New health care provisions recently passed through the American Rescue Plan. As a result, Covered California™ is offering new and expanded financial assistance in order to lower premium costs and make health care coverage more affordable. The new
law ensures that everyone eligible will pay no more than 8.5% of their income on their health care premiums. To help as many uninsured and unsubsidized Californians as possible, Covered California is opening a new special enrollment period on April
12, which will run through the end of 2021.
Your on-exchange clients don’t need to do anything. If they qualify, their new premium assistance will automatically be reflected on their June billing statements. Most people will see a much lower bill — this includes
on-exchange clients who haven’t qualified for financial help in the past. Clients who want to see exactly what they qualify for should log in to their Covered California account starting April 12 for details.
To check if your off-exchange clients (including first-time applicants and existing enrollees with Sharp Health Plan) qualify for financial help under the new American Rescue Plan, please contact our certified enrollment specialists by email or 1-858-499-8211. Off-exchange clients who are newly eligible for premium assistance will need to re-enroll with Sharp Health Plan through Covered California. After enrolling, they will receive
a new member ID card and onboarding materials confirming their coverage.
After a client selects a plan for coverage through Sharp Health Plan, their new coverage will begin on the first day of the next month. Note: Application due dates are determined by Covered California.
Please refer to our 2021 Individual and Family Plan Quick Guide to help answer questions your clients may have about our IFP plans. Individual on- and off-exchange rates and summaries of benefits are also great resources and can provide more details about coverage options.
We must receive your client’s first premium payment in full by the 25th of the month before their new coverage starts. If full payment is not received by then, you will need to submit a new application.
In California, having health care coverage is the law. If you don’t have health coverage, you may have to pay a state tax penalty. Find out if your client qualifies for an exemption with Covered California or the California Franchise Tax Board.
You will continue to receive a standard commission of 5% of the total premium for first-time enrollees. Thank you for your continued business!
If you have questions, please contact our individual and family plan sales team. We’ll gladly assist you 8 am to 5 pm, Monday to Friday.
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