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California Health Insurance Plans and Rates

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Health Plan Issuers

The Covered California health insurance marketplace must partner with California’s Health Plan Issuers to meet its enrollment goals. The cooperation of the carriers will be essential to Covered California success. As Covered California begins enrollment activities starting in October, 2013 and into its first years of operations in 2014 and beyond, the investment that health plans devote to marketing and retention will play a critical role in creating consumer awareness of thttps://www.cahba.com/exchange/covered-california.htm.


Covered California will likely need a high level of commitment from carriers, particularly in the early days. A key consideration in working with carriers to market Covered California is the ACA requirement for consumers to receive broad information on all available options. Carriers can be expected to balk at contributing marketing resources that could benefit their competitors Covered California.

There is also a need for the Covered California to ensure that marketing and enrollment efforts undertaken by issuers is fair and balanced manner. Covered California will need to develop processes that monitor and review those activities.

Application and Enrollment

Carrier enrollment assistance in the Exchange will require policies and procedures regarding how to connect health plan staff to Covered California’s information systems. Privacy issues will be a key consideration, particularly for individuals who may be eligible for subsidies. Covered California may provide the ability for health plan staff to access the Exchange’s online enrollment system to facilitate completion of the enrollment process and provide a seamless experience for the member.


An estimated 615,000 individuals or approximately one-third of all Californians who are currently covered by individual health insurance will be eligible for subsidies through the Covered California. Among the issues to be addressed is informing individuals who are currently enrolled with issuers that they now have new options available, including receiving premium subsidies if they are income-eligible. Because these individuals have existing relationships with issuers, the situation is possibly more complex than the treatment of new enrollees. However, it is equally important that these individuals understand their full range of options.

Health plan issuers could be required to provide information to their current enrollees at the time their current policy comes up for renewal. At minimum, the information provided to current enrollees should identify where additional information is available and the types of information they may find. However, it is likely that many currently-insured individuals will prefer to retain their current coverage, and those who are satisfied with that coverage should be able to retain it with minimum action on their part.

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