The Covered California Health Exchange is the government agency offering subsidized Obamacare plans for this state. The California Health Exchange was created to assist citizens and legal residents with applying for marketplace coverage in order to comply with the Affordable Care Act (ACA). When the law was passed in 2010, each of the 50 states had to decide to either create a state-run health insurance exchange or offer enrollment through a federally-operated exchange. This state chose to create their own exchange and called it “Covered California”.
WHAT DOES THE CALIFORNIA HEALTH EXCHANGE DO?
The Exchange helps Californians comply with the Obamacare mandate. It helps individuals and families obtain health coverage that includes the minimum essential benefits required by the law. Certain carriers are certified to offer subsidized Obama Care Plans and Prices plans and dental plans through the Exchange. These Covered California plans can sell insurance on or off the Exchange. But for qualified consumers, rates can be better if the medical plan is purchased through the marketplace. For people with a household income that is below 400% of the Federal Poverty Level (FPL), Covered Ca may qualify them to receive financial assistance, also called a “Subsidy”, which reduces their premium. And if income is between 138% and 250% of the FPL, the State Exchange may also qualify individuals for extra discounts that reduce their cost for medical services. These extra discounts are referred to as Cost Sharing Reductions. To be eligible for a subsidy and potentially for cost sharing reductions, you must fall within Covered California income limits and not be offered affordable, full coverage healthcare through an employer, Medicare, etc. Enrollments need to be submitted through the State Marketplace, a Certified Insurance Agent, or a Certified Enrollment Counselor.
THE OBAMA CARE MANDATE: WHAT IS REQUIRED?
The mandate refers to the federal law that requires all American citizens and legal residents to have qualified medical insurance. This medical coverage may be acquired off-exchange or through Covered California. The mandate is also known as the Affordable Care Act, or Obama Care. Under the mandate, Americans and legal residents are required to do one of the following:
Be enrolled on a qualified health plan (You can be uninsured for part of the calendar year and not be subject to a penalty so long as you are uninsured for less than three consecutive months.)
File an exemption from the mandate at tax time
Pay a penalty for being uninsured at tax time
WHAT IS A QUALIFIED HEALTH PLAN?
For Californians to be in compliance with the mandate, they’ll need to be enrolled on a qualified health plan, plan that meets the government’s requirements for minimum essential coverage. The main coverage requirement is that the insurance must cover the 10 minimum essential benefits, such as preventive services, Prescription Drug Coverage, and maternity and newborn care. A medical plan can still be a qualified health plan without the minimum essential benefits if the plan is a grandfathered plan, which is a medical plan that was in force before March 23, 2010 when the mandate was passed and which has not undergone major changes. Qualified health plans may be acquired through Covered California, Medi-Cal, Medicare, group insurance, a plan through the military, or off-exchange directly through the carrier.
HEALTH INSURANCE THROUGH COVERED CALIFORNIA
Covered California offers coverage from these health insurance companies.
These health insurance companies meet all the state and federal requirements for plans as well as additional standards established by Covered California. They represent a mix of major insurers and smaller companies, regional and statewide doctor and hospital networks, and for-profit and nonprofit plans. They deliver exceptional value and choice with affordable premiums, a wide choice of benefit levels and good access to doctors and hospitals in all areas of the state.
For more information about the health insurance companies Covered California works with, visit the Contact Your Health Insurance Company page.
Californians with limited incomes may be eligible for Medi-Cal. For information about the Medi-Cal program, please click here.
HOW CAN WE HELP?
As a certified licensed agency with Covered CA, USI Professional makes it simple. We’ll get you a quick quote, help you discover the plan that’s right for you, and introduce you to the application process. We can also help you calculate your government subsidy, see if you qualify for cost sharing and help you enroll in a health plan that will meet your needs, fit your budget and keep you from getting a penalty.
We use simple everyday language to help you understand the plans and the process. Why wait? Call us today
WHY WE DO IT?
Aside from healthcare being our livelihood, we like people and want to help you succeed in obtaining coverage. Instead of dreading shopping for insurance, feeling confused or being pressured to buy something, we want you to be able to get the help you are looking for. Like you, we are all consumers who need to shop for a variety of products and services. As to how we get paid, when you enroll through us (at the same prices you’ll get through Covered CA or anywhere), we get a commission from the health insurance carrier you choose. You do not pay extra by enrolling with us.
Phone: +1 (669) 241-8213 (Live Support)
Address: 365 Grandin Ct, San Jose, CA 95123
Licensing: Life and Health for California
License #: 0M94730