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Covered California and Obamacare related questions from consumers, employers and agents are answered by Phil Daigle with the best information available at the time. Archived entries may no longer be accurate as the Covered California and Obamacare knowledge-base is evolving quickly. TO REQUEST A PERSONAL RESPONSE INCLUDE EMAIL ADDRESS.

California Health Benefit Exchange vs Mass Connector

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Question: The Massachusetts Connector Exchange has had many problems, not the least of which is increasing rates for small businesses. What's different about the California Health Benefit Exchange?

Answer: First, the Connector has separate exchanges for those receiving subsidies ( up to 300% FPL in MA) and unsubsidized participants. It's actually two different programs. In the California Health Benefit Exchange all individuals will enter one door and be select from the same offering of health plans regardless of financial status. In addition, all Californians, both inside the exchange and across the outside commercial market are in the same risk pool. What that means to the California health care shopper, is that premium calculations within each market - individual and small group - are based on a carrier's combined risk for it members both inside and outside of the Exchange. This will help to prevent adverse selection which plagued the Collector early on.

There are other differences like:
Payment of subsidies go directly from the government to the carriers, not through the exchange, as is the case with the Collector, is a big operational difference, and
Standardized plan offerings both inside and outside the exchange for both the individual and small group markets should help competition and lower prices as a result.

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