Medi-Cal Update 2023-11 Loss of Employer-Sponsored Coverage

Loss of Employer-Sponsored Coverage Due to a Strike or Lockout 

Date References Clerical Handbook Revised
11/09/2023 MEDIL 23-48 N/A MC HB Chapter 2 

Background

Individuals engaged in a strike or lockout with their employer may lose their employer-sponsored coverage due to the dispute. The individuals may then apply for Medi-Cal or request Medi-Cal in a family member's case. Eligibility staff must determine whether the individuals qualify for Medi-Cal using the appropriate budgeting method outlined in the MC HB Chapter 7. If the individual does not qualify for Medi-Cal but is eligibile for a Covered California premium assistance plan, they will be eligible for the maximum premium assistance through the Covered California/CalHEERS system. Eligibility staff must assist the individual in completing the report a change process in CalHEERS and select "strike lockout" as the reason for losing coverage.

Changes

Medi-Cal HB Chapter 2 has been updated with the information in this update. 

Implementation

Effective July 1, 2023.

Data Systems

CalHEERS has been programmed with the changes in CalHEERS release 23.7.1.1 (2). 

Forms

JOB AID (JA): Report A Change (July 28, 2023) has been posted to the intranet. 

SS

BS Supervisorrvisor

Please share this information with your staff immediately upon receipt. 


Angela Shing, Director

Department of Employment & Benefits Services

Contact Person: Manuel Garcia, SSA BPIS, (408) 755-7540