom call too.
Who has authority to #sign an application for Insurance?
Can a Parent negotiate and purchase coverage for a competent adult child?
Age of Majority 18 The age when a child legally becomes an adult. The age of eighteen in California becomes the age of individual freedom for the individual. You become a full-fledged citizen with the right to make your own choices – and, consequently, pay the consequences for your own mistakes.
A legal guardian is a person who has the legal authority (and the corresponding duty) to care for the personal and property interests of another person, called a ward. Guardians are typically used in three situations: guardianship for an incapacitated senior (due to old age or infirmity), guardianship for a minor, and guardianship for developmentally disabled adults.
Most countries and states have laws that provide that the parents of a minor child are the legal guardians of that child, and that the parents can designate who shall become the child’s legal guardian in the event of death, subject to the approval of the court. Some jurisdictions allow a parent of a child to exercise the authority of a legal guardian without a formal court appointment. In such circumstances the parent acting in that capacity is called the natural guardian of that parent’s child. Wikipedia
- Our webpage on Conservatorships
A power of attorney (POA) or letter of attorney
is a written authorization to represent or act on another’s behalf in private affairs, business, or some other legal matter. The person authorizing the other to act is the principal, grantor, or donor (of the power). The one authorized to act is the agent or, in some common law jurisdictions, the attorney-in-fact. Wikipedia
A health care agent is a person you choose in advance to make health care decisions for you in the event that you become unable to do so. A health care agent can help make medical decisions on your behalf at the end of life or any other time you are not able to communicate, such as if you are severely injured in an accident. A health care agent also may be called a health care proxy or surrogate or an attorney-in-fact. Web MD Agent of Health Care Fillable Form
Be sure to put in our AGENT # 2094784
Delta Dental – Covered CA Plans
- Delta Dental PPO Premium Plan covers implants at 50%, after a 12-month waiting period.
- Delta Dental Individual & FamilyTM Delta Dental PPOTM Family Dental Plan 669 KB
- Delta Dental PPOTM Children’s Dental PPO for Small Businesses 790 KB
- Delta Dental PPOTM Family Dental PPO for Small Businesses 794 KB
- Delta Dental Individual & FamilyTM DeltaCare® USA Family Dental HMO 872 KB
- DeltaCare® USA Children’s Dental HMO for Small Businesses 837 KB
- DeltaCare® USA Family Dental HMO for Small Businesses 848 KB
All our plans are Guaranteed Issue with No Pre X Clause
Quote & Subsidy Calculation
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- Our Quote Engine Takes all the complexity out of using pencil and paper to figure out the premiums per the Obamacare/ACA rules under CFR §1.36B-3 *
- Get more detail on the Individual & Family Carriers available in CA