Health and Wellness inspired by ‘Pokémon Go’

You could say I’ve worked on wellness my entire life: for myself, for my family, and for the world at large mainly for my clients and colleagues that I love. I went into the Healthcare Industry with the whole-hearted intention of helping others stay well and teaching life practices to facilitate this.

Working on wellness is truly a lifelong pursuit. I personally know how difficult it is to get people to change comfortable habits that they have perfected for many years. But while people don’t generally want to change, sometimes it is necessary. In some cases, the decision to choose wellness and throw out old habits can literally make the difference between life and death.

We now think of technology and devices as things that promote health and wellness in our lives. But it was still a surprise for me to encounter the new Pokémon app and to observe how it instantaneously changed people’s exercise habits worldwide. I was amazed to discover how the Pokémon app pushed people out of their comfort zones and forced them to develop new habits of walking and being outside, all while being fun and engaging. I was startled to see how many people play this new game called ~ Pokémon.

Around the time that the Pokémon app emerged, I found myself on a beautiful beach playing the game with my 21-year old son. It was right before he was going off to college.

My kids and I were together on a final, end-of-summer getaway in sparkling La Jolla, CA. With our busy schedule we only had three days of vacation together and were looking forward to wrapping up summer and going back to our new realities.  For me, of course, the end of summer meant that the 4th Open Enrollment for the ACA/Obama Care was right around the corner.

My kids had spent most of their summer immersed in nature at Camp, where my son worked as an advisor and my daughter as a camp counselor. They love that camp and consider it a second home, in spite of being completely cut off from technology while there. This actually caused them to really stay active, enjoy nature. They always look, taller, happier, and healthie when they return from camp. Sometimes, I barely recognize them.   

We decided on La Jolla for our three-day jaunt because the Insurance License Board Test was being offered there at that time. We could spend quality time together as a family and also get the licensing exam under their belts. Yes, my kids are both are getting certified ~

All Stories

1095-A Form Information

What is Form 1095-A?

The Affordable Care Act, also known as Obamacare, requires most U.S. residents to have health insurance.  It also offers a tax break, the Premium Tax Credit commonly known as APTC to help offset the costs of health coverage. You should receive a copy of Form 1095-A if you bought your plan from a state exchange.  If you bought your plan direct from a carrier, you’ll receive a Form 1095-B.  These forms provide information needed to claim the tax credit on your tax return.

Form 1095-A Health Insurance Marketplace Statement 

If enrolled in a health plan through the Health Insurance Marketplace in 2015 you will receive a Form 1095-A, Health Insurance Marketplace Statement from the Marketplace, not the IRS.

The Form 1095-A will tell you the dates of coverage, and the total amount of monthly premiums for your insurance plan.

If you set-up a account, Covered CA or Washington Healthplanfinder account, you can get a copy of the Form 1095-A, Health Insurance Marketplace Statement online.

*** you may receive multiple 1095-A forms for each policy ID

More information is available for Marketplace members at the following website:

Form 1095-A Disputes

If you dispute the coverage information provided from their 1095-A form(s) here is what you need to do:

The member will need to file a HICS Case.

  • FL, MI, NM, OH, TX, UT, and WI - the Member needs to contact the Marketplace Exchange directly.
  • CA - The member will contact Covered CA.
  • WA - The member will contact WA Healthplanfinder.

Once the HICS case is reviewed, a determination will be made.

The Marketplace is responsible for consumer outreach and the generation of a corrected 1095-A form back to the you.

Good Luck!

Special Enrollment

Consumers who experience a qualifying life event can enroll in a Covered California health insurance plan even outside of the open-enrollment period. This is called special enrollment. Below is a list of common qualifying life events for special enrollment that apply year-round.


  • Losing health coverage. For example, consumers are no longer eligible for Medi-Cal, or they lose health coverage through their job.
  • Income changes so much that a consumer becomes newly eligible or ineligible for help paying for their insurance. For example, if a consumer is already getting help paying for their insurance premium, and their income goes down, they may be able to get extra help.
  • Turning 26 years old and are no longer eligible to stay on your parents’ plan.
  • Change in place of residency, which allows a consumer to gain access to new Covered California health insurance plans. This includes moving to California from another state. This also applies to individuals who are released from jail or prison.
  • Having a child or adopting a child, receiving a child into foster care, or placing a child in adoption or in a foster home.
  • Getting married or entering into a domestic partnership.
  • Becoming citizens, national or lawfully present individuals. This event applies only to people who were not previously citizens, nationals or lawfully present.
  • Being a member of a federally recognized American Indian or Alaska Native tribe. A consumer in this category may enroll in health insurance or change health insurance plan once a month even if the open enrollment period is over.
  • Covered California can also determine, on a case-by-case basis, that the consumer experienced an exceptional circumstance, which could allow for a special enrollment period.

These are just some of the more common qualifying life events. Consumers can click here to read more about special enrollment and qualifying life events. To apply for coverage through special enrollment, click here.

Signing Up for Health Insurance or Changing Health Insurance Plans After a Qualifying Life Event

Consumers have 60 days from the date on which the qualifying life event happens to enroll in a Covered California health insurance plan or change their existing Covered California plan. For example, if a consumer has a child on June 1, they have until July 31 to notify Covered California, complete an application for their new child, choose a health plan and pay for it. If they do not get health coverage for their child, they may have to pay a tax penalty.

If 60 days pass and consumers do not sign up for health coverage, they will have to wait until the next open enrollment period.

Keep in mind that consumers can enroll in Medi-Cal at any time. They do not need a special enrollment period to enroll in Medi-Cal. To find out if they are eligible or someone in their family is eligible for Medi-Cal, they should complete the online application by clicking on "Apply".

How to Enroll After a Qualifying Life Event

For many qualifying life events, consumers can enroll online. They can also call the Covered California Service Center at (800) 300-1506. Service Center representatives can answer any questions consumers have about a qualifying life event and can help them enroll in or change health insurance plans. Consumers can also get help from a Covered California Certified Enrollment Counselor, Covered California Certified Insurance Agent, Certified Plan Based Enroller, or county eligibility worker.

If consumers would like help working with Covered California or their health insurance company, contact the Health Consumer Alliance at (888) 804-3536 to get free local assistance. Consumers can also visit the alliance's website at

Avoiding Gaps in Coverage

Consumers will need to plan ahead to avoid gaps in health coverage. It helps to know that in general, the start date for coverage depends on the date of enrollment. If consumers enroll by the 15th day of the month, their coverage will start on the first day of the next month. If consumers enroll after the 15th day of the month, their coverage will start on the first day of the second month. For example, if consumers enroll on June 13, their coverage will start on July 1. If they enroll on June 16, their coverage will start August 1. Consumers can use this rule as a guideline to help plan their new coverage and avoid gaps.

Start Dates for Coverage

For most qualifying life events, the start date for coverage depends on the date that consumers enroll, as discussed above. If consumers enroll by the 15th day of the month, their coverage will start on the first day of the next month. If consumers enroll after the 15th day of the month, their coverage will start on the first day of the second month.

But there are a few exceptions to the start date rule:

  • A consumer loses Medi-Cal coverage, job-based coverage or other coverage, and they use a special enrollment period, their coverage would start on the first day of the next month following plan selection, regardless of when during the month they make their plan selection.
  • A consumer gets married and uses a special enrollment period, their coverage will start on the first day of the next month following their plan selection, regardless of when during the month they make their plan selection.
  • A consumer adopts a child or places a child in adoption or foster care, and they use a special enrollment period, their coverage starts on the date of the birth, the adoption or the placement for adoption or foster care.
  • On a case-by-case basis, Covered California may start consumers’ coverage earlier.

Signing Up for Medi-Cal Coverage

Consumers can sign up for Medi-Cal at any time. They do not need a special enrollment period to sign up for Medi-Cal. To find out if they or someone in their family is eligible for Medi-Cal, complete the online application by clicking on "Apply" or by calling the county human services office.

Canceled Medi-Cal Coverage and Special Enrollment

Losing Medi-Cal coverage is considered a qualifying event that would trigger a special enrollment period for consumers. Other qualifying events include the loss of a job, a marriage or divorce, or the birth of a child. In the case of such an event, consumers would be eligible to enroll within 60 days of that event. During that period they could not be denied coverage by a health plan in Covered California or in the individual market, and would be eligible for the premium assistance that is only available through Covered California.


Originally posted by CoveredCalifornia

The Final 2 Deadlines is Today and 01/31/16!

The third Open Enrollment of Covered California and the Private market is wrapping up!

The final two deadlines are:

1/15/2016 for a start date of 2/01/2016 and

1/31/2016 for a start date of 3/01/2016!

These dates apply to BOTH Covered California policies AND private market policy coverage. Final applications must be submitted by the end of this month to avoid penalties. Now is the time to review your current coverage!

You may be eligible for a subsidy with Covered CA or pay the full cost under a private policy but you need to act quickly.

Beyond 1/31/2016, only people with a Qualifying Event (QE), such as a marriage, divorce, relocating residence, losing employer coverage, or a pregnancy will be able to buy a new policy or make changes to an existing policy. People who qualify for Medi-Cal may enroll at any time. Small or Large Employers may review or get new group coverage throughout the year.

If you unable to enroll before the deadline, it is to your benefit to acquire a Short Term Health Insurance Policy. Such plans are available throughout the year but they are not ACA compatible plans. They do offer comprehensive coverage in case of emergency and better coverage than stay uninsured.

The A+ Insurance team and myself are in the process for rapping up this 3rd Open Enrollment here in CA.

~Spread the love & light ~ this is the only way, blessings from our heart to yours!

Travel Insurance - Travel with a Piece of Mind

While traveling outside the U.S. with your family during the holidays, remember to get medical travel insurance!

Travel with a "Peace of Mind".

When traveling abroad with your family, the last thing you want to worry about is how would you be protected if something unfortunate were to happen to you. HTH Worldwide Travel Medical Insurance is the best solution that is also very affordable.

As a member, you will have access to wonderful physicians in more than 180 countries. Your are also able to see any health care provider of your choice. The plan also covers: office visits, prescription drugs, hospital care, surgery and more.

The Ultimate Cheat Sheet On Health Reform for Small Businesses

This cheat sheet provides a quick reference for small businesses on health reform (aka the Affordable Care Act or ObamaCare).

Small businesses (with fewer than 50 employees) are largely unaffected by health reform. Yet, many small business owners and HR managers feel confused about their requirements under health reform.

The purpose of this article is to provide a quick reference guide for small businesses about how health reform impacts your business and your employees - and how to take advantage of health reform changes to offer more affordable health benefits.

ACA Employer Mandate Delay Will Cost About $12 Billion.

The Washington Post  (7/31, Kliff) reports in its “Wonk blog” blog on a study by the Congressional Budget Office finding that the Administration’s delaying of the employer healthcare coverage mandate under the Affordable Care Act has added $12 billion to the overall cost of the legislation, mostly due to reduced fines that would have been levied against employers for failing to comply

Great News From Medical Travel Insurance Company GeoBlue!

GeoBlue® announced the launch of the Spanish-language version of  This site serves the tens of millions of U.S. citizens and residents who speak Spanish as their first language and who are shopping for the right international health plan and services for their short or long-term trip overseas.

GeoBlue® customers now have Spanish-language access to product information, online purchasing and customer service.  Director of Individual Product Sales for GeoBlue®, Brendan Sharkey said, "We see a log of interest in our international health insurance products in markets such as Chicago, Los Angeles and Miami where Spanish speakers represent a large segment of the population.  With this new service, we are enabling a broader audience to better manage their healthcare overseas."

GeoBlue® health plans provide an array of international medical assistance services that traditional domestic health insurance plans do not.

For more information about
Medical Travel Insurance call our office!

Obamacare and the IRS

The president’s health care law provided for thousands of new IRS agents...but it failed to deal with the shortage of nurses and doctors to actually take care of people.

Governor Brown Signs Legislation to Reform California's Health Insurance Market

SACRAMENTO (May 9, 2013)- Helping put an end to the practice of denying health care coverage to Californians with pre-existing conditions, Governor Edmund G. Brown Jr. yesterday signed legislation to protect consumers and reform California's private health insurance market as required by the federal Patient Protection and Affordable Care Act (ACA).