It\’s about 50/50 and you shouldn\’t feel bad regardless of which side you fall on. About half of the online California health insurance shoppers we talk to are looking at options pretty well in advance of when their current coverage (usually group or Cobra coverage) ends. The other half…well they need coverage in five days. New changes with the major California carriers now impact the earliest available effective date available but we also need to look at how long the process takes. Let\’s jump in to the question of when exactly you can get coverage effective if approved for an individual family health plan.

First of all, the online application is definitely the fastest approach and the vast majority of applications submitted today are online. Before we jump into how long the process is likely to take for an average applicant, let\’s first establish the absolute earliest possible effective date you\’re now allowed to request. Essentially, we have to go 15 days out from the online app submittal as our earliest possible effective date. For example, if you apply to Blue Shield of California on June 1st, the earliest possible effective date will be June 16th even if approved before then. This is an unintended consequence of guaranteed issue for children which was mandated as part of Health Reform. That\’s the effective date window we\’re looking at. What about the process itself?

If you talk to a California health carriers, they\’re likely to say 4 weeks plus. We\’ll just say that\’s them being conservative and the majority of our application come in with a decision well under that 4 week warning. Here\’s the typical timeline we see although we do get expedited processing due to the volume of applications we process with the major carriers. From when the completed application is in house (usually means successfully submitted online), we can usually expect a phone interview in 3-5 business days. The carriers have really gone away from requesting medical records which can take weeks to process and is very costly. Around 2-3 years ago, they went to conducting phone interviews instead. You can expect a nurse practioner to call the applicant generally within 3-5 business days to conduct a phone interview with general questions on health and specific questions on issues listed in the application health history section.

Once the phone interviews have been conducted, we usually get a decision within 3-5 business days. Make sure to have the phone interview as quickly as possible as the application process cannot move forward until it is complete. Eventually the application underwriting process will time out and coverage will be deferred without the interview.

So all told, we\’re usually looking at a two week process which coordinates well with our 15 days effective date window. The first month\’s payment will generally not be deducted until the actual approval during this process and you have a 10 day free look window from when they notify you of their offer for a full refund. There are situations where the carrier wants additional information than what\’s available on the application or through the phone interview. In this case, they can request medical records for a provider. This can slow things down significantly (usually 1-2 weeks) since there\’s some back and forth between the carrier and the doctor\’s office. We do not see as many requests for medical records which is good news. Now, most of our individual California health applications are finalized in about two weeks. This is actually a big improvement over a few years back when many apps would take 3-4 weeks. A step in the right direction.

Dennis Jarvis is a licensed California health insurance agent with extensive knowledge of the Individual California health market. affordable California health insurance

Dennis Jarvis is a licensed California health insurance agent with extensive knowledge of the Individual and Small Group California health insurance market. http://www.calhealth.net

Author Bio: Dennis Jarvis is a licensed California health insurance agent with extensive knowledge of the Individual California health market. affordable California health insurance

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