Public Comment to Covered CA Board Meeting 10.8.2015

Covered CA demands agents work for FREE
to enroll and service Medi-Cal participants



I would like to address the issue of Certified Agents being forced into slavery by having us enroll Medi-Cal without being compensated for our time.


It’s not just filling out a Covered CA application, but explaining the benefits, how to use the plan, pick a doctor, verifying MAGI and so much more.  Plus, it’s a malpractice lawsuit waiting to happen.  Why is it that agents have to post a $2m  Insurance Policy and if Covered CA or Medi-Cal makes a mistake, will they claim Government Immunity?  We WASTE so much time filling out applications that could easily and are filled out by the public as very few people can figure out how to appoint us as their agent.  Maybe we could do Pro Bono work, if we weren’t wasting time!  We were promised in training that all enrollee’s would have to select or decline an agent in the ONLINE enrollment process.  Give us an affiliate link, just like ALL the Insurance Companies do OUTSIDE the Exchange!


If we are FORCED into slavery, at least give us the tools to do the job right.  I have the LEAD website for those who want to know about Medi-Cal redetermination.  See screen shot below.  While I might be in #4 position, the DHCS material is out of date! Or doesn’t work.  Sure, I have a degree in Insurance from San Diego State, CPCU, RHU, REBC etc. but why do you expect me to work for FREE and do stuff that Covered CA and Medi-Cal can’t or isn’t.  I will grant that Ms. Marean-Williams of DHCS did write the summary that I cut and pasted into my site.  But hey, it’s bad enough how many of MY pre Health Care Reform clients Covered CA STOLE from me by advertising that agents were no longer needed and just come and do your application ONLINE, direct.  Heck, here’s a prospect that I play Tennis with, who was given the WRONG information and I told him so, but still thinks that going direct with Covered CA is the best thing!    I also resent the number of Facebook friends I’ve lost as they feel Medi-Cal and subsidies are great, but no agent should dare advertise or inform the public of anything against the sanctity of President Obama.


We don’t even have a contact sheet for Medi-Cal or any sales material to explain how to use the plan or anything!   I recently had a guy come in who told me over the phone he earned $18k.   Turns out it was only $13k.   I allowed him to use an extra computer to enroll online at   but that didn’t work.  So, I enrolled him through my Covered CA portal and updated my website after hearing back from Medi-Cal.  The portal said he was incarcerated.  See screen shot below.  Now, you’ve made me an Immigration & Parole Officer without the benefit of a Firearm.  I spent say 30 minutes on the phone & email prior to our meeting, one hour enrolling and explaining… 20 minutes checking and explaining that Covered CA said if they didn’t believe he was NEVER in jail, Medi-Cal would call him or me.


See the link   where a woman found out that her child’s survivor benefits don’t count in MAGI for Medi-Cal and now I will have to give back all the service fees, plus read all her emails on how terrible the Social Services are and no one can tell her anything!   Do you expect me to know all these rules when I’m not being compensated or in the 8 hour in person training where ½ the material was incorrect!  Nor did we even get a free lunch.


So, PLEASE if Covered CA is happy to STEAL my clients from Pre Health Reform, then let Medi-Cal write these people that qualify up too.   At least Blue Cross and Shield allowed agents to keep their clients, but what about the husband and wife AB 1672 groups, those with Pacificare – UHC, Aetna, Health Net and those that may have switched from Blue Cross to Shield or vice versa?


I’ve asked Covered CA a dozen times about affiliate links, have those been forwarded to you?




Email us [email protected] if you want the screen shots or just wait till my comments are posted on Covered CA’s Board Meeting website.   Also see the analysis of the Board Meeting at Insure Me

One comment on “Public Comment to Covered CA Board Meeting 10.8.2015

  1. Steve . . .

    I’m right there with you. And LA County DPSS is the worst offender among all 58 county Medi-Cal agencies.

    I just spent 40 minutes on the phone on Tuesday this week in a telephonic Medi-Cal determination appeal, in which my health insurance client’s CoveredCA application, without her knowledge or consent (or mine as her authorized representative), was altered in the CalHEERS system by an unidentified LA Co DPSS employee to the extent that it was completely locked up, and the DPSS employee then went on to create an entirely new application — WITHOUT ANYONE’S CONSENT — that showed annual income of $900, forcing my client off her insurance plan and onto Medi-Cal, despite the FACT that when LA Co DPSS first reviewed the application I submitted in Nov 2014 it determined that she was NOT eligible for Medi-Cal.

    The client only discovered her termination from health insurance when she showed up for a doctor’s appointment in May and was told her insurance was cancelled. A couple of weeks later is when she first received any correspondence from LA Co DPSS. Of course, that was entirely useless. It directed her to contact her eligibility worker at a phone number that was never answered at any time during normal work hours. In lieu of that, the letter told her she could come to the office to schedule an appointment — except that the office address was a PO Box. No way to visit that.

    After a month of trying to contact DPSS, the client turned to me for additional help,and I was able to file the appeal directly with CA DSS in early July. But it took three months for the hearing to be scheduled. In advance of that I spent nearly two weeks trying to contact the LA Co DPSS appeals person, Rhonda Pleasant, who eventually returned my call, only to tell me that, “Yes, we know she’s probably not eligible for Medi-Cal, but we prefer to be ordered by the (Administrative Law) Judge to take her off Medi-Cal.” At the hearing, Ms. Pleasant had to admit that she failed to send me an advance copy of LA Co DPSS’ response to the appeal, as require by law.

    So, the upshot of the hearing is that LA Co DPSS is supposed go into the CalHEERS system to release my client, effective October 31, early enough for me to reenroll her in a health plan with an effective date of November 1. But I have no confidence this will happen as ordered.

    As a result, I have literally been robbed of at least six months’ commissions on this one account by LA Co DPSS, not to mention the hours I spent making phone calls to CoveredCA back in May and August, and to LA Co DPSS in June, July, and August, and the hours spent with the client, either in person, by phone, text, or email. And even though the alteration of the health insurance application is a specified misdemeanor in the Insurance Code, I’m sure I have no recourse.

    I don’t necessarily mind assisting folks apply for Medi-Cal, because that is part of our public responsibility as licensed agents, and most of them are appreciative of my efforts. But I will certainly agree that it is entirely unfair not to compensate us to some extent for doing so. CoveredCA knows this, DHCS knows this, the legislature knows this, and yet, apparently, no one cares. Especially CAHU, which is why I could care less about that organization and its “advocacy” on behalf of California health insurance agents.


    Life & Disability Insurance Analyst
    California Insurance License #0596197

    Pomona, CA 91766

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