The CoveredCa FPL charts for 2018 and 2019 reflect the result accurately. The discrepancy
in the 266% column first appeared in 2020 and has grown every year since then. Since the
result in the 266% column is higher than the accurate result, then the "bar is raised" so t
so incomes that should qualify for insurance appear to qualify for Medi-Cal. The quoting
algorithm generates a similar erroneous result.
2019 - 266% of FPL shows accurate calculation
2020 - 266% of FPL is not represented accurately
2021 - 266% of FPL is not represented accurately
2022 - 266% of FPL is not represented accurately
2023 - 266% of FPL is not represented accurately
2024 - 266% of FPL is not represented accurately
2025 - 266% of FPL is not represented accurately
Why it matters - Damages
Families whose children should have been covered by insurance as part of the family at no additional cost
have been forced to pay full price to keep their children's doctors. Child premiums for Silver plans run
$3000 to $5000 per year which, which should have been covered at no cost under the family income formula.
Why it matters - Rights Violations
Families who could not afford private insurance are forced to give up existing health care providers for
their children with ongoing treatment and switch to Medi-Cal.
Why it matters - Public Disclosure
Concealment of their rate calculation algorithm precludes independent parties from validating their quotes.
Said algorithm is provably inaccurate.
Why it matters - Fraud
Since the same error appears in PDFs for public disclosure and the quoting algorithm, it is reasonable to
conclude that collusion is involved. In sample quotes generated from the Shop and Compare tool, results
computed from the algorithm exceed the already inaccurate calculations posted on the PDF. That suggests
that the totals displayed in the PDF are not derived from the quoting algorithm but from a separate
process, the two having been manually coordinated.