What if you\’re an existing health insurance member on the individual and family market in California? What happens to you Jan 1st? Great question as we get closer to the Jan 1st 2014 change over and it will be a massive change-over. Let\’s walk through what members can expect for the transition to health reform since so much focus has been on enrolling the uninsured.

Two distinct groups of individual and family health members

There are actually two separate pools of members. If a person\’s coverage started before 3/23/2010, they are in a Grandfathered pool and they will not have to change plans Jan 1st (providing they have not made any changes toe original policy that would invalidate the Grandfathered status). These members can change if they want to into one of the new Exchange or non-Exchange plans but they do not need to and they will likely not want to. The Grandfathered plan\’s rates should be much better than the new Exchange plan rates unless you qualify for a subsidy. Our Health Exchange Quote page will be able to show you Exchange plans with and without subsidies as well as non-Exchange plans (no subsidy) all at one place starting October 1st. Unless you qualify for a health subsidy, you will probably want to keep your Grandfathered Plan depending on rate, tier, etc. Again, October 1st is when you can compare. We recommend those members with Grandfathered status to stay put till we see what the new plans/rates look like. Once your plan is changed, Grandfathered status is gone for good.

Non-Grandfathered California health plans

If you do not have a Grandfathered plan (effective date or changes after 3/22/2010), your plan will go away Dec 31st, 2013. You will automatically be rolled into a \”mapped\” health plan that\’s the most similar to your current health plan most likely in the non-Exchange pool. The rates and benefits are identical between Exchange and non-Exchange plans so there\’s no downside there. This mapping is for people who choose to do nothing at the time of change over. You will also have the ability to change plans to any of the new California Exchange plans (Platinum, Gold, Silver, and Bronze plus a Catastrophic option for young adults under 30) or equivalent non-Exchange plans. The first effective date is Jan 1st and the last available one to make changes for is April 1st but the plan change must be requested 15 days prior to requested date. For example, if you request a plan change request Jan 20th, your change will go into effect March 1st (and not Feb 1st). Basically, it\’s the 1st half of the preceding month to request the 1st of the following month. For example, if you want a Jan 1st plan change, you would need to request the change in the first half of December (or starting October 1st). March 31st is the last date to request a plan change into the new Exchange or non-Exchange plans and if you miss this window, you will have to wait till the end of 2014. This first open-enrollment window is 6 months, Oct 1st through March 31st.

End of 2013 will be very busy for California health insurance

The State only recently required that the IFP members all change Jan 1st. We were hoping it would occur on the anniversary month of when the member originally joined to spread out the incredible volume of changes and enquiries that will hit. We are talking about 10\’s of millions of Californians all investigating coverage options at one time. The carriers will be inundated as will any group dealing with this transition. Please be patient. We have worked to make all the tools available online with instant quotes for both Exchange (with or without subsidy) and non-Exchange plans available based on your income level (which drives subsidy eligibility) at no cost to you. We really want to empower the California health insurance shopper and member and of course, we\’re here to help with your questions during this time.

Dennis Jarvis is a licensed agent whose focus is helping people and companies find cheap California health insurance. More info: Existing California Health Members and Exchange Transition

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 agent whose focus is helping people and companies find cheap California health insurance. More info: Existing California Health Members and Exchange Transition

Category: Finances
Keywords: california health exchange,california health exchange transition,existing california health members