Covered California Coverage Options Unit

Starting Monday, Nov. 25, a unit of specially trained Service Center Representatives will be available to provide assistance to consumers who have questions or concerns about potential premium increases, plan options, changes in network, or other issues related to their transition from current market non-grandfathered health plans to coverage under the Affordable Care Act.

The hotline, at 855-857-0445 will operate Monday through Friday, 8 a.m. to 8 p.m. and Saturday from 8 a.m. to 6 p.m. The unit will be housed at the existing Rancho Cordova Service Center.

The unit is made up of 25 Service Center representatives getting customized training to handle questions from this specific group of enrollees. It’s expected that 900,000 current enrollees will be moved off plans that are discontinuing as of Dec. 31, 2013, because they don’t meet the minimum benefits of the ACA.

Here are some key facts about the new unit:

• Hotline representatives will be skilled in answering questions tailored to affordability.
• Changes are being made to the current phone system so the caller will hear a brief message and then can be directly routed to the Options Unit
• Many of the questions received by this unit may require input or support from the health plan to address consumers’ detailed questions. Covered California representatives will be able to transfer consumers directly to health plan staff, or they can work with consumers on a three-way call.

SCR’s will be trained to:

1. Speak with the consumer to understand their situation
2. Educate the consumer on the ACA and their options
3. Calculate the consumer’s eligibility for premium assistance or affordability exemption
4. Remind consumers of deadlines for getting insurance so there are no gaps
5. Transfer consumer to health plan staff or arrange for a three-way call