What is the California Senate Bill (SB) 260?

Navigating the health insurance system can be an overwhelming and confusing experience for many people. There are terms you’ve never heard of and constant changes are taking place. This can easily make you feel lost. St. Louise Resource Services works to relieve the stress of navigating the health insurance system for you. We’re here to guide and support you as you access health care benefits and social services.

Among the many changes taking effect in 2023 that may affect your health care benefits is SB 260. What is SB 260 and how might this affect you?

What is SB 260?

Senate Bill No. 260, also known as SB 260, is an amendment to an existing California state law regarding health care coverage. The existing law requires health plans and insurers to send notices about the availability of Medi-Cal and Covered California to consumers who lose their coverage for any reason.

SB 260 is an addition to that law in order to minimize any gaps in coverage for consumers. Specifically, SB 260 would require health plans and insurers to transfer a list of people who lose coverage to Covered California. Covered California will then reach out to consumers directly to inform them of potential financial assistance and explain available coverage options.

SB 260 also ensures that people who no longer meet the qualifications for Medi-Cal due to income can seamlessly enroll in Covered California without gaps. SB 260 would require Covered California to auto-assign these enrollees into the lowest Silver plan option in Covered California and activate coverage when the initial premium payment is received.

This ultimately means that if an individual no longer qualifies to Medi-Cal due to income and gets transferred over to Covered California, Covered California simply contacts the individuals with a health plan ready for them to select. If they want a different plan, they choose another plan on their own or with a Certified Enrollment Counselor. If no type of action is taken after receiving the notice, then the individual will not be covered. 

How does this affect my healthcare benefits?

If you are someone who is covered by Medi-Cal, these changes may affect you if you were ever to make more than the income limit for Medi-Cal.

Those who make more than the income limit, and hold a citizenship or legal residency status, qualify for health insurance through Covered California. Under SB 260, Covered California would contact you and notify you of your options to remain insured.

SB 260 would ensure that you obtain health coverage in a quick and efficient manner, so you have no gaps in coverage.

How can StLRS assist you with the SB 260 and your Medi-Cal?

It’s important to always update your contact information with Medi-Cal. This will ensure that their offices can get in touch with you if there’s been a change in your coverage or if they need additional information from you.

Our friendly and bilingual Family Service Coordinators can assist you with reporting changes and submitted necessary documentation to your Medi-Cal cases. We also have Certified Enrollment Counselors who are properly trained to assist you with Covered California enrollment, renewals, and Shop and Compare.

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