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California Health Insurance Get The Help and Benefits You Deserve Today
David Fluker Insurance Services
Gilroy, California - Serving California Residents Since 1995
California License 0B58920
David J. Fluker, Licensed Life & Health Insurance Agent. California State License # 0B58920
Authorized Independent Agent Serving California Residents.
Web Site ©1999-2016 by David Fluker - David Fluker Insurance Services. All Rights Reserved.
Welcome to my web site. I am an independent insurance broker residing in Gilroy, California. My agency is a web-based agency which allows me to work with people all over California as opposed to just a few local communities.
I have been serving the insurance needs of California residents since 1995. As an independent agent, I work for myself and on your behalf, not for an insurance company. I am available to help you understand the insurance policies available, find the policy that makes the most sense for your situation, help you apply for coverage and provide service on your policy. You can always call me instead of an insurance company for questions, issues or changes in your life or coverage. There is no fee or cost to you for my services. Scroll down for Frequently Asked Questions.
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Online contact and registration forms from Wufoo
This web site is owned and maintained by David Fluker Insurance Services, which is solely responsible for it's content. The site is not maintained by nor affiliated with Covered California, and Covered California bears no responsibility for it's content. The e-mail addresses and telephone numbers that appear throughout the site belong to David Fluker Insurance Services and cannot be used to contact Covered California.
As a Covered California Certified Insurance Agent, I can help you enroll on the exchange for health coverage that may include Premium Tax Credits, Cost Sharing Reductions, or both. I can help set up your account over the phone or from a completed paper application. As your appointed agent, I can monitor your Covered California enrollment and, at your request, report changes to the exchange on your behalf.
The instant online quoting service provides instant online quotes from multiple insurance companies for Individual & Family coverage on and off exchange as well as Medicare Supplements. All information entered for instant quotes is only seen by me and is never shared, sold or provided to any third party for any reason.
I hope that you find my web site helpful, useful and able to meet your needs in terms of information. I look forward to hearing from you and helping you find the right health insurance coverage plan to meet your needs.
Thank you for visiting and let me know if you have any comments or suggestions on how to improve my site.
FREQUENTLY ASKED QUESTIONS
I missed the open enrollment period. Will I have to wait until next year to obtain compliant health coverage?
Possibly, however there are a variety of circumstances and qualifying life events that could allow you to purchase coverage through Covered California outside of the open enrollment period. Contact me and we can investigate any options which might be available in your case.
What happens if I don't have an ObamaCare compliant plan or any health plan this year?
Failure to maintain compliant health coverage (coverage that meets the essential benefits rules) for 90 or more days during the year may result in a tax penalty by the IRS. For 2016, that penalty will be 2.5% income for each adult on the return who did not maintain compliant coverage, and 1.25% for each child who did not maintain compliant coverage. Affordable coverage rules may also come into play if the lowest cost Bronze plan available is more than about 8% of individual/family income (including any subsidy) and may relieve any potential tax penalty.
When is the next annual Open Enrollment Period?
For 2017 enrollments, the annual Open Enrollment Period (OEP) will be from November 1, 2016 to January 31, 2017. Plan start dates will be January 1, 2017 and after depending on enrollment date.
What kinds of health coverage are compliant under the Affordable Care Act?
The following are considered compliant health coverage under the ACA:
Individual/Family Health Insurance that is purchased on or off of Covered California in tiers Bronze, Silver, Gold or Platinum
Individual/Family Grandfathered Health Insurance plans purchased prior to March of 2010
Student Health Plans
Employer-Sponsored Group Health Plans
Medi-Cal (California Medicaid)
Can I purchase a Catastrophic level plan?
Catastrophic level plans are sometimes attractive as they normally have a very low premium. However, they are only available to those under 30 years of age and anyone over 30 who has obtained a valid waiver from HHS (Health and Human Services) due to affordability rules.
The income chart shows I should get an Advanced Premium Tax Credit subsidy on my Covered California health plan. But the enrollment results show I don't get a subsidy. Why?
The income chart provided by Covered California is a general guideline. Each situation is different. While the chart may show that your income should qualify for APTC, the enrollment system calculates your income against the SLCSP (Second Lowest Cost Silver Plan) available in your rating area. This is known as the "benchmark" plan. If the cost of the Benchmark Plan is very low, then it will effect your eligibility for APTC subsidy. .
How many days Grace Period do I get to pay my ObamaCare premiums?
If you purchased your plan on-exchange (Covered California) and receive a subsidy, you have 90 days grace period. All other circumstances you have a 30 days grace period. All plans purchased off-exchange (private market) have 30 days grace period.
Are the health plans sold off-exchange in the private market different or better than the plans sold on Covered California?
In California generally the carriers selling plans on Covered California are simply duplicating those plans off-exchange in the private market as required by the law. All must meet the same compliance standard and metal tiers (Bronze, Silver, Gold, Platinum) and must cover the essential benefits mandated in the affordable care act. Some carriers will add a few "extra" plans in the private market they do not sell on Covered California. Generally these are Bronze or Silver level plans. Also, occasionally an insurance company may opt out of Covered California and only sell plans off-exchange in the private market. These plans still must meet compliance standards.
Does my doctor have to take my Covered California health insurance?
No. Medical providers are free to accept or deny any health insurance plan depending on their contracts with the insurance companies. It is important to verify that your provider is in the network of the health plan you are considering if you wish to continue to see your doctor.
What happens if I get more premium subsidy that I should have?
Depending on your final annual income, you may be required to pay back some or all of the subsidy on your taxes. This is why Covered California requires you to report any changes of income +/- 10% within 30 days. That way they can adjust your subsidy during the plan year to help avoid this issue.
If I have an event that qualifies for a Special Election Period (SEP) like loss of employer coverage, how long do I have to enroll in Covered California?
You have 60 days from the date of the qualifying event.
What is a Cost Sharing Subsidy? Is it different from the Tax Credit Subsidy?
A cost sharing subsidy is a different type of subsidy available to those who qualify. Generally incomes between 139%-213% of Federal Poverty Level (FPL) may qualify for both the tax credit subsidy and cost sharing subsidy. The tax credit (when advanced) helps pay premium costs. The cost sharing subsidy reduces the amounts of things like deductibles, co-pays and out of pocket annual expenses.