The vision of the California Health Benefit Exchange is to improve the health of all Californians by assuring their access to affordable, high quality care. The mission of the California Health Benefit Exchange is to increase the number of insured Californians, improve health care quality, lower costs, and reduce health disparities through an innovative, competitive marketplace that empowers consumers to choose the health plan and providers that give them the best value.
The California Health Benefit Exchange is guided by six primary values.
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Visit Covered California's new consumer-friendly homepage at www.CoveredCA.com.
NEW: Covered California Announces Local Community Grants (Press Kit)
NEW: LATEST NEWS - Final Staff Recommendation for Qualified Health Plan Model Contract Between Contractor and Covered California, The California Health Benefit Exchange - May 6, 2013
NEW: COVERED CA MEDIA ADVISORY: Covered CA to hold Board Meeting in dual locations (Sacramento and Los Angeles)
NEW: COVERED CA - Riverside, CA Town Hall Media Advisory
NEW: QHP Model Contract v4 Redline, Attachments, and Presentation Slides
NEW: COVERED CA - Rancho Cordova Call Center Press Release
NEW: COVERED CA - Fresno Call Center Press Release
NEW: COVERED CA - Pinnacle Selected to Administer Small Business Program
NEW: Webinar - Update on the CalHEERS Project and Usability Approach
NEW: Second Draft Qualified Health Plan Model Contract
NEW: Milliman Report - Factors Affecting Individual Premiums
NEW: COVERED CA - Actuarial Report Shows Potential Impact on Premiums
Factors Affecting Individual Premiums - FAQ
Factors Affecting Individual Premiums - Key Points Chart
Pediatric Dental Emergency Regulation Filing 3-22-2013
QHP Standard Benefit Plan Design Emergency Regulation Filing 3-22-2013
PRESS RELEASE: Covered California Partners with Contra Costa County to Operate Customer Call Center
PRESS RELEASE: Kathleen Keeshen Named General Counsel of Covered California
PRESS RELEASE: Bridge Plans Improve Continuity & Affordability of Care
Health Benefit Exchange Form 801 Gift Report
NOTICE TO SUPPLEMENTAL DENTAL AND VISION BIDDERS
NOTICE to Pediatric Standalone Dental Plan (Ped EHB only) Bidders
Covered California Announces Standard Benefit Plans for Consumers
Covered California Announces Senior Leadership Appointment - Jeffrey Rideout, MD, Senior Medical Advisor
Covered California Receives the First E. Richard Brown Award from Insure the Uninsured Project
The next Board Meeting will be on May 23, 2013.
Additional Board Meeting Information
NEW: May 14,2013: HBEX17 - General Agents
NEW: April 30, 2013: HBEX23 - Marketing Recruitment Support
NEW: April 25, 2013: QHP Model Contract New Provisions and Policies Ready for Comments from Stakeholder
NEW: April 22, 2013: HBEX22 - Notice of Intent to Award
NEW: April 17, 2013: HBEX20 - Notice of Intent to Award
NEW: April 12, 2013: HBEX21 - Notice of Intent to Award
NEW: April 12, 2013: Redline of Attachments to QHP Model Contract
NEW: April 9, 2013: HBEX24: Project Management Oversight, Small Business Health Options Program (SHOP)
NEW: April 5, 2013: HBEX19 - Addendum 2
NEW: April 5, 2013: HBEX18 - Notice of Intent to Award
NEW: April 5, 2013: HBEX22: Facility Readiness Support
April 4, 2013: Second Draft Qualified Health Plan Model Contract
March 25, 2013: HBEX19: Final Responses to Questions Received by 3/15/2013
March 19, 2013: HBEX20 - Business Process Management Support
March 12, 2013: HBEX19 - Request for Offer for Health Care Training
February 27, 2013: HBEX18 - Tribal Community Mobilization RFP
January 28, 2013: HBEX11 - Notice of Intent to Award
January 18, 2013: HBEX 12 - County Service Center Notice of Intent to Award
January 8, 2013: HBEX 16 - Exchange Vision Benefits Solicitation
January 8, 2013: HBEX 15 - Exchange Dental Benefits Solicitation
January 4, 2013: HBEX12 Request for Offer - Notification 2 (Notice of Intent to Award Date)
California was the first state in the nation to enact legislation creating a health benefit exchange under federal health care reform. Enabling legislation can be found here: Chapter 655, Statutes of 2010 (Perez) and Chapter 659, Statutes of 2010 (Alquist).
Starting in 2014, the California Health Benefit Exchange will make it easier for individuals and small businesses to compare plans and buy health insurance on the private market.
The Exchange will enhance competition and provide the same advantages available to large employer groups by organizing the private insurance market, including a more stable risk pool, greater purchasing power, more competition among insurers and detailed information regarding about the price, quality and service of health coverage.
The Exchange will support consumer choice by making comprehensive information about health plans available in an objective, easy-to-understand format, including:
- a website that provides standardized comparison information on qualified health plan benefit plans/options
- a calculator for applicants to compare costs across plan options
- a web-based eligibility portal to help link individuals to health coverage options available to them
- a toll-free consumer assistance hotline
Individuals and small employers meeting federal citizenship requirements may enroll in the exchange. Federal health care reform makes tax credits and subsidies available in 2014 to Californians with incomes between 133 and 400 percent of the federal poverty level (in 2010, approximately $29,000 to $88,000 for a family of four). The Exchange will ensure that Californians eligible for federally-authorized tax credits and subsidies get those benefits. Small employers with less than 50 employees may also purchase coverage through the exchange.
The federal government awarded California $1 million to fund preliminary planning efforts related to the development of an exchange. On August 12, 2011, the California Health Benefit Exchange received a $39 million Level I Exchange Establishment grant that will help the state plan for and design the Exchange and will be used to recruit necessary technical and support staff and to contract for specific subject matter experts. After 2014, the Exchange must be self-supporting from fees paid by health plans and insurers participating in the Exchange.
Voluntary Health Plan and Insurer Participation
Health insurance products offered through the Exchange must be available in the same form to consumers purchasing coverage outside the Exchange. All health plans and insurers participating in the Exchange must offer all Exchange plans at the federally designated bronze, silver, gold and platinum levels. Catastrophic plans will only be available through health plans and insurers participating in the Exchange. The catastrophic plans will be available both inside and outside the Exchange from these health plans and insurers.
The Exchange is an independent public entity within state government with a five-member board appointed by the Governor and the Legislature.
Two members are appointed by the Governor; one by Senate Rules Committee; and one by Speaker of the Assembly. The Secretary of the Health and Human Services Agency or another designee will serve as an ex-officio voting member of the Board. Appointed members will serve four year terms.
- Members of the board or of the staff of the Exchange are subject to strict conflict-of-interest provisions. They may not be employed by, a consultant to, a member of the board of directors of, affiliated with, or otherwise a representative of, a carrier or other insurer, an agent or broker, a health care provider, or a health care facility or health clinic.
The Exchange does not change how existing state health care coverage programs are administered.
Medi-Cal and the Healthy Families Program will continue to be administered by the Department of Health Care Services (DHCS) and the Managed Risk Medical Insurance Board (MRMIB), respectively.
- The Exchange will screen for and enroll individuals in Medi-Cal or the Healthy Families Program if they are eligible for those programs. The federal law requires state exchanges to perform this function.
- The Exchange will coordinate with DHCS, the MRMIB, and California counties to ensure that individuals are seamlessly transitioned between coverage programs if their eligibility changes.