February 6, 2015 Covered OC Meeting

 Renewals and Open Enrollment  Sales Division Initiatives  New Federal Tax Requirements  Medi-Cal Payment Update  Resources  Questions Agenda 2

Covered California renews 92% of its consumers Renewal Update 3 For a plan by plan breakdown of renewals, reference the 1/29 Community Partner Alert available on IPAS and CoveredCA.com/Agents.

Through January 26: New Individuals Selected a Qualified Health Plan for 2015 Total: 273, OPEN ENROLLMENT

Sales Division Initiatives

6 Promote Your Business Storefronts

7 Promote Your Event

Agents m/agents/webinars/ Community Partner ssisters.org/ 8 Bi-Monthly Sales Webinars

Weekly Updates & Alerts 9 Sign up:

New Federal Tax Requirements

1095-A and APTC Reconciliation 11 Law requires that individuals must either have health insurance throughout the year, qualify for an exemption from coverage, or make a payment when filing 2014 federal income tax returns in Covered California will send consumers a new form called a 1095-A, which consumers will use when filing taxes to: Demonstrate they had health coverage in 2014, and “Reconcile” the amount of APTC they received based on their estimated income with the amount of tax credits they are eligible for based on their annual income reported on their tax return. As a result of this reconciliation process, some consumers may be eligible for a tax refund, while others may receive a reduced refund or owe back some of the APTC they received.

APTC Reconciliation Limits

13 Tax Penalty 2014 Tax Penalty Per Adult$95.00 OR 1% of yearly household income; Whichever is greatest Per Child (under age 18) $47.50 Family Maximum (Using the above method) $285.00

14 Tax Penalty OROR Per Adult$325.00$ % of household income; whichever is greatest 2.5% of household income; whichever is greatest Per Child (under age 18) $162.50$ Family Maximum (using the above method) $975.00$2, *Note: After 2016, the penalty stays the same but is adjusted for inflation

1095-A Toolkit includes: Sales Division Training Webinar IRS Forms 1095-A, 8962 and 8965 Covered CA 1095-A Dispute Form Covered CA 1095-A FAQs Covered CA Talking Points CalHEERS Job Aid 1095-A Fact Sheets (English & Spanish) DHCS Medi-Cal 1095-A Fact Sheet Consumer Notices Links to Resources A Toolkit

Medi-Cal Payment Update

Medi-Cal Payments 17 # Certified Enrollment Entities PaidTotal Paid Covered CA Plans552$2,814,276 Medi-Cal Payments662$4,147,348 Total Payments made to CEEs $6,961,624 Approximately $1.3 million will be send to CEEs in early February for Medi-Cal enrollments through September 30, # Certified Insurance Agents PaidTotal Paid Medi-Cal Payments~3,000$1,185,114 Total Payments Medi-Cal payments made to CIAs $1,185,114 Approximately $1.3 million will be sent to Agents in mid-February for Medi-Cal enrollments through September 30, 2014.

Resources

19 CEC Help and Support CEC/PBE Help Line: (855) Contact: – –

20 Agent Help and Support Agent Service Center: SHOP Service Center Agent

21 Questions

22 Mary Watanabe Deputy Director, Sales Division