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15 Day Effective Date Rule

California health insurance Individual Health Insurance Guides 15 Day Effective Date Rule

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EFFECTIVE DATE
15 DAY RULE
 
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New 15 Day Effective Date Rule for Individual California Health Insurance

Call it the law of unintended consequences applied to California health insurance by health reform.  Some changes of course have been welcomed while others have made the market less flexible.  One of the changes has do with effective dates for individual family California health insurance policies and what's allowed.  The desired effective date is an important concern for most applicants so let's take a look at what you can expect.

First, we need to make a distinction between Short Term or Temporary California health and traditional or "permanent" plans.  Short term still operates the same in that you can generally pick the day following your online app submittal or the signature on the hard copy application if approved.  For example, if you submit the online application (finalized) on Jan 1st, the earliest possible effective date is Jan 2nd (at 12:01 am).  This has not changed from before.  What about traditional individual and family California health insurance plans?

Unfortunately, we've taken one step backwards here.  With the major carriers (such as Anthem Blue Cross or Blue Shield of California) we use to have the same rules as short term in that we could request the day following online app submittal as the earliest effective date.  This is no longer the case.  The major carriers are now requiring that the earliest available effective date (if approved) is 15 days following the online app submittal or hard app submission/signature.  This is a pretty big difference as many people start the process of looking for replacement coverage (say for exhausted Cobra or losing group coverage) a little late in  the process expecting that it can turn around faster.  There's always a rush of calls and applications in the 7-10 days prior to the 1st of any given month for this reason.  This is an issue.  Even if approved, the earliest effective date might be days if not weeks after the required 1st of the month needed to insure there is no lapse in coverage.  So what's our advice?

Start early and take advantage of California's 10 day free look window.  Many people do want to really compare or they are too busy to do so till...later.  We've all been there.  You do want to submit the online app 15 days prior to when you'll need though so at least start the process.  We can help go through the options and quickly narrow the right plan since out of the dozens of plans on the market, there's really about 7-10 that make any sense and the pricing between carriers will narrow this further.  Keep in mind that you have a 10 day free look window from when the carrier comes back with their decision to cancel the policy never effective and there's no application fee so there's no downside to starting the process early (or at least 15 days early). 

Why the change of effective date and how does it tie to Health Reform changes.  No one's come out and given a reason but if we had to guess, it has to do with guaranteed issued for children changes.  Since children can now get coverage regardless of health, some people will wait to get coverage until something big comes a long...say a surgery.  The 15 days allows them to avoid immediate large needs for someone who doesn't get coverage until the last minute (akin to buying home insurance when you're house is on fire).  The carriers then had to apply the same to rule to all enrollees including medically underwritten adults.  That's our take on the situation but again, no one has said as much.  The take away?  For California individual health insurance, apply at least 15 days prior to your ideal effective date to make sure you do not have a lapse in coverage. 

Other important concepts to help you understand your California health insurance quote are:

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