News Release

Date Posted

Covered California Announces Continued Strong Enrollment and Reminds Consumers That Penalty Remains in Place Through 2018


  • The Patient Protection and Affordable Care Act’s requirement that consumers have health insurance remains in place, and consumers may face stiff tax penalties if they are not covered in 2018.
  • A recent study estimates 70 percent of consumers, who are uninsured and eligible for financial help, could purchase health insurance coverage for less than the price of the tax penalty.
  • Most consumers are paying less in monthly premiums than they did a year ago.
  • More than 342,000 consumers have newly enrolled during the current open-enrollment period, which remains ahead of last year’s pace, and continues in California through Jan. 31.

SACRAMENTO, Calif. — Covered California announced new enrollment figures as it approaches the final weeks of the annual open-enrollment period, and sought to quell consumer confusion by clarifying the federal penalty rules in place for 2018.

Covered California announced that 342,000 new consumers had signed up for health insurance through Covered California through Sunday, Jan. 21. The pace of new enrollees for the current open-enrollment period remains ahead of last year, when sign-ups did not surpass 320,000 until Jan. 23, 2017. In addition to the new sign-ups, more than 1.2 million existing Covered California members have renewed their coverage for 2018. And the good news is that the vast majority will see a decrease in their net monthly premium payment after receiving more financial assistance.

“The demand — as well as the need — for health insurance is as strong today as it was when we first began offering coverage five years ago,” said Peter V. Lee, executive director of Covered California. “The people of California are taking advantage of the quality plans and lower costs available through Covered California in 2018.”

Covered California also reminded consumers that the Affordable Care Act’s individual shared responsibility payment, often called the individual mandate, remains in place throughout calendar year 2018. Consumers who do not have health insurance could face stiff tax penalties if they are not covered. These penalties are a minimum of $695 per adult and $347.50 per child, up to $2,085 per family, or at least 2.5 percent of annual household income - whichever is greater (for an estimated maximum penalty of $3,816 per individual and $19,080 for a family of five). The recent tax bill removes the penalty but it does not go into effect until 2019.

The Internal Revenue Service website currently states “taxpayers remain obligated to follow the law and pay what they may owe at the point of filing‎.”

In addition, the IRS had previously indicated it would not implement a policy proposed by the prior administration to reject tax returns where the consumer did not indicate whether they had coverage during the tax year. This announcement led to confusion in 2017 about the IRS’ intention to enforce the federal penalty. In October 2017 however, the agency announced that in order “to avoid refund and processing delays when filing their 2017 returns in 2018,” consumers should indicate “whether they and everyone on their return had coverage, qualified for an exemption from the coverage requirement or are making an individual shared responsibility payment.” Click here to see the IRS announcement: https://www.irs.gov/tax-professionals/aca-information-center-for-tax-professionals.

“The real penalty for not having health insurance is getting sick or injured and facing medical bills that are in the tens or even hundreds of thousands of dollars,” Lee said. “Health insurance provides security and peace of mind, and this year we are seeing that coverage is more affordable than many people think.”

A recent study by the Kaiser Family Foundation found estimated that 70 percent of consumers who are eligible for financial help and uninsured could purchase health insurance coverage for less than the price of the tax penalty. To see the complete study, click here: http://files.kff.org/attachment/Issue-Brief-How-Many-of-the-Uninsured-can-Purchase-a-Marketplace-Plan-for-Less-Than-Their-Shared-Responsibility-Penalty.

Open enrollment, which continues through Jan. 31, is the one time each year — if your life circumstances have not changed — that health insurance companies must take everyone who wishes to sign up.

A recent Covered California analysis found that the net monthly premiums for enrollees who receive financial help are on average 10 percent lower than what new and renewing consumers paid last year. The lower prices are a result of more financial help being available for consumers who qualify for assistance. The Affordable Care Act is designed to protect consumers by providing more premium tax credits when premiums rise. And for the many Californians in the individual market who do not get financial help, the robust competition has meant that for many, premium increases have been kept in the single digits.

Since 2014, more than 3 million people have purchased health insurance through Covered California, and nearly 4 million have enrolled in the state’s Medi-Cal program. Together, the gains have cut the rate of the uninsured in California from 17 percent in 2013 to a historic low of 6.8 percent as of June 2017.

Consumers interested in learning more about their coverage options should go to www.CoveredCA.com where they can get help to enroll. They can explore their options and find out if they qualify for financial help by using the Shop and Compare Tool. They can also get free and confidential enrollment assistance by visiting www.coveredca.com/find-help/ and searching among 800 storefronts statewide, or more than 17,000 certified enrollers who can assist consumers in understanding their choices and enrolling, including individuals who can assist in other languages. In addition, consumers can reach the Covered California service center by calling (800) 300-1506.

About Covered California

Covered California is the state’s health insurance marketplace, where Californians can find affordable, high-quality insurance from top insurance companies. Covered California is the only place where individuals who qualify can get financial assistance on a sliding scale to reduce premium costs. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget. Depending on their income, some consumers may qualify for the low-cost or no-cost Medi-Cal program.

Covered California is an independent part of the state government whose job is to make the health insurance marketplace work for California’s consumers. It is overseen by a five-member board appointed by the governor and the Legislature. For more information about Covered California, please visit www.CoveredCA.com.

Analysis of Potential 2019 Premium Increases Across the Nation Shows Danger of Dramatic Rate Increases Without Federal Action


  • An analysis of potential premium changes in states across the nation shows increases of 16 to 30 percent likely in 2019 if federal steps are not taken.
  • While the Patient Protection and Affordable Care Act’s subsidies would largely insulate subsidized consumers from these costs, millions of unsubsidized consumers would pay the full price of these increases. Many would likely be priced out of coverage.
  • Continued policy and premium uncertainty risks further carrier withdrawals, leaving more consumers with only one health plan and even the prospect of “bare counties.”
  • The analysis reviews three federal policy options that could stabilize markets and mitigate the impact of premium increases in many states.
  • Covered California’s open-enrollment period is still underway and consumers have through Jan. 31 to sign up for coverage.

SACRAMENTO, Calif. — Covered California issued an analysis Thursday that examined the potential impacts of the current open-enrollment period — which remains open in California, but ended in federally facilitated marketplace states on Dec. 15 — and of recent federal decisions on premiums in individual markets across the nation. The analysis found that premiums could increase dramatically in 2019, with increases from 16 to 30 percent if no steps are taken to mitigate these increases.

“Recent federal decisions are threatening to dramatically increase premiums for millions of people,” said Peter V. Lee, executive director of Covered California. “This report underscores the fact that health care is local, but also that no state is immune from the impacts of recent federal policies.

“There are immediate steps that can be taken at the federal level to reduce those risks and protect millions of Americans. Absent federal action, the health insurance premiums paid by the over 6 million Americans who do not receive federal subsidies will increase dramatically in 2019, with some states facing 30 percent spikes in premiums.”

The report, “The Roller Coaster for Consumers Continues: The Prospect for Individual Health Insurance Markets Nationally for 2019: Risk Factors, Uncertainty and Potential Benefits of Stabilizing Policies,” was produced by Covered California’s plan management and policy staff, led by Chief Actuary John Bertko and informed by review by outside academic and policy experts. The findings include a review of market factors and impacts on 2018 enrollment, potential premium impacts for 2019 and federal policies that could mitigate those factors. “While California’s open-enrollment period is not yet closed, we are already looking ahead to 2019 and conducted this analysis because the window of time for policymakers to act is short,” said Lee.

For the full report, see: http://board.coveredca.com/meetings/2018/01-18/CoveredCA-Roller_Coaster_Continues_1-18-18.pdf.

The individual marketplace faced several challenges in the past year, and the 2019 plan year has the potential to be just as volatile and uncertain. Three recent federal actions identified by the report that could potentially influence premiums in 2019 are:
  • Removing the Penalty: The Tax Cuts and Jobs Act eliminated the penalty for not having health insurance starting in 2019. Independent analysis projects drops in enrollment, and because those dropping coverage are likely to be healthier, premium increases for those who remain that could range from 8 to 13 percent.
  • Reduced Marketing and Outreach: The federal government reduced its marketing investment by 90 percent, from $100 million to $10 million, and its outreach budget from $63 million to $37 million. The reduced investments come on the heels of the administration’s decision to pull its marketing during the last week of open enrollment in January 2017. During that time, the enrollment in the federally facilitated marketplace has dropped nearly 10 percent (see Table 1).
Table 1: Enrollment in the Federally Facilitated Marketplace – 2016-2018


While California and other state-based marketplaces are not affected by these decisions, the 39 states served by the federally facilitated marketplace (FFM) could face premiums that are 4 to 9 percent higher in 2019 because of the decision not to promote enrollment.
  • Short-Term, Limited-Duration Health Plans and Association Health Plans: The potential expansion of short-term, limited-duration plans, and potentially the impact of association health plans selling across state lines, could siphon healthy consumers from the common risk pool of the individual markets, worsening the risk mix and raising premiums for those who remain covered.
“The 9 million Americans who receive subsidies will be protected from these premium increases, which could be more than 30 percent in some regions, because the federal government will pick up most of the costs,” Lee said. “However, 6 million Americans who do not get any financial help — from an employer or the federal government — will not have any protections and will be faced with paying the entire increase by themselves.”

Covered California’s analysis included a detailed summary of the unsubsidized consumers, who are primarily enrolled off-exchange, who would be most directly affected by the potential rate increases. An estimated 6 million people do not receive any financial assistance to help pay for their health insurance. With an estimated median income of $75,000, many are not high-income earners and would most likely struggle to afford premium increases of this magnitude (see Figure 1).

Figure 1: Premium Increases Directly Affect Unsubsidized Consumers

“Without any action, we are talking about millions of working middle-class families who do not get financial help, and who will get hit hard by the choice of paying the full price or giving up the health insurance they need,” Lee warned.

In addition to the higher premiums, the continued uncertainty could force some health insurance carriers to withdraw from their markets, leaving consumers in more regions with no choice of plans in the individual market.

The report analyzed the potential impact of three federal actions that could stabilize premiums for consumers:
  • Funding State-Based Reinsurance: A state-based invisible high-risk pool or reinsurance — run by states or allowing states to “opt-out” of administering the program and rely instead on CMS to run the program — could produce a rate reduction ranging from 9 to 16 percent and encourage health plans to continue their participation. Earlier this month, Covered California issued a report and analysis of the elements needed to make such programs effective: “Reducing Premiums and Maximizing the Stabilization of Individual Markets for 2019 and Beyond: State Invisible High-Risk Pools/Reinsurance.”

    For the full report, see: http://hbex.coveredca.com/data-research/library/CoveredCA_Reducing_Premiums_1-10-18.pdf
  • Marketing Investment to Promote Enrollment in FFM States: The federal government’s promoting enrollment by supporting marketing and outreach investments in 2019 could lead health insurance carriers to reduce rates between 2 and 4 percent. The report details the 9 percent decrease in enrollment in FFM states since 2016, with lower enrollment resulting in higher premiums for those who do not receive subsidies. The combined effect of low marketing in 2018 and that policy continuing for 2019 is estimated to result in premium increases that range from 4 to 9 percent. Covered California also released today a study that found the enrollment drop in 2018 could have been even greater if not for a dramatic increase in the news coverage of the enrollment periods and deadlines. Ogilvy, a global leader in communications and media, was commissioned to examine coverage trends for the 2017 and 2018 open-enrollment periods. The report found that mentions of “enrollment,” “enrollment period” and “deadline” increased by 53 percent, 125 percent and 129 percent respectively year over year (see Table 2).
Table 2: Coverage Nationally of Open Enrollment Increased Dramatically Year Over Year: 2017 to 2018



“Studies clearly document that both news coverage and advertising drive enrollment,” said Lee. “Enrollment nationally benefited from a dramatic uptick in coverage for 2018, but there is no reason to expect the same coverage for 2019.”

For Ogilvy’s full report, see: http://board.coveredca.com/meetings/2018/01-18/Ogilvy-Enrollment_Coverage_Measurement-Final-01-18-18.pdf.
  • Reinstituting the Health Insurance Tax Holiday: Providing health insurance carriers with a “holiday” from the health insurance tax could reduce premiums by an additional 1 to 3 percent. A one-year holiday from the health insurance tax is included in a short-term spending bill, currently under consideration in Congress, which aims to avert a federal government shutdown.
“Federal policy clearly makes a huge difference in the lives of millions of consumers — for 6 million, policy choices can mean premiums jumping 30 percent or more. Action is needed in the next months to provide stability and protect consumers from staggering premium increases,” Lee said.

Covered California has long maintained that a robust marketing campaign is key to attracting new consumers to the health exchanges and maintaining a healthy consumer pool that reduces premiums for everyone.

“California has invested heavily in marketing and outreach. These investments, along with other policy choices made in California, have resulted in this state’s having one of the healthiest consumer pools in the nation — this translates directly to lower premiums for those who bear the full cost of their insurance,” said John Bertko, chief actuary of Covered California.

“This analysis uses the best available evidence to assess the potential impacts of a range of policies on premiums across the nation. The report underscores that ‘health care is local’ — the impacts on premiums will vary dramatically by state and by health plan, but it’s clear that many Americans face the prospect of premium increases of 30 percent or more without federal action.”

Covered California also wants consumers to know that while the enrollment deadline for most states was Dec. 15, Californians have through Jan. 31, 2018, to explore their options and select a plan that best fits their needs. Consumers who enroll by midnight on Jan. 19 will have their coverage start on Feb. 1.

A recent Covered California analysis found that the net monthly premiums for the over 1 million Californians who receive financial help are on average 10 percent lower than what new and renewing consumers paid last year. The lower prices are a result of more financial help being available for consumers who qualify for assistance.

Since 2014, more than 3 million people have purchased health insurance through Covered California, and nearly 4 million have enrolled in the state’s Medi-Cal program. Together, the gains have cut the rate of the uninsured in California from 17 percent in 2013 to a historic low of 6.8 percent as of June 2017.

Consumers interested in learning more about their coverage options should go to www.CoveredCA.com where they can get help to enroll. They can explore their options and find out if they qualify for financial help by using the Shop and Compare Tool. They can also get free and confidential enrollment assistance by visiting www.coveredca.com/find-help/  and searching among 800 storefronts statewide, or more than 17,000 certified enrollers who can assist consumers in understanding their choices and enrolling, including individuals who can assist in other languages. In addition, consumers can reach the Covered California service center by calling (800) 300-1506.

About Covered California
Covered California is the state’s health insurance marketplace, where Californians can find affordable, high-quality insurance from top insurance companies. Covered California is the only place where individuals who qualify can get financial assistance on a sliding scale to reduce premium costs. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget. Depending on their income, some consumers may qualify for the low-cost or no-cost Medi-Cal program.

Covered California is an independent part of the state government whose job is to make the health insurance marketplace work for California’s consumers. It is overseen by a five-member board appointed by the governor and the Legislature. For more information about Covered California, please visit www.CoveredCA.com.

Covered California Looks Ahead to 2019 With Continued Strong Enrollment but National Uncertainty


  • Consumers have until the end of Friday, Dec. 22, to sign up for health coverage that begins on Jan. 1, 2018. Covered California’s open-enrollment period runs through Jan. 31, 2018.
  • More than 220,000 new enrollees selected a plan through Dec. 15, which remains ahead of last year’s pace.
  • Based on the first month’s enrollment, most consumers are paying less for their coverage in 2018.
  • The impending removal of the individual mandate penalty, with other key actions, means significant uncertainty for 2019 — which could lead to collapsing individual markets in many states in the absence of strong federal stabilization policies.

SACRAMENTO, Calif. — Covered California updated its enrollment data on Wednesday and alerted consumers to a key deadline that is approaching. While the open-enrollment period has ended in most states, uninsured consumers in California have until midnight on Dec. 22 to sign up if they want their coverage to begin on Jan. 1, 2018.

“The time is now to ring in the New Year with a quality health plan that provides protection and peace of mind,” said Peter V. Lee, executive director of Covered California. “We have seen thousands of people signing up every day as we near this key deadline, and Covered California wants to make sure everyone knows that time is running out to get health coverage that starts on Jan. 1.”

The latest data shows that more than 220,000 new consumers signed up for coverage through Dec. 15, which is about 10 percent more than last year, when 199,000 consumers selected a plan during the same time period. In addition, approximately 1.2 million existing Covered California consumers have had their coverage renewed for 2018.

With the continued health care policy debate at the federal level, Covered California also noted that the individual market faces significant uncertainty in 2019. Three of the main causes of this uncertainty are:
  • Repeal of the individual mandate penalty: Repeal will take effect in 2019, and could threaten the individual market in many states. Health insurance companies rely on certainty when setting their rates, and may decide to exit their markets in the face of an uncertain market caused by a shrinking pool of consumers who are less healthy.
  • Lack of federal marketing: Health insurance needs to be sold, particularly to young and healthy individuals who are less likely to feel compelled to purchase coverage on their own. The federal administration significantly reduced the marketing and outreach budget for the current open-enrollment period, which could lead to fewer consumers enrolled, a less healthy risk mix and higher premiums for consumers.
  • Recent executive order: The president’s executive order called for regulations that would allow the sale of “association health plans” or “short-term plans.” Depending on how these regulations are structured, these plans could skim healthier individuals off the individual market and leave consumers without comprehensive coverage. Not only would these consumers be enrolled in “Swiss cheese” policies that were common prior to the Affordable Care Act, those left in the exchanges would see higher premiums because of a less healthy consumer pool.
Without federal action to offset the destabilizing effects of these issues, Covered California estimates that between 10 and 20 states could be left without any carriers in their exchanges in 2019. Consumers in the remaining exchanges could also face dramatically higher premiums, particularly those who do not receive any financial assistance.

During its December board meeting, Covered California discussed several federal policies that could make a difference in stabilizing individual markets across the country and noted that now is the time for bipartisan efforts to protect consumers and lower premiums. These policies include:
  • Reinsurance or high-risk pool: Implementing state-based risk stabilization programs such as reinsurance or invisible high-risk pools is the focus of bipartisan legislation proposed by senators Susan Collins and Bill Nelson. If appropriately structured and funded, it could reduce premiums by between 10 and 12 percent in 2019, while providing the certainty health carriers need to remain in markets. For a detailed look at some of the structural issues that such a program should include, click here: http://hbex.coveredca.com/data-research/library/State-Based_Invisible_High_Risk_Pools_or_Reinsurance-12-17-20%20(002)_final.pdf.
  • Federal marketing commitment: Other bipartisan legislation proposed by senators Lamar Alexander and Patty Murray includes provisions that would require the federal government to spend $100 million annually to promote enrollment. While Covered California relies on its own funding to invest more than $100 million in marketing and outreach, federal proposals like this would inject stability into states that rely on the federally facilitated marketplace.
  • Restore cost-sharing reduction (CSR) funding: While many states developed a workaround to compensate for the cancellation of reimbursement payments to carriers that provide low-cost services to low-income consumers, it is an imperfect solution that is less effective and actually costs the federal government more through increased tax credit spending. The Alexander-Murray proposal would restore this funding.
  • Removing the health insurance tax: The removal of this tax, which is included in the Patient Protection and Affordable Care Act, would lead directly to lower premiums.
You can see the full presentation from the board meeting here: http://hbex.coveredca.com/data-research/library/PPT-Protecting-Consumers-and-Providing-Competitive-Options-Dec-2017.pdf.

“President Trump today tweeted that removing the individual mandate penalty ‘means Obamacare is being repealed.’ With that announcement, we hope that Congress and the president can now turn their attention to bipartisan solutions needed to stabilize the individual insurance market across the nation,” Lee said. “While one provision of the Affordable Care Act will go away in 2019 — the tax penalty for not buying insurance — consumers can be confident that they will have access to the same quality, affordable health coverage from Covered California in 2018 and in the years to come.”

Lee added, “The lynchpin of the Affordable Care Act is financial help for millions of Americans and changing the rules so insurers must cover everybody. Those elements remain in place.”

Covered California also wants consumers to know that while the enrollment deadline for most states was Dec. 15, Californians will have through Jan. 31, 2018, to explore their options and select a plan that best fits their needs. While consumers can sign up for coverage in the month of January, if they wait until then, their coverage will not start until Feb. 1 or March 1.

A recent Covered California analysis found that the net monthly premiums for enrollees who receive financial help are on average 10 percent lower than what new and renewing consumers paid last year. The lower prices are a result of more financial help being available for consumers who qualify for assistance. The Affordable Care Act is designed to protect consumers by providing more premium tax credits when premiums rise.

“With the deadline of Friday, Dec. 22, to get coverage that starts Jan. 1, we want to make sure that consumers know about the increased financial help that is available to help bring health care coverage within reach,” Lee said.

Since 2014, more than 3 million people have purchased health insurance through Covered California, and nearly 4 million have enrolled in the state’s Medi-Cal program. Together, the gains have cut the rate of the uninsured in California from 17 percent in 2013 to a historic low of 6.8 percent as of June 2017.

Consumers interested in learning more about their coverage options should go to www.CoveredCA.com where they can get help to enroll. They can explore their options and find out if they qualify for financial help by using the Shop and Compare Tool. They can also get free and confidential enrollment assistance by visiting www.coveredca.com/find-help/ and searching among 800 storefronts statewide, or more than 17,000 certified enrollers who can assist consumers in understanding their choices and enrolling, including individuals who can assist in other languages. In addition, consumers can reach the Covered California service center by calling (800) 300-1506.

About Covered California
Covered California is the state’s health insurance marketplace, where Californians can find affordable, high-quality insurance from top insurance companies. Covered California is the only place where individuals who qualify can get financial assistance on a sliding scale to reduce premium costs. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget. Depending on their income, some consumers may qualify for the low-cost or no-cost Medi-Cal program.

Covered California is an independent part of the state government whose job is to make the health insurance marketplace work for California’s consumers. It is overseen by a five-member board appointed by the governor and the Legislature. For more information about Covered California, please visit www.CoveredCA.com.







Covered California Extends Enrollment Deadline as Consumer Interest Surges


  • The number of new consumers signing up for coverage remains ahead of last year’s pace, with more than 38,000 selecting a plan during the past three days.
  • Consumers now have until the end of Dec. 22 to sign up for health care coverage that will begin on Jan. 1.
  • Based on the first month’s enrollment, most consumers are paying less for coverage.
  • Covered California is working to distinguish the deadline for open enrollment in California — which ends Jan. 31 — from the shorter period for much of the nation.

SACRAMENTO, Calif. — In response to a strong surge in demand, Covered California is giving consumers more time to sign up for health coverage that will begin on Jan. 1, 2018.

Over the past three days, Covered California has seen more than 38,000 new consumers sign up for coverage, which means that as of Dec. 13 more than 182,000 new consumers have signed up for coverage since open enrollment began. Compared to the same time last year, when 156,000 had signed up, this enrollment marks an increase of 26,000, or 17 percent. Many of these new members are taking advantage of the fact that the cost of coverage is lower than it was last year for most consumers.

“Covered California is seeing a huge influx of consumers, and we know that not everyone is getting through on the phone or is able to get an appointment with a certified enroller,” said Peter V. Lee, executive director of Covered California. “We’re extending the deadline for Californians to get coverage starting Jan. 1 because we do not want to leave anyone behind. Our responsibility is to make sure we help every single person seeking to enroll get the coverage they need.”

A recent Covered California analysis found that the net monthly premiums for enrollees who receive financial help are on average 10 percent lower than what new and renewing consumers paid last year. The lower prices are a result of more financial help being available for consumers who qualify for assistance. The Patient Protection and Affordable Care Act is designed to protect consumers by providing more premium tax credits when premiums rise.

“Covered California wants to make sure that consumers use the increased financial assistance that is available to help bring health care coverage within reach,” Lee said. “Covered California is here for you today, and we will be here for you tomorrow. Now is the time to sign up for health insurance that can protect you and your family.”

Consumers now have until the end of Dec. 22 to sign up for coverage that will begin on Jan. 1. Covered California also wants consumers to know that while the enrollment deadline for most states is Dec. 15, Californians will have through Jan. 31, 2018, to sign up for coverage. While consumers can sign up for coverage after Dec. 22, their coverage will not start until Feb. 1 at the earliest.

After Jan. 31, Covered California will continue to enroll people who have a change in their circumstances — such as losing their insurance when they leave a job — and enrollment in Medi-Cal is not subject to open enrollment. However, if your life situation has not changed, you will not be able to enroll for coverage in the individual market until next year’s open-enrollment period, whether through Covered California or by enrolling directly with a health plan outside the exchange.

Since 2014, more than 3 million people have purchased health insurance through Covered California, and nearly 4 million have enrolled in the state’s Medi-Cal program. Together, the gains have cut the rate of the uninsured in California from 17 percent in 2013 to a historic low of 6.8 percent as of June 2017.

Consumers interested in learning more about their coverage options should go to www.CoveredCA.com where they can get help to enroll. They can explore their options and find out if they qualify for financial help by using the Shop and Compare Tool. They can also get free and confidential enrollment assistance by visiting www.coveredca.com/find-help/ and searching among 800 storefronts statewide, or more than 17,000 certified enrollers who can assist consumers in understanding their choices and enrolling, including individuals who can assist in other languages. In addition, consumers can reach the Covered California service center by calling (800) 300-1506.

About Covered California
Covered California is the state’s health insurance marketplace, where Californians can find affordable, high-quality insurance from top insurance companies. Covered California is the only place where individuals who qualify can get financial assistance on a sliding scale to reduce premium costs. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget. Depending on their income, some consumers may qualify for the low-cost or no-cost Medi-Cal program.

Covered California is an independent part of the state government whose job is to make the health insurance marketplace work for California’s consumers. It is overseen by a five-member board appointed by the governor and the Legislature. For more information about Covered California, please visit www.CoveredCA.com.

Covered California for Small Business Continues to Grow and Announces New Partnership With EaseCentral



  • Covered California for Small Business tops 40,000 members — a 30 percent year-over-year growth.
  • This new partnership means more health insurance choices for employees of California small businesses.
  • EaseCentral’s technology will help consumers and businesses save money by improving efficiencies, reducing errors and speeding up the application-approval process.


SACRAMENTO, Calif. — A partnership with EaseCentral is the latest advancement for Covered California for Small Business, which has seen its enrollment steadily grow from 14,183 in 2014 to more than 40,000 as of Dec. 1, 2017.

The new partnership, announced on Wednesday, will help the exchange continue its strong growth. Earlier in 2017, Covered California for Small Business announced its 2018 statewide weighted average rate increase of 5.6 percent for employers and their employees, which is down from the 5.9 percent increase in 2017. This was great news for the California small-business community.

EaseCentral will include Covered California for Small Business in its integrated software platform. Employees of small businesses across the state will be able to log on and see the plan choices provided through Covered California for Small Business. The automated system will lead to cost savings and an improved enrollment process for certified agents and the small businesses they work with across the state.

Covered California for Small Business will be offering five health plans in 2018, including two preferred provider organization (PPO) plans with full provider networks, from Blue Shield of California and Health Net, and two health maintenance organizations (HMO) that are provider- and hospital-based, from Kaiser Permanente and Sharp Health Plan. Rounding out the 2018 portfolio is Chinese Community Health Plan in San Francisco.

Businesses with up to 100 employees can apply for health insurance coverage for their workers through Covered California for Small Business. Federal tax credits may be available to employers with 25 or fewer employees. The partnership with EaseCentral will bring these options and choices to business owners across the state.

“By adding this partnership to the many ways we support small business, tens of thousands of small businesses who use EaseCentral will enjoy better connectivity with Certified Insurance Agents and general agents, making enrolling in Covered California for Small Business even easier,” said Peter V. Lee, executive director of Covered California. “It is time to move the small-business marketplace into the 21st century’s web-enabled world of e-commerce. It’s a faster, better and a much less costly way of doing business.”

The immediate beneficiaries of this partnership will be California small businesses that provide health care coverage to their employees, since it will virtually eliminate paper enrollment applications and will enable them to renew and perform account maintenance transactions through Covered California for Small Business’s online portals. EaseCentral’s technology can reduce the costs of enrollment and ultimately those savings can be transferred to their employees.

“We believe in technology’s ability to make health care easier,” said David Reid, CEO and cofounder of EaseCentral. “Additionally, the subsequent cost savings are crucial, especially for small businesses. Automation opens the door to reallocating resources, costs and time to other aspects of the company. Time and time again, we’ve seen that investing in the adoption of these tools has a positive impact on the bottom line, in almost every case.”

The partnership will also give more choice to the California small businesses that currently use EaseCentral. The integration was tested by Claremont Insurance Services, a sales leader for Covered California for Small Business. Company president Michael Traynor said his company saw “significant operational efficiencies” while using the platform.

Visit www.CoveredCA.com/forsmallbusiness/for information on how to apply.

About Covered California
Covered California is the state’s health insurance marketplace, where Californians can find affordable, high-quality insurance from top insurance companies. Covered California is the only place where individuals who qualify can get financial assistance on a sliding scale to reduce premium costs. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget. Depending on their income, some consumers may qualify for the low-cost or no-cost Medi-Cal program.

Covered California is an independent part of the state government whose job is to make the health insurance marketplace work for California’s consumers. It is overseen by a five-member board appointed by the governor and the legislature. For more information about Covered California, please visit www.CoveredCA.com.

Covered California Teams Up With Asian American Leaders Ahead of Key Enrollment Deadline


  • Consumers who want their health insurance to start on Jan. 1, 2018 must sign up for coverage by Dec. 15
  • While the federal deadline for open enrollment is Dec. 15, Covered California’s open enrollment period runs through Jan. 31, 2018.
  • Based on first month’s enrollment, most consumers are paying less for coverage.

LOS ANGELES, Calif. — Covered California on Tuesday joined with leaders of the Asian-American community to promote enrollment in health insurance and alert uninsured consumers about a key deadline that is approaching. While Covered California’s open enrollment period runs through Jan. 31, consumers must sign up by Dec. 15 if they want their coverage to begin on Jan. 1, 2018.

“Covered California is teaming up with leaders of Asian-American communities to make sure that we reach out to everyone who is eligible for coverage,” said Peter V. Lee, executive director of Covered California. “We want to make sure that consumers know they need to sign up by Dec. 15 if they want their health care coverage to start at the beginning of the year.”

Covered California will take part in a press conference with Chinese and Korean leaders at Asian Americans Advancing Justice in Los Angeles, and then meet with Vietnamese leaders in Orange County.

The most recent enrollment data shows 240,000 Asian-Americans have enrolled in a health plan through Covered California, with more than 79,000 living in Los Angeles County.

“Every community in California can benefit from health care coverage that provides peace of mind, security and access to the best doctors and facilities in the state,” Lee said.

Covered California has built an extensive network of Asian-language resources, including online resources available in Chinese, Korean, Vietnamese, Lao, Tagalog and Hmong. These can be found by visiting www.CoveredCA.com and scrolling to the bottom of the page or by clicking below:

Consumers can also speak to certified enrollers in their language by calling Covered California’s service center at (800) 300-1506 or visiting https://www.coveredca.com/find-help/ to find a certified enroller in their community. The in-person assistance is free, confidential and available in a variety of languages.

Covered California’s events come on the heels of a recent Covered California analysis that found that the net monthly premiums for enrollees who receive financial help are on average 10 percent less than what new and renewing consumers paid last year. The lower prices are a result of more financial help being available for consumers who qualify for assistance. The Affordable Care Act is designed to protect consumers by providing more premium tax credits when premiums rise.

“With the Dec. 15 deadline coming up, we want to make sure that consumers know about the increased financial help that is available to help bring health coverage within reach,” Lee said. Covered

California also wants consumers to know that while the enrollment deadline for most states is Dec. 15, Californians will have through Jan. 31, 2018 to explore their options and select a plan that best fits their needs.

Since 2014, more than 3 million people have purchased health insurance through Covered California, and nearly 4 million have enrolled in the state’s Medi-Cal program. Together, the gains have cut the rate of the uninsured in California by more than half.

About Covered California
Covered California is the state’s health insurance marketplace, where Californians can find affordable, high-quality insurance from top insurance companies. Covered California is the only place where individuals who qualify can get financial assistance on a sliding scale to reduce premium costs. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget. Depending on their income, some consumers may qualify for the low-cost or no-cost Medi-Cal program.

Covered California is an independent part of the state government whose job is to make the health insurance marketplace work for California’s consumers. It is overseen by a five-member board appointed by the governor and the Legislature. For more information about Covered California, please visit www.CoveredCA.com.

Covered California Hits the Road Again Ahead of Key Enrollment Deadline


  • Consumers who want their health insurance to start on Jan. 1, 2018, must sign up for coverage by Dec. 15.
  • While the federal deadline for open enrollment is Dec. 15, Covered California’s open-enrollment period runs through Jan. 31, 2018.
  • Covered California’s “Covered in Art Tour” resumes Tuesday and will make an additional eight stops from Palm Springs to Redding.
  • Based on the first month’s enrollment, most consumers are paying less for coverage.



LOS ANGELES, Calif. — Covered California kicked off an eight-stop bus tour on Tuesday to promote enrollment in health insurance and alert uninsured consumers about a key deadline that is approaching. While Covered California’s open-enrollment period runs through Jan. 31, consumers must sign up by Dec. 15 if they want their coverage to begin on Jan. 1, 2018. In addition, a recent analysis shows that the price of coverage is lower than last year for most consumers.

“Covered California is back on the road, making sure that consumers know they need to sign up by Dec. 15 if they want their health care coverage to start at the beginning of the year,” said Peter V. Lee, executive director of Covered California. “We’re seeing the lower costs to consumers bringing people to our door. We don’t want to leave anyone behind.”

The bus tour will make stops at locations throughout the state where local artists will paint murals to attract attention and promote health and wellness. A total of 16 murals will be painted at sites such as enrollment centers and community buildings.

“The ‘Covered in Art’ project is a living demonstration of the fact that health care is local and that Covered California is woven into the fabric of local communities,” Lee said.

The tour will begin with two stops in Los Angeles before heading to Palm Springs, Fresno, Modesto, Sacramento, Chico and Redding.

A recent Covered California analysis found that the net monthly premiums for enrollees who receive financial help are on average 10 percent lower than what new and renewing consumers paid last year. The lower prices are a result of more financial help being available for consumers who qualify for assistance. The Patient Protection and Affordable Care Act is designed to protect consumers by providing more premium tax credits when premiums rise.

“With Friday’s deadline to get coverage that starts Jan. 1, we want to make sure that consumers know about the increased financial help that is available to help bring health care coverage within reach,” Lee said.

Covered California also wants consumers to know that while the enrollment deadline for most states is Dec. 15, Californians will have through Jan. 31, 2018, to explore their options and select a plan that best fits their needs. While consumers can sign up for coverage in the month of January, if they wait until then, their coverage will not start until Feb. 1 at the earliest.

Since 2014, more than 3 million people have purchased health insurance through Covered California, and nearly 4 million have enrolled in the state’s Medi-Cal program. Together, the gains have cut the rate of the uninsured in California by more than half.

Consumers interested in learning more about their coverage options should go to www.CoveredCA.com where they can get help to enroll. They can explore their options and find out if they qualify for financial help by using the Shop and Compare Tool. They can also get free and confidential enrollment assistance by visiting www.coveredca.com/find-help/ and searching among 800 storefronts statewide, or more than 17,000 certified enrollers who can assist consumers in understanding their choices and enrolling, including individuals who can assist in other languages. In addition, consumers can reach the Covered California service center by calling (800) 300-1506.

About Covered California
Covered California is the state’s health insurance marketplace, where Californians can find affordable, high-quality insurance from top insurance companies. Covered California is the only place where individuals who qualify can get financial assistance on a sliding scale to reduce premium costs. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget. Depending on their income, some consumers may qualify for the low-cost or no-cost Medi-Cal program.

Covered California is an independent part of the state government whose job is to make the health insurance marketplace work for California’s consumers. It is overseen by a five-member board appointed by the governor and the Legislature. For more information about Covered California, please visit www.CoveredCA.com.



Covered California’s Open Enrollment Continues at a Brisk Pace with New Data Showing Most Consumers Who Renewed and Enrolled in November will Pay Less in 2018


  • More than 102,000 new consumers selected a plan during the first month of open enrollment, a 28 percent increase over the same time period last year.
  • Consumers receiving subsidies who signed up in November will pay 10 percent less per month in 2018 than 2017.
  • 1.2 million Covered California enrollees have been renewed for 2018, similar to last year’s totals.
  • Consumers who want their health insurance to start on Jan. 1, 2018 must sign up by Dec. 15.

SACRAMENTO, Calif. — Covered California announced today that more than 102,000 new consumers signed up for coverage during the first month of California’s three month open enrollment period, substantially ahead of last year’s pace when more than 80,000 consumers signed up for coverage. The data covers the period from Nov. 1 through Nov. 30.

“Consumers are continuing to check out their options and take advantage of the lower prices for many enrolling and renewing in coverage,” said Peter V. Lee, executive director of Covered California. “We know that Californians sign-up when they realize how low their costs are. We’re seeing many Californians shop and enroll because the financial help is bringing coverage within reach for many.”

In addition, a new analysis finds that the net monthly premiums for the 85 percent of Covered California enrollees who get financial help – the price they will pay after a plan’s premium is discounted by the federal subsidy – is an average of 10 percent less than new and renewing consumers paid last year (see Table 1).

The data showed that the average net price for plans selected by new and renewing consumers this year is $120 per month, down from $134 per month at this point last year. And, for those who selected a bronze plan, the average cost for 2018 was only $45 per month, compared to $87 in 2017.

“When you do the math, hundreds of thousands of Californians are the winners – getting quality coverage at lower rates than last year,” Lee said. “Consumers are finding out they can get quality coverage for less than they expect.”

The experience of an individual will vary based on their circumstance, including whether they get subsidies to help purchase coverage, where they live and the plan options they choose. The analysis found that consumers who select a Silver-tier plan are on average paying $3 per month less than they were in 2017, while consumers who select a Gold-tier plan will pay on average $78 less per month.

Table 1:  Comparing Net Prices of Plans Selected for 2017 and 2018 coverage for Californians Receiving Financial Assistance in Covered California[1]
Metal Tier
2017
2018
Difference
Difference in Percent
Bronze
$87
$45
-$43
-49%
Silver
$135
$132
-$3
-2%
Gold
$290
$212
-$78
-27%
Platinum
$360
$286
-$74
-21%
Average
$135
$120
-$14
-10%

[1] Data excludes minimum coverage plan selections, a metal level not available to all consumers.  Net prices mean the amount a consumer pays after accounting for federal financial assistance.

The lower prices are a result of more financial help being available for consumers who qualify for assistance. The Affordable Care Act is designed to protect consumers by providing more premium tax credits when premiums rise.

“With a key deadline coming up, we want to make sure that consumers know about the increased financial help that is available to help bring health care coverage within reach,” Lee said.

Covered California released its enrollment data at the same time as the federal government updated its renewal and new enrollment data for the open enrollment period in the 39 states supported by the federally facilitated marketplace. 

The weekly enrollment snapshot from the Centers for Medicare and Medicaid Services found that about 989,000 new plan selections had been made between Nov. 1 and Dec. 2. While this is 22 percent higher than the estimated 811,000 new enrollment during the same time last year, it is on pace to fall well short of last year’s new enrollment totals because the federal open enrollment period has been cut in half and ends Dec. 15.

“The new enrollment in states supported by the federal marketplace is troubling given there remain only ten days when consumers in those states can benefit from the open enrollment period,” Lee said.  “It’s hard to see how enrollment over the next ten days will come close to last year’s enrollment, which foreshadows spikes in health care premiums in many states in 2019 absent federal action.”

Covered California’s analysis also looked at the prices being paid by consumers who are unsubsidized and do not receive any financial assistance. While subsidized consumers will fare better next year, the average unsubsidized consumer will see an estimated increase of 10 percent.

Using price data for coverage on and off the exchange – where Silver plans are less expensive -- Covered California estimates that unsubsidized consumers will pay an average of $478 for their 2018 Covered California plan. This is based on Covered California plan selections to date for Bronze, Gold and Platinum and ranges from an average of $389 for a Bronze plan to $644 for Platinum coverage (see Table 2).

The price for Silver coverage is estimated to better reflect that price experience most unsubsidized Silver enrollees will have in 2018 because they are able to purchase near-identical Silver-level coverage off-exchange without it including a surcharge to fund the federally required cost-sharing reduction program. Due to uncertainty at the federal level, Covered California directed its carriers to place a “CSR-surcharge” on their Silver products sold on the exchange. The same Silver product sold directly to hundreds of thousands of Californians in the individual market outside of Covered California do not have the CSR-surcharge.

Table 2:  Comparing Prices of Plans Selected for 2017 and 2018 coverage for Californians Who Are NOT Eligible for Financial Assistance

Metal Tier
2017
2018
Difference
Bronze
$354
$389
$35
Silver*
$446
$494
$48
Gold
$491
$546
$55
Platinum
$582
$644
$62
Average
 $436
 $478
$43
*Silver prices are estimated; prices for other tiers reflect actual difference in what unsubsidized enrollees are paying for 2018 coverage based on enrollment as of Nov. 30. The average unsubsidized Silver gross premium shown is an estimate based on current 2018 enrollment data and prior Covered California analysis that cost sharing reduction (CSR) surcharges represents approximately 10.1% of the actual 2018 gross silver premiums.

“Contrary to the national narrative that health insurance prices are skyrocketing, our data shows that most Covered California consumers are actually paying less in 2018 for subsidized coverage, and even those not receiving financial help face average increases of 10 percent in 2018,” Lee said.

Consumers who want their insurance coverage to begin on Jan. 1, 2018 must enroll by Dec. 15, but -- unlike a majority of other states in the nation -- California’s open enrollment period continues through Jan. 31, 2018.

Consumers who purchase coverage on the individual market outside the Covered California exchange do not have to pay the cost-sharing surcharge placed on those with unsubsidized Silver coverage in the exchange. For this reason, consumers who have unsubsidized coverage in the exchange should consider switching metal tiers or enrolling in a Silver plan directly through their insurance company to ensure they get the best value.

Since 2014, more than 3 million people have purchased health insurance through Covered California, and nearly 4 million have enrolled in the state’s Medi-Cal program. Together, the gains have cut the rate of the uninsured in California by more than half.

Consumers interested in learning more about their coverage options should go to www.CoveredCA.com where they can get help to enroll. They can explore their options and find out if they qualify for financial help by using the “Shop and Compare” tool. They can also get free and confidential enrollment assistance by visiting www.coveredca.com/find-help/ and searching among 800 storefronts statewide or more than 17,000 certified enrollers who can assist consumers in understanding their choices and enrolling, including individuals who can assist in other languages. In addition, consumers can reach the Covered California service center by calling (800) 300-1506.

About Covered California
Covered California is the state’s health insurance marketplace, where Californians can find affordable, high-quality insurance from top insurance companies. Covered California is the only place where individuals who qualify can get financial assistance on a sliding scale to reduce premium costs. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget. Depending on their income, some consumers may qualify for the low-cost or no-cost Medi-Cal program.

Covered California is an independent part of the state government whose job is to make the health insurance marketplace work for California’s consumers. It is overseen by a five-member board appointed by the governor and the legislature. For more information about Covered California, please visit www.CoveredCA.com.