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Covered California News & Commentary

Topics of interest to both consumers and agents related to Covered California and the ACA biased in favor of the successful implementation of the Exchange and deliberately apolitical.


August 2013 Archives


Covered California Tests TV Ads

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Beginning Labor Day, television ads will hit the airwaves in three test markets: San Diego, Sacramento and Chico/Redding. By October, other television markets will be added. The phased approach will allow Covered California to test the ads and fine-tune its customer service process.

“With a six-month open-enrollment period from October through March 2014, Covered California’s media team recommended we build our campaign to promote enrollment with an eye toward the beginning coverage date of Jan. 1, 2014,” Peter Lee said. “We’ve done the background research to make sure we reach people in ways that are specific to their hopes, fears and concerns and that reflect the rich diversity of California’s population.”

From October on, these and other broadcast advertisements will run statewide along with print and radio ads connecting with specific ethnic communities, as well as languages beyond English and Spanish. The ads will expand awareness of the health benefit exchange, of how the process for shopping and signing up for insurance coverage works, and of how people can find out whether they qualify for financial assistance.

Covered California has budgeted $45 million for the initial push of paid media through March 2014 and plans to spend another $35 million from April to December 2014. The funds come from a one-time federal grant.


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Covered California previously said they would implement a new quality rating system for health insurers this fall, two years earlier than required by the ACA. Now it looks like that may slip by a year. According to Peter Lee, currently available insurer data are out of date and only cover plans that differ significantly from those that will be offered through the Exchange. Covered California instead is determining strategies for quickly collecting performance data during the first year of the exchange and creating its own ratings.

The Exchange may have underestimated the demand for a rating system. You only have to look at how Generations “X” and “Y” use ubiquitous online rating applications like Yelp to help make decisions about where to eat and what to buy. While definitely not part of Gen-x or Gen-y, I generally look for some objective comparative data to make purchasing decisions.

Beth Capell of Health Access made a good point “it’s important for consumers to have information on quality in year one, even if it’s not everything we want…If for five bucks more a month I can get a 4-star plan instead of a 2-star plan, I should have that information.”

Better-performing insurance companies under currently available quality data are all HMOs. Kaiser Permanente, Sharp Health Plan and Western Health Advantage jointly wrote that the exchange should prominently display quality ratings. They argued that officials should label plans as “not yet rated” if data are not useful for certain insurers, rather than withholding ratings for all insurers. That would certainly be to their advantage, so insurers who sell PPOs should be looking for ways to help Covered California quickly gather performance data so that they can compete on a level playing field in the ratings game.


SHOP GAs Announced

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Calrement.jpeg Covered California has announced the selection of General Agents (GA) for the SHOP. They are Claremont Insurance Services, Dickerson Employee Benefits, LISI, and Warner Pacific. The most notable omission is Word & Brown, one of California’s premier GAs. Dickerson.jpeg

Choice Administrators’ CaliforniaChoice brand is a private small group exchange owned by Word & Brown. CaliforniaChoice is Covered California’s chief competitor so that could the reason lisi-logo.jpg that Word & Brown was not selected or chose not to participate as a SHOP GA. The public SHOP and private CaliforniaChoice exchanges will feature the following carriers in common: Health Net, Kaiser, Sharp and Western Health. However, CaliforniaChoice will include both Aetna and Anthem Blue Cross exclusively; while SHOP will include Chinese Community Health Plan and Blue Shield of California exclusively.
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Covered California opted to exclude all GAs from the individual exchange, a market that has not been penetrated to any great degree by GAs in California. In light of the changes brought on by the ACA, Word and Brown has expanded its Individual Department as well, offering various services to support agents.


SHOP Carriers Announced

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Covered California announced participants for the new Small Group Health Options Program (SHOP) marketplace. Six health insurance plans will be made available. The participants will include:

  • Blue Shield of California
  • Chinese Community Health Plan
  • Health Net
  • Kaiser Permanente
  • Sharp Health Plan
  • Western Health Advantage

The plans, a mix of HMOs and PPOs, will be sold through licensed agents who are trained and certified by Covered California.

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