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California Health Insurance   Get The Help and Benefits You Deserve Today
800-509-0659
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 agent residing in Gilroy, California.  My agency is a web-based agency which allows me to work with people all over California as opposed to only 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.
Need Help? Have A Question?
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.
Covered California Certified Agent
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 also have instant online quoting for small employer groups, short-term interim health coverage, international travel medical health coverage, dental & vision plans and term life insurance coverage.

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 BUY HEALTH INSURANCE?

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 8.13% of individual/family MAGI 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
*  Medicare
*  Medi-Cal (California Medicaid)
*  TRICARE
*  VA

CAN I PURCHASE A CATASTROPHIC LEVEL HEALTH 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 RECEIVE AN PREMIUM TAX CREDIT SUBSIDY FOR 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 HAVE TO PAY MY OBAMACARE PREMIUMS?  I'VE HEARD 30 AND 90 DAYS.

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 ACCEPT 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 THAN 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 SPECIAL ENROLLMENT 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. 


Contact Information
David Fluker Insurance Services
800-509-0659
408-847-6139
767 Maria Way
Gilroy, California 95020

E-Mail info@davefluker.com
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   2017 OBAMACARE OPEN ENROLLMENT BEGINS ON NOVEMBER 1st  
Immigration Status and Eligibility: What You Need to Know


Who is Eligible for Covered California?

All U.S. citizens, U.S. nationals and noncitizens lawfully present in California may apply for health care through Covered California.

Who is Not Eligible for Covered California?

If you are not lawfully present in California, you are not eligible for a Covered California plan. However, you can still apply through Covered California to find out if you are eligible for Medi-Cal or to find coverage for family members who are lawfully present. For example,
if your child is a U.S. citizen, you can apply on his or her behalf. You only need to provide information on immigrant status for family members applying for coverage

What if I am from a Mixed Immigration Status Family?

If your family includes some noncitizens that are not lawfully present, you can still apply for health care through Covered California.
When applying, remember that family members who are not lawfully present are not eligible for Covered California health plans, but may be eligible for Medi-Cal.

Your Immigration Status Will Be Kept Confidential

All immigration information provided to Covered California will be kept private and secure. It will not be shared with or used by any immigration agency to enforce immigration laws.

Signing Up for Covered California Will Not Affect Your Immigrant Status

In general, receiving help to pay for a Covered California health plan or receiving coverage through Medi-Cal will not affect immigration status or the chances of becoming a citizen or lawful permanent resident of the U.S.


Note: Rules for not lawfully present individuals & families may be changing in California under SB 10.  I will post updates here and on my Facebook page so be sure to follow me on Facebook.  Currently Valley Health Plan in Santa Clara County allows off-exchange enrollments with no citizenship or lawfully present status requirements.


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