Source: https://individuals.healthreformquotes.com/open-enrollment-for-individuals-families/ccr-code-regulations-ca-%C2%A76504-special-enrollment-periods/special-enrollment-triggering-events/move-new-county/?replytocom=101730
Timestamp: 2020-03-31 13:09:17
Document Index: 766407760

Matched Legal Cases: ['§6504', '§155', '§6504', '§155', '§10965', '§ 155', '§ 155', '§ 435', '§ 155']

Permanent Move different county or state Special Enrollment ACA Permanent Move different county or state Special Enrollment ACA
Home › Open Enrollment & Special Enrollment › §6504 Special Enrollment Periods CCR California Code of Regulations › CFR §155.420 Federal Qualifying Events, Triggers › Move – New County, State or Back in USA
When you move to a different county or in from another state or out of country, that gives you a special enrollment period to get or change health insurance. See below for details.
10 CCR California Code of Regulations §6504 Special Enrollment Periods
(9) A qualified individual or enrollee, or his or her dependent, gains access to new QHPs [Qualified Health Plan – Insurance Companies] as a result of a permanent move. into a new county or the USA and new coverage [free quotes] is available you can get new healthcare coverage, without waiting for the annual open enrollment as you qualify for a Special Enrollment (Main Page) as provided by law in:
CFR §155.420 Special enrollment periods
4.2017 Federal
(7) … and—
See also CA Insurance Code §10965.3 (d) (1)
Rating Regions Chart
CA Residency Guidelines Franchise Tax Board Publication # 1031
FAQ’s CMS 1.19.2016
CMS Fact Sheet 5.6.2016 – Must have prior coverage – can’t move just to get coverage.
Email us if you have any questions and we can consult and help you enroll with year around service at no addtional charge. The Insurance Companies pay us to help you.
Blue Shield CALIFORNIA RESIDENCY DEFINITION
A resident of California is an individual who
(a) has not established a permanent residence outside of California and
(b) intends to reside in California for at least 180 days of the year following his or her effective date.
These requirements apply whether an application is submitted during open enrollment (OE), or under a special enrollment period (SEP).
These requirements also apply to newborn babies and their parents. For example, if an expecting couple from New York is on vacation and the baby is born in California, the parents are not considered residents of California and the baby is therefore not eligible for a Blue Shield plan. This is because (for practical reasons) the residency of the parents or legal guardians determines the residency of the infant. These requirements apply whether the parents or legal guardians reside outside of California or outside of the country. Regarding surrogate mothers, unless she is claiming parental rights, her residency is irrelevant to determining the residency of the infant. Instead, the residency of the parents or legal guardians is what is important.
Applicants for Blue Shield coverage under a SEP must verify California residency by submitting two examples of documentation from Blue Shield’s SEP checklist. In addition, applicants seeking coverage under an SEP for a permanent move must have had coverage at some point during the 60 days prior to their moving to California. [Citation Needed]
Required Proofs to show you moved
Blue Shield Simplified Guide for Open Enrollment and Proofs for moving
INFANTS & DEPENDENT CHILDREN (applying solo):
Birth Certificate of the child (Hospital, County, or Government issued only) OR Supportive documentation confirming the adoption or legal guardian status (as applicable)
SCHOOL AGED CHILDREN (applying solo):
School Enrollment Record from the former state California School Enrollment Record (school aged child)
ADULT APPLICANTS & FAMILIES:
Verification of recent address change, such as a utility billing statement, rental agreement, or mortgage statement from the previous residence and at least one of the following:
Current utility billing statement confirming the California address
Notify Your Marketplace about Your New Address
If you moved this year or are planning to move, you probably have a list of organizations to notify about your new address – like the U.S. Postal Service, utility companies and even the IRS. If you get health insurance coverage through Covered CA , you should add one more important notification to your list: your Marketplace.
If you are receiving advance payments of the premium tax credit, it is particularly important that you report changes in circumstances, such as moving to a new address, to the Marketplace. There’s a simple reason. Reporting your move lets the Marketplace update the information used to determine your eligibility for a Marketplace plan, which may in turn affect the appropriate amount of advance payments of the premium tax credit that the government sends to your health insurer.
Reporting the changes promptly will help you get the proper type and amount of financial assistance. Getting too much premium assistance means you may owe additional money or get a smaller refund when you file your taxes. On the other hand, getting too little could mean missing out on monthly premium assistance that you deserve.
the birth or adoption of a child or other changes affecting the composition of your tax family
Temporary Plans – if you missed Open Enrollment – or are traveling
Blue Card Program Blue Cross Platinum specimen Policy
Out of Area Services & Blue Card Program
Eligibilty Page 25
Lawful Prescense
Legal Resident of CA
Health Net Proof of Residency Requirements
Lexis Nexus Review
Reside in Service Area
Our World Wide Coverage Webpage
Travel Policies – Instant Quotes, Benefits, Information and Enrollment
Related Pages in Special and Open Enrollment Section
Exceptions to Individual Mandate
Blue Shield Residency Verification Form
CA 19 Rating Regions
CA Residency Guidelines
FTB # 1031
6 comments on “Move – New County, State or Back in USA”
I’ve been out of the country since April 1 and plan to continue to be out of the country until at least Sept 1.
My healthcare plan is $235.28 per month which seems both expensive and pointless while I’m out of the country since there are very little benefits abroad.
Is it possible to get a retroactive refund on my healthcare for these months and cancel the policy until I’m back in the states?
I doubt that your 6 month stay out of country changes anything with your residency.
What does “intends to reside” mean?
For the purposes of § 155.305(a),”intends to reside” means that an applicant has a present intent to reside where he or she is living, and intends to remain in the Exchange service area where he or she is seeking coverage. Individuals visiting an Exchange service area for a transitory purpose, for example, to attend to a business matter, obtain medical care, or for personal pleasure, do not have a present intent to reside, and do not meet the residency requirement for Marketplace coverage for the Marketplace service area they are visiting.
Certain individuals who cannot indicate intent, such as children, can establish residency without showing intent to reside. For more information, see Questions 1 and 4 as well as 45 C.F.R. § 155.305(a)(3) and 42 C.F.R. § 435.403.
Does an individual’s residence change when he or she leaves an Exchange service area temporarily?
No. An individual who leaves an Exchange service area temporarily with intent to return to the original Exchange service area continues to be a resident for the purposes of Marketplace coverage during the temporary absence.
Permanent Move S E P
How does someone qualify for the Permanent Move S E P to enroll in a QHP or change their enrollment in a QHP?
To qualify for the Permanent Move S E P under 45 C.F.R. § 155.420(d)(7), a QI or his or her dependent must gain access to new QHPs as a result of a permanent move.
For the purposes of qualifying for this S E P, a move is considered permanent if a QI (or his or her dependents) moves and meets the Marketplace residency requirement—as described in Questions 1 and 4 with respect to a new location. An individual who moves to a new location temporarily without an intent to reside there or otherwise meeting the Marketplace residency requirement, including for personal pleasure or to obtain medical care, does not qualify for the Permanent Move S E P.
Similarly, an individual who moves permanently, but does not gain access to new QHPs as a result of the move, would not qualify for the Permanent Move S E P. For example, this may occur if an individual permanently moves within the same apartment building, neighborhood, town, or county, depending on the QHPs offered in the individual’s service area.
https://www.regtap.info/uploads/library/ENR_FAQ_ResidencyPermanentMove_SEP_5CR_011916.pdf
So, if you cancel coverage, I don’t see how you would qualify to get coverage when you come back to USA.
There are travel policies that you can get.
Here’s our page on coverage out of country. Do NOT take our summary as Gospel. Read your Evidence of Coverage!
$235/month sounds very low. Must be a bronze plan for a young person. Get quotes here.
Don’t forget, if you get hurt, sick, ill, kidney disease, cancer, etc. outside the USA, you can always come back and get follow up treatment here. How much does chronic care treatment cost?
Blue Shield Proofs Required:
I lived overseas last year and this year, I was in the US in January for 3 weeks, left and came back last month and moved back
Sounds good to me, we just need to have the proofs that you are a new resident in CA. The proofs are listed above and on the Blue Shield simplified guide page 5 # 12. Email or bring to our meeting as many as you can get.
I’m a US Citizen along with my wife and children. We have been living in China the past two years.
1. How do we get Health Coverage when we come back to the USA?
2. How do we get a 1095 A or B so we can file our taxes?
3. What’s this you said on the phone about an exemption?
1. When you will come back, if it’s not Open Enrollment, you would qualify for a Special Enrollment CFR 155.420 (d) (7) as it’s a move to a new region. Get FREE no obligation quotes here.
2. You don’t need a 1095 A, as your exempt from the mandate and not being in the USA – Service Area, you wouldn’t qualify to buy coverage.
3. File form 8965 to show that you are exempt from the mandate. Links and instructions are on this page.
Citizens living abroad and certain noncitizens—
A U.S. citizen who was a bona fide resident of a foreign country or countries for an uninterrupted period that includes an entire tax year; Learn More – 8965 Instructions