Exit Actions and Their Effective Date?

[G.Gordon]

What is everyone's thoughts on when someone has to exit ACA coverage?

Say we call today, before the 15th, it should go into effect the 1st.

What if we call after the 15th, qualifying event is May 1, Medicare for example, will they be released the 1st?

 

[bluediamond]

I wrote one with an effective date of Jan 1 knowing he was going on Medicare 2/1. He called and cancelled around the 23 of Jan for Feb 1 and the marketplace said he was cancelled that day. His supplement went into effect 2/1 along with Part D, FB been drafting his sup and part D and keeps sending him overdue notice's on the under 65. I suppose they will stop next month since it will be 90 days he has not paid the under 65 on mp.

 

[G.Gordon]

Like situation today. MP CiC rep told us the "transition" was effective today, not May 1. No explanation or resolution to the discrepancy. All I can imagine, is for others with like situations, you have to call in the day before or same day of the needed plan change. What a freaking mess.

 

[somarco]

He called and cancelled around the 23 of Jan for Feb 1 and the marketplace said he was cancelled that day.

One of the healthcare.guv flunkies told him this? What does the carrier say? If coverage is indeed cancelled that day is there a pro-rata refund for unearned premium?

What a freaking mess.

No sh*t

 

[bluediamond]

One of the healthcare.guv flunkies told him this? What does the carrier say? If coverage is indeed cancelled that day is there a pro-rata refund for unearned premium?



No sh*t

Yes, they told him that and there were claims pending, but FB never dropped him and still hasn't although he had only paid his initial premium for Jan. He's going to the doc and running tests and his sup and Medicare are paying. As far as I know the claims that were pending when he called the mp were paid by FB and they should have. Nope no premium was returned to him.

 

[somarco]

How would HC.guv know if he had claims pending? They don't even know who has paid premiums or how many enrollee's had prior coverage.

 

[bluediamond]

Guess I must have worded that wrong. I know he had claims pending, I saw them, he gave me his pw to his "my blue service" to look at.

 

[RayNY]

Somarco,

They don't report that information. I guarantee you they know and are not releasing it. As inept as they may appear, some of it's a farce.

 

[Ann H]

How would HC.guv know if he had claims pending? They don't even know who has paid premiums or how many enrollee's had prior coverage.

They get the information from the NSA.

 

[yorkriver1]

OK, you've been watching "The Good Wife"...lol, if not, you'll like it....they have a great NSA story line...
Now, on the other topic. Anthem told me that the Healthcare Marketplace is determining effective dates from SEP eligibility, even some seem to be backdated.
So, EE gets terminated today from employer/& 4/30/14 from group plan. They found out today... just got that call...they could be determined as eligible for 5/1/14 coverage on Marketplace. HC.gov also confirms this, in 2nd call today. 1st call to HC.gov said, no only if applying by 15th of month. That seems to violate the whole purpose of SEP, to give unbroken coverage, but, then silly me, using logic.
Makes it hard to give clients reliable information. Luckily, COBRA is backstop in case 5/1/14 turns into 6/1/14.
Will possibly do non-subsidy HC marketplace app for best price/benefits on plan for client--carrier available only on marketplace.
Off marketplace, Anthem says can do up to last day of month, with valid SEP.