Dear Tom and Alan:

Pretty sure I’ve done something wrong. I went through Covered California and enrolled in a Blue Shield plan. At the time, my (lack of) income qualified me for a subsidy.

So…I got a $650 plan and it only cost me $140 per month! Really hate to give that up, but my income went up a little bit in 2015. How and when and to whom do I report my change? I don’t even have a total for last year and, of course, I haven’t done my taxes yet. Help!

P.S. My 30-year-old son just moved back to California and needs health insurance. Is he too late to get covered?


Tom: OK, Pam, let’s take the easy one first. Your son is not too late to get covered in California. The deadline to apply this year is Jan. 31.

If he applies before Jan. 15, he’ll get an effective date of Feb. 1, after Jan. 15 but before Jan. 31, he’ll start March 1. On top of that, his moving to California is a “qualifying event” so he’s guaranteed to be accepted.

Al: Thank you, Pam, for coming into our office. You helped me overcome my fear of trying to get through to Covered California during the open enrollment period.

Regular readers of our column will recall my incessant whining about hours on hold waiting for a live person during the first two years of the Affordable Care Act (ACA). Because of you, my three calls to Covered California went through in just minutes, and each time we reached a helpful and knowledgeable representative.

Tom: What a fraidy-cat. Anyway, Pam, since your account is online with Covered California, you can go in and look at it, make changes, etc.

Since you now have a certified agent, he can access your information and also make changes on your behalf. So you can report your income change yourself or via your agent once you have the numbers for 2015.

Al: The Covered California representative I spoke to made it sound really simple to report changes on the website. I don’t believe her, of course, so I’ll just call.

Tom: For a household of two, Pam’s income will have to be less than $63,720 in order for her to continue to receive all or part of her subsidy for 2016. Once the income is reported to Covered California, they will let Pam know how it will affect her monthly premium with Blue Shield.

By the way, the first two years of ACA Blue Shield changed its provider network to an exclusive provider organization, which was limited to four local counties.

We’re told that the company has brought back its preferred provider organization, which was their original network for the entire state. Evidently, subscribers can choose one or the other for this year.

Submit questions or reach the Health Insurance Guys at Schrette Insurance, 1556 First St., Suite 105, Napa, 94559; 255-9511;; or


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