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Agent Compensation in Covered California

Individual Exchange Covered California Compensation

Agents will be compensated for facilitating enrollments in the Covered Californiaindividual exchange for both subsidized and non-subsidized enrollees. Agents will not be compensated for enrollments in Medi-Cal. Compensation rates will be the same as outside the Exchange. Commissions will paid by the carriers directly to the agents.

SHOP Exchange Compensation

Agents will be the primary sales channel for the Covered California SHOP. Unlike the individual exchange, the SHOP will pay agents directly. The Covered California will likely match carrier commissions although they are still considering the option to set their own commission rates which would also be based on the prevailing commissions. In either case, the Exchange supports a level playing field among the carriers and the SHOP program.

Required Training

The Covered California health insurance marketplace will develop curriculum and training that are specific to agents. Agents will be receive specific training on eligibility for subsidies and Covered California coverage including Medi-Cal before being permitted to enroll consumers in Qualified Health Plans. Once training requirements are met, trained agents will be certified by the Exchange.

Agents and Navigators

Agents cannot be paid as Navigators. Covered California will make certain that agents are not both paid by plans as agents and by the Exchange as Navigators. Carriers will work with Covered California to develop a continually updated list of Exchange-eligible agents to prevent accidental dual compensation.

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