Common Questions
To understand the available options in Covered California, let’s answer the following commonly asked questions.
I have a job that provides me with health insurance, but it is not affordable. What are my options?
In case your employer-provided health coverage cannot be deemed as affordable under Obamacare, you can apply for premium assistance with Covered California. This will aid you in reducing the monthly health insurance premiums, thus making it less expensive.
You can reach out to Covered California directly or ask the help of a licensed insurance agent to qualify for premium assistance. They will help determine if you qualify, and find the best plan for you.
I could pay for myself, but not for my family. What am I supposed to do?
This is a very common problem called the family glitch. When the challenge is that one can pay for their individual coverage, the family may still not be able to access affordable coverage through the employer pay.
So, in this situation, one will be looking at obtaining a family plan that is available through Covered California. However, you may not qualify for premium assistance if you have an employer-sponsored plan that is affordable for you.
Are there any situations where the affordability standards are not applicable?
Well, there are certain standards or provisions that may allow for affordability to be ignored. Such provision may change based on the particular situation. Therefore, it is advisable to check the requirements for eligibility for the exception to ascertain if one meets the exception.
I did not enroll in my workplace health plan because I was not hired during the open enrollment period. What do I do?
If you have missed your job’s open enrollment, you may still be eligible to join a health plan via Covered California. However, you will generally need to experience a qualifying life event, such as loss of job, marriage, or childbirth, within the last 60 days of application.
In addition, let us say that you have a job and your employer provided you with health insurance coverage, but it does not fit in the category of reasonable health plans as defined by the employer.
