Covered California expands financial help

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.

What this means for you and your Sharp Health Plan clients

On-exchange clients

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.

TIP: To ensure the best experience for your clients who pay their premiums through Sharp Health Plan’s payment portal, we highly recommend that they set up recurring payments to pay their “balance due.” This will ensure they’re paying the correct amount each month.

Off-exchange clients

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.

New coverage starts on the first of the month

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.

Key selling points for our IFP plans

• High-quality health insurance is more important than ever. In addition to having some of the lowest rates in the region, Sharp Health Plan is one of the highest member-rated health plans in California and in the nation.
• Sharp Health Plan provides the most affordable access to Sharp HealthCare through Covered California, including Sharp Community Medical Group, Sharp Rees-Stealy Medical Group and all Sharp hospitals.
• Sharp Health Plan has reduced rates on our on-exchange Silver and Bronze plans.

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.

State tax penalty information

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.

Broker compensation

You will continue to receive a standard commission of 5% of the total premium for first-time enrollees. Thank you for your continued business!