Opportunity exists for 400,000 residents to enroll in affordable health insurance through Covered California
A new federal rule takes effect on Monday, opening the door for nearly 400,000 people to enroll in a moreaffordable health plan through Covered California. The change means families who have been ineligible for financial help because one member is insured through an employer may now be eligible for subsidies to lower the cost of their premiums if they enroll in a health plan offered through Covered California.
"The door to moreaffordable health coverage is opening today for hundreds of thousands of Californians," said
What You Need to Know
In October, the
Starting today, when families apply for 2023 coverage during the current openenrollment period, their eligibility for financial help will be determined by whether the cost of coverage is considered affordable for the employee's spouse and dependents.
400,000 Californians Could Get MoreAffordable Coverage
According to the study, the 391,000 people who would benefit include:
319,000 people who would be able to save money by switching from their employersponsored coverage, or coverage through the individual market, to Covered California.
72,000 uninsured people who would be newly eligible for financial help through Covered California.
A study by the
New Rule Enables 391,000 Californians to Receive Financial Help to Make Their Health Insurance More Affordable Through Covered California 305,000 EmployerSponsored Coverage, 14,000 Individual Market, 72,000 Uninsured.
"With the holidays coming up, this could be a huge gift for hundreds of thousands of Californians, where they could get covered or see significant savings on their health insurance premiums," Altman said. "The new rule will enable Californians who are more likely to be lowincome, women and children, to have a new path to quality health insurance through Covered California."
Families Could See Significant Savings
Individuals and their families could be eligible for financial help through Covered California if their employersponsored coverage exceeds 9.12 percent of their household income.
For example, Jose and Alma are married and have two children. The couple has a combined annual income of
Jose's employer offers employeeonly and family coverage. Employeeonly insurance costs
Since the family coverage is not considered affordable because it costs more than 9.12 percent of their household income, Alma and the children are eligible for financial help through Covered California. Thanks to the Inflation Reduction Act, they would spend no more than 8.5 percent of their household income on health insurance premiums.
"By addressing this critical issue, the Biden administration is building on the Affordable Care Act and its mission to expand access to quality health care coverage," Altman said. "Covered
Covered California Offers New Tools to Help Consumers
In order to determine whether Californians can benefit from the new rule, Covered California is unveiling a new affordability tool and worksheet, which can help people estimate whether they or their family members qualify for federal financial help.
In addition to the tool, consumers can also contact an agent or certified enroller, visit our support page or use Covered California's Help on Demand service to have an enroller contact them within 15 minutes.
In order to find out if the health coverage offered by your employer is considered affordable, you will need the following information:
1. Total estimated 2023 household income.
a. Include the income for you, your spouse and anyone you claim as a dependent when you file taxes. Income includes wages and tips, salary, selfemployment income, interest and dividends received, alimony received,
2. Whether your employersponsored coverage meets the minimum standard.
a. Plan pays at least 60 percent of the total cost of medical services and substantially covers hospital and doctor services.
3. How much you would pay for the lowestcost health plan offered by your employer for employeeonly and family coverage.
In addition, Covered California will also be reaching out to consumers via email to explain the new benefit and how they can determine their eligibility.
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