Covered California provides a 95-day Reasonable Opportunity Period

Covered California

Apr 8, 2022

95-day Reasonable Opportunity Period

Covered California provides a 95-day Reasonable Opportunity Period (ROP) during which a conditionally eligible consumer can submit verification documents to clear inconsistencies in their application. If the consumer does not resolve the inconsistency by providing the required documentation by the end the ROP, Covered California may terminate Advanced Premium Tax Credit (APTC) and Cost-Sharing Reductions (CSR), or plan coverage. However, during the COVID-19 pandemic, which may have caused difficulties for the consumer to obtain documentation, Covered California temporarily provided extended time and paused any actions that would have otherwise taken place due to the consumer not resolving the inconsistency. At this time, though, no further extensions are planned, and enrolled consumers will need to start providing the requested documentation to resolve inconsistencies within the 95-day ROP – failure to do so may result in termination of financial assistance or plan coverage. A Portal Alert for Notice ID “NOD03” will appear in your secure mailbox in CalHEERS for all affected consumers that need to be contacted or assisted with taking the required action(s). The corresponding notice can also be found in the consumer’s case titled “Warning – Documents Needed“.