If you have employees that waived group health insurance due to Medi-Cal eligibility this information is IMPORTANT!  May 11th, 2023 is the official end of the Public Health Emergency due to COVID. This will have many impacts on health care and health insurance. This blog deals only with the issue of Medi-Cal redetermination. If you want a full overview of changes you can visit HHS at Fact Sheet: End of the COVID-19 Public Health Emergency | HHS.gov .

When the public health emergency was declared at the beginning of COVID it made qualifying for Medi-Cal much easier, it also froze any redetermination of Medi-Cal eligibility. Starting as early as May 19th, 2023 Medi-Cal eligible people will be getting a letter from CalHEERs requiring them to validate their status on Medi-Cal. This mailing will occur over a period of months, so this loss will be phased in. While the mechanics are unclear, it appears that if they fail to validate, they (and potentially family members) will be moved to an Individual health insurance plan with Covered California.  Depending on their recognized household income they may, or may not, be entitled to a premium subsidy on Covered California.

The important issue to understand is that if your employee has been offered affordable** group health insurance they personally ARE NOT eligible for any premium subsidy. Thankfully, as of this year, their family members could still get a subsidy (depending on income) even though the employee cannot. The loss of Medi-Cal will be a valid qualifying event and open a window for that employee (and their dependents) to come on your group health plan.

Practically speaking, an employer cannot know when/if a Medi-Cal eligible employee is losing that coverage, so it is the employees’ responsibility to communicate with their employer. When/if that event occurs, we just wanted you to better understand the parameters. As always, feel free to reach out to your account manager with any  questions!

The Peters & Milam Team

As always, if you have any questions or if we can help in any way, please reach out!
Call us at (805) 687 - 3225, or send us an email at info@petersmilam.com. We can't wait to hear from you!

-Dave Peters & Steve Milam