Covered California Certified Enroller Practice Exam

What occurs if an enrollee does not pay the outstanding premium balances after exhausting their grace period?

1. They are fined

2. Coverage will be terminated retroactively

3. They lose the ability to reapply

4. They can request additional time

The correct answer is: Coverage will be terminated retroactively

If an enrollee does not pay the outstanding premium balances after exhausting their grace period, the correct consequence is that coverage will be terminated retroactively. This means that the insurance coverage will end, and the termination will reflect back to the date when the last premium was paid. It's important for enrollees to understand that they are responsible for making timely premium payments to maintain their coverage. The retroactive termination can leave an enrollee without coverage for the time they believed they were insured, which can have serious implications for accessing health services and incurring costs. The other options do not accurately reflect the consequences of non-payment after the grace period: fines are not typically imposed for missed payments in this context, losing the ability to reapply is not an automatic consequence since individuals may still choose to enroll in future periods, and while they may wish for additional time to pay, there’s no guarantee that such requests would be granted once the grace period has lapsed.