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Covered California Service Centers

The California Exchange must create a Service Center or call center that will become the main channel for millions of Californians to obtain their health care coverage starting in 2014. In addition to providing a one-stop marketplace for qualified health plans (QFPs), the Exchange is the exclusive source of premium subsidies and cost-sharing reductions. As such The Exchange Service Center will be required to screen individuals for subsidy eligibility or eligibility for for Medi-Cal.

Centralized Multi-Site Service Centers

Covered California has selected a multi-site model. The main center will be in Rancho Cordova (500 jobs), the other 2 will be in Contra Costa (300 jobs), and Fresno (200 jobs). This model provides for the centralized distribution of calls out to each individual service agent who may be located at a central facility in Rancho Cordova or located in Contra Costa of Fresno and who logs on to the central system to accept calls. This direct distribution of calls across all agents means that all callers will be handled through a managed queue, and all callers would receive the same level of service relative to the type of call. The statewide call center will also field calls from customers who have overlapping program needs with non-health programs. These calls will be transferred to the appropriate county, state or regulatory agency.

Service Center Challenges

Service Center Agents must meet the needs of a diverse customer base with a wide range of needs including: enrolled customers, individual applicants, agents, navigators, providers, health plan issuers, and employers. The Service Center must be open to access through a variety of channels, including: phone, web, e-mail, fax, mail, and brick and mortar. Finally, the Service Center must provide native language support.

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