Napa's Health Insurance Guys: Did he miss open enrollment?

Dear Kyle, Tom and Alan:

I'm 31 and going to need some health insurance. My COBRA ran out last summer, so I think I better get something so there's no penalty they'll stick me with.

My friend says open enrollment is over, so I can't just call up the company and tell them I'm ready. What are my options?

Duff

Kyle: OK, Duff, it's good you're pursuing this. I've read the penalty for no coverage in California for 2022 is a minimum of $800 for an individual. If you do get a penalty I think it would be prorated for the months you were without.

From what you've told us, you can't go direct to an insurance company to sign up for a plan because it has been too long since the end of your COBRA. You can, however, enroll through Covered California if you have experienced a Qualifying Life Event (QLE) within the past 60 days.

Tom: We looked this up on the Covered Ca website and printed out four pages(!) of QLE, so the odds are good.

For example, if you've been unemployed all this time and think it might continue so that your projected income for 2023 is $18,755 or less, you will almost certainly qualify for Medi-Cal which will definitely remove the threat of a penalty. Also, if you start making money again and Medi-Cal kicks you off, you're guaranteed to be able to enroll in Covered Ca (again, within 60 days just to be safe).

Al: Here are some of the other QLE: if affected by a state of emergency, e.g., Covid, wildfire or flood; new driver (independent contractor) for a ride-sharing company; getting married; have, adopt or foster a child; move to California or move within the state and gain access to at least one new Covered Ca health insurance plan (kind of a puzzler); gain citizenship or other lawfully present status.

Kyle: Among the four pages there is also mentioned "domestic abuse or spousal abandonment." There is an additional page of instructions if this QLE is chosen.

Duff, if you are a member of a federally recognized American Indian tribe, you can enroll at any time and change plans once a month! Also, if you have lost coverage due to returning from active duty military service including reserves or California National Guard. Or, Alan's favorite…released from jail or prison.

Al: This certainly wouldn't happen in Duff's case, but if your agent misinformed or misled you.

Now, this next one used to be very common at the onset of the Affordable Care Act. You were reasonably unaware of an event that would have qualified you for enrollment.

If you are, or were, a member of AmeriCorps/Vista/National Civilian Community Corps.

Kyle: Duff, we've come up with more options than we thought possible. If you qualify for Medi-Cal, great. Otherwise, a new job with benefits; get married (what?); or, start driving for Uber or Lyft.