News Release

Date Posted

Covered California Announces Appointment of Doug McKeever as Chief Deputy Executive Director, Program

SACRAMENTO, Calif. — Covered California Executive Director Peter V. Lee today announced the appointment by the Board of Directors of Doug P. McKeever as Chief Deputy Executive Director, Program.

In this role, McKeever will report to the executive director and will manage the Plan Management, Outreach and Sales, Marketing, Service Center and Policy divisions, with a staff of close to 1,000 employees under his leadership. He will be responsible for developing and implementing plans to increase growth and improve consumer services and health plan relations through strong support and management.

“Doug McKeever comes to us with a tremendous reputation in both health care and public service,” said California Health and Human Services Secretary and Covered California Board Chairwoman Diana Dooley. “We are fortunate to have him, and his hiring is a testament to Covered California’s building for the future.”

McKeever comes to Covered California from CalPERS, where he has been a senior-level executive since joining the agency. McKeever is the deputy executive officer at CalPERS, where he is responsible for all areas related to health care and contracts for carriers, billing reconciliation, long-term care and state and federal health care and pension policy, legislation and regulations. He and his team work with all of the large health plans in Covered California, as well as dealing with the same health care dynamics with providers.

“While it has been a privilege to work at CalPERS, this is a great opportunity to focus on health care and be part of Covered California’s work to both provide needed coverage and improve how health care works for all Californians,” McKeever said.

“Doug McKeever brings a wonderful background, experience and perspective that will help Covered California as we move into the future,” Lee said. “He is a great fit for us and will work hard to assure we continue to deliver on our important mission.”

McKeever will officially begin work at his new position on Jan. 3, 2017.

McKeever has 27 years of experience working for the state of California. He was the director of juvenile programs for the California Department of Corrections and Rehabilitation (CDCR), covering all of the state detention facilities and prisons housing the state’s youth. In this position he was responsible for such areas as health care and education. He also served as director of mental health at CDCR. McKeever currently sits on numerous health care-related boards. The salary for McKeever’s position is $230,000.

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 can qualify for financial assistance that is available on a sliding-scale basis to reduce insurance costs. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget. Based on income, some consumers may qualify for the low-cost or no-cost Medi-Cal program.

In addition, Covered California for Small Business is available for small businesses to purchase insurance for their employees.

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 to Launch Open Enrollment Tuesday for Health Coverage in 2017


  • Changes to the insurance products mean consumers will save when they access care.
  • New shopping tools and 300 new storefronts make it easier for consumers to shop for coverage.
  • More choices in 2017 in Orange, San Francisco and Santa Cruz counties.
  • Enrollees will get a primary care doctor when they enroll to ease access to care.

Click for Español

SACRAMENTO, Calif. — Californians who need health insurance will find new ways to shop for coverage and new ways to save in 2017 when open enrollment begins on Tuesday. More than 92 percent of consumers will have three or more health plans to choose from, and none will have fewer than two.

“California has built a robust marketplace where insurers are competing for consumers and where there is financial help to buy top-quality insurance,” said Peter V. Lee, executive director of Covered California. “Starting next week, all consumers can choose from a variety of affordable health care options, with coverage that gives them the protection they need for whatever health issues come their way.”

Making Care More Affordable
  • For 2017, most consumers will see a lower copay for their primary care visits, and urgent care costs in every plan will be the same as the primary care visit, helping consumers save up to $55 per visit.
  • Consumers in Silver, Gold and Platinum plans will pay a flat copay for emergency room visits in 2017 without having to satisfy a deductible, which could help them save thousands of dollars.
These improvements for 2017 build on features already in place that help make care more affordable for Covered California enrollees. Most outpatient services in Silver, Gold and Platinum plans are not subject to a deductible, including primary care visits, specialist visits, lab tests, X-rays and imaging. Even consumers in Covered California’s most affordable Bronze plans are able to see their doctor or a specialist three times before the visits are subject to the deductible.

“We know health care is expensive, so we took steps to make sure consumers who do buy coverage get the care they need without having to first meet their full deductible,” Lee said.

New Health and Dental Plan Choices for 2017

Three of Covered California’s 11 health plans are expanding their coverage areas. Molina Healthcare is moving into Orange County, Kaiser Permanente will be available in Santa Cruz County and Oscar Health Plan of California will be offering coverage in San Francisco County.

The other plans continuing to offer coverage for 2017 are Anthem Blue Cross of California, Blue Shield of California, Chinese Community Health Plan, Health Net, L.A. Care Health Plan, Sharp Health Plan, Valley Health Plan and Western Health Advantage.

Covered California is also adding two new family dental plans, Liberty Dental Plan and California Dental Network. They will join Access Dental Plan, Anthem Blue Cross, Delta Dental of California, Dental Health Services and Premier Access. Liberty Dental Plan will offer coverage in all ZIP codes in 2017, and California Dental Network will offer very competitive rates in the Bay Area, Los Angeles and Orange counties, and in parts of Sacramento, the north Bay Area, the Central Valley, the Inland Empire and San Diego.

More Consumer Help While Shopping

Consumers shopping for health coverage can get a wide variety of free support to learn about their options online, by phone, at community events and at more than 800 Covered California storefronts statewide.

An upgraded online shopping tool enables consumers to see 12 plan options on a page and filter their choices by plan, plan type, price, out-of-pocket costs, quality rating and metal tier, among other features. Consumers can also select their preferred plan and the information will be transferred to the application automatically. Another feature is the ability to shop for health or dental insurance and switch between the two offerings.

Consumers who want assistance by phone can leave their number for a call back from the Covered California Service Center. Soon, consumers will have the option of getting an immediate call from an expert enroller to assist them with their shopping and application.

“Covered California is making it easier than ever to sign up — whether it is online, over the phone or in person,” Lee said. “We think this will ensure that our interested customers get the help they need to complete the application process.”

Improving Access to Care

Starting in 2017, Covered California enrollees who do not have a doctor will be matched to a primary care physician who has an open practice within 60 days of their coverage taking effect so that they have an advocate and entry point to the health care system. They can designate a different physician at any time.

“Health care reform isn’t just about making insurance available, it’s about doing things to make it easier for consumers to get the right care at the right time,” Lee said. “We think this is going to be helpful for our consumers — especially those in need of their first physician. We never want the inability to find a doctor to prevent people from accessing the care they need.”

New Television Advertising and Third Annual Bus Tour

A new addition to Covered California’s advertising campaign is a unique television ad aimed at encouraging individuals to get insured. “The Scene,” developed with Campbell Ewald, leverages the viewer’s point-of-view during an emergency situation. The ad reinforces that life can change in an instant, and encourages individuals to be covered when it does. “The Scene” is one element of a comprehensive statewide, multi-ethnic, multi-lingual advertising campaign utilizing television, radio, print, out-of-home, digital and social ads, in addition to targeted outreach aimed at enrolling the African American, LGBT, Spanish-speaking and Asian-language-speaking communities.

In addition, the Covered California bus will travel throughout communities in
California to promote enrollment starting Nov. 12.

Similar to last year, Covered California estimates that as many as 400,000 individuals will enroll and that the total enrollment will be similar to what it was after open enrollment ended in 2016 — approximately 1.4 million people.

Since the exchange opened its doors in 2014, more than 2.8 million Californians have purchased health insurance through Covered California, and the rate of the uninsured in the state has been cut in half.

Open enrollment continues through Jan. 31, 2017. Consumers interested in learning more about their coverage options should go to CoveredCA.com or call (800) 300-1506.

About Covered California

Covered California is the state’s marketplace for the federal Patient Protection and Affordable Care Act. Covered California, in partnership with the California Department of Health Care Services, helps individuals determine whether they are eligible for premium assistance that is available on a sliding-scale basis to reduce insurance costs or whether they are eligible for low-cost or no-cost Medi-Cal. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget.

Small businesses can purchase competitively priced health insurance plans and offer their employees the ability to choose from an array of plans and may qualify for federal tax credits. Covered California is an independent part of the state government whose job is to make the new market 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 Urges Existing Members to Shop and Compare for 2017 Plans as Renewal Begins


  • More than 92 percent of consumers can choose from three plans or more.
  • Plan expansions and savings available through shopping show how the competitive marketplace is working.
  • Uninsured rate has been cut in half in California since 2013.
  • Nearly 80 percent of consumers can benefit from shopping.

Click for Español

SACRAMENTO, Calif. — Amid news from the U.S. Census Bureau that the rate of California’s uninsured has reached record lows, Covered California’s third-ever renewal period began this week for its existing 1.3 million members.

Beginning this week, Covered California consumers will receive renewal notices indicating they can keep their current health plan or switch to another plan for 2017.

“This year, consumers can visit CoveredCA.com to explore their options for coverage in 2017,” said Peter V. Lee, executive director of Covered California. “Most of those renewing with us get subsidies that mean they are paying only a portion of the premium. But even without considering the subsidy, nearly 80 percent of our consumers will either be able to pay less than they are paying now for health insurance, or see their rates go up by no more than 5 percent if they shop and switch to another plan.”

U.S. Census Bureau data released in September shows the Patient Protection and Affordable Care Act has helped cut the rate of the uninsured in half in California, from 17.2 percent in 2013 to 8.6 percent in 2015.

Members renewing their coverage will have access to an upgraded shopping tool that enables them to see their current plan and 2017 rates highlighted side-by-side with their other insurance plan choices for next year.

“This feature will make it much easier for consumers to shop and compare before selecting a plan for 2017,” Lee said. “This is particularly important where there is a larger variation in premium increases than we’ve seen in prior years — with some plans raising rates by 5 or 6 percent, and others in the high teens.”

Earlier this week, California’s regulatory authorities completed their review of Covered California’s rates for 2017 and made a finding that they are not unreasonable.

In addition, the new Shop and Compare tool offers features to upgrade the shopping experience, including displaying health and dental plans separately, showing up to 12 product options on a page instead of three and offering more ways to filter plan choices for the consumer.

In 2017, Covered California will feature coverage from 11 health insurance companies: Anthem Blue Cross of California, Blue Shield of California, Chinese Community Health Plan, Health Net, Kaiser Permanente, L.A. Care Health Plan, Molina Healthcare, Oscar Health Plan of California, Sharp Health Plan, Valley Health Plan and Western Health Advantage.

In addition, some insurance carriers will be increasing their coverage areas, with Molina expanding into Orange County, Kaiser Permanente available in Santa Cruz County and Oscar offering coverage in San Francisco County.

With insurers entering new areas, almost all consumers (92.6 percent) will have at least three insurers to choose from in their region, and none will have fewer than two. In addition, more than 93 percent of hospitals in California will be available through at least one health insurance company in 2017, and 74 percent will be available in three or more plans.

Covered California has also improved its patient-centered benefit designs by increasing a consumer’s access to care through reducing the number of services that are subject to a consumer’s deductible. In 2017, consumers in Silver 70 plans will save as much as $55 on an urgent care visit and $10 on a primary care visit. In addition, consumers in Silver, Gold and Platinum plans will pay a flat copay for emergency room visits without having to satisfy a deductible, which could mean thousands of dollars in savings. Urgent care costs in every 2017 plan will be same as the primary care visit, resulting in significant consumer savings.

These improvements build on features already in place that ensure most outpatient services in Silver, Gold and Platinum plans are not subject to a deductible, including primary care visits, specialist visits, lab tests, X-rays and imaging.

Even consumers in Covered California’s most affordable Bronze plans are allowed to see their doctor or a specialist three times before the visits are subject to the deductible.

Covered California members wishing to explore their options for 2017 should visit CoveredCA.com and sign in to their account. There they will see their current plan and have the option of shopping to compare other plans for 2017. Consumers who take no action by Dec. 15 will be automatically renewed into their existing plan. Consumers can also contact their Certified Insurance Agent or Certified Enrollment Counselor, or call Covered California at (800) 300-1506 for enrollment or renewal assistance.

Individuals who have health coverage through Medi-Cal renew their coverage throughout the year when contacted by Medi-Cal.

About Covered California

Covered California is the state’s marketplace for the federal Patient Protection and Affordable Care Act. Covered California, in partnership with the California Department of Health Care Services, helps individuals determine whether they are eligible for premium assistance that is available on a sliding-scale basis to reduce insurance costs or whether they are eligible for low-cost or no-cost Medi-Cal. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget.

Small businesses can purchase competitively priced health insurance plans and offer their employees the ability to choose from an array of plans and may qualify for federal tax credits. Covered California is an independent part of the state government whose job is to make the new market 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 Announces Rate Change and Expanded Coverage Choices for 2017


  • Statewide weighted average rate increase is less than 6 percent.
  • Blue Shield of California expands to Full PPO network statewide.
  • Kaiser Permanente moves into Santa Cruz County.

Click for Español

SACRAMENTO, Calif. — Covered California announced today the rates and expansion plans for its small group health insurance exchange, Covered California for Small Business. The statewide weighted average rate increase is 5.9 percent, for employers and their employees beginning Jan. 1, 2017, which is down from the 7.2 percent increase in 2016.

“Covered California is building competitive insurance marketplaces that work for both individuals and for California’s small business market, bringing choice, stability and rate moderation to employers, their employees and the many consumers who don’t have employer-based coverage,” said Covered California Executive Director Peter V. Lee. “The options and rates announced today demonstrate that the marketplaces are working to keep insurance premiums under control, and they are giving consumers more choices than ever.”

Starting Jan. 1, Blue Shield of California will take its Full PPO plan statewide across all metal tiers with coverage available to employees working out-of-state. Blue Shield of California will also offer a new plan, Trio HMO Network, powered by a recent innovation in health care, the accountable care organization (ACO). Additionally, Kaiser Permanente will bring coverage to Santa Cruz County. Both expansions improve options for employers in rural parts of the state and expand access to the small business tax credit only available through Covered California for Small Business.

“The expansion of the small group market is allowing thousands of businesses to take advantage of the new control and choice now offered by Covered California for Small Business,” said Kirk Whelan, director of Individual and Small Business Outreach and Sales. “Employers can select up to two adjoining metal tiers and then set their contribution level at one tier or the other. Meanwhile, the employee — knowing the employer’s contribution level — has the flexibility to choose which of the two tiers fits best with the employee’s budget and needs.”

Whelan also noted that Covered California for Small Business operations are sound, with new employers being enrolled within three days of filing an application, and a year-over-year retention of almost 90 percent. There is also growing interest and participation among insurance agents certified to sell plans on the exchange.

“We’ve seen a near doubling since 2014 in the number of agents writing policies, with many agents continuing to enroll multiple groups throughout the year,” Whelan said.

Covered California for Small Business also announced the addition of Rogers Benefit Groups to the ranks of general agents working with the exchange. The company joins general agents Claremont Insurance Services, Dickerson Employee Benefits, LISI and Warner Pacific.
All six carriers participating in 2016 will return for 2017: Blue Shield of California, Chinese Community Health Plan, Health Net, Kaiser Permanente, Sharp Health Plan and Western Health Advantage.

Currently, more than 28,000 individuals have insurance through Covered California for Small Business, which makes it one of the largest Small Business Health Options Programs in the nation.

Lee pointed to the moderate rate change for Covered California for Small Business as another example of the benefits the Affordable Care Act is delivering for millions of Californians and Americans across the country.

“While some have focused on large potential increases in some parts of the country, there has been little attention paid to the fact that for the individual market, 2017 is a transition year,” Lee said. “It is important to remember how much of an impact the end of the temporary reinsurance program is having on rates, and the relatively low increase for small business helps focus attention on what stability can look like.”

The reinsurance program was designed to moderate rate increases during the first three years while exchanges were being established. The American Academy of Actuaries estimates the removal added up to seven percent to premiums for 2017.

“Take that one-time adjustment away and the rate changes for individual and small group marketplaces in California would be nearly identical,” Lee said. “We are building competitive markets where consumers win. Covered California brought choice to the individual market and now we’re doing it in the small business market.”

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 providing insurance through Covered California for Small Business. Visit www.CoveredCA.com/forsmallbusiness/ for information on how to apply.

Family dental plans are optional and will be provided by Access Dental, Delta Dental, Liberty Dental, Dental Health Services, Premier Access Dental and California Dental Network.

About Covered California
Covered California is the state’s marketplace for the federal Patient Protection and Affordable Care Act. Covered California, in partnership with the California Department of Health Care Services, helps individuals determine whether they are eligible for premium assistance that is available on a sliding-scale basis to reduce insurance costs or whether they are eligible for low-cost or no-cost Medi-Cal. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget.

Small businesses can purchase competitively priced health insurance plans and offer their employees the ability to choose from an array of plans and may qualify for federal tax credits. Covered California is an independent part of the state government whose job is to make the new market 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.

New Survey Shows the Affordable Care Act Has Dramatically Reduced California’s Uninsured Rate

  • Seventy-two percent of California’s previously uninsured gained coverage since the Affordable Care Act went into effect.
  • The majority of the recently insured say their experience with their current Covered California plan has been positive.
  • Nearly half of the remaining uninsured are unaware of the financial help available only through Covered California.


SACRAMENTO, Calif. — Covered California Executive Director Peter V. Lee said a survey released Thursday by the Kaiser Family Foundation titled “A Final Look:  California’s Previously Uninsured After the ACA’s Third Open Enrollment Period” provides a compelling picture of how the Patient Protection and Affordable Care Act is changing the lives of millions of Californians.
The survey found that 72 percent of California’s previously uninsured population has gained health coverage since the Affordable Care Act went into effect. That share is up from 58 percent of Californians who became insured after the launch of Covered California and the Medi-Cal expansion in 2014.
“California has made great strides over the past three years, with consumers getting coverage under the Affordable Care Act, getting better employer-based coverage and benefiting from a competitive market that has cut California’s uninsured rate to 8.1 percent,” Lee said. “We know we have more to do to assure that all eligible Californians are able to get the affordable, quality care they deserve, but we should pause to appreciate the progress made in three short years."
The survey found that recently insured consumers are getting access to quality care:
Seventy-seven percent say their health needs are being met, which is up from 49 percent in the first survey conducted before the launch of the Affordable Care Act and Covered California’s first open-enrollment period.
Seventy-six percent are satisfied with their choice of primary care doctors.
Seventy percent say their experience with their current Covered California health care plan has been positive.
Additionally, recently insured consumers say that their new health care coverage is a good value and that the coverage makes them feel more financially secure.
Sixty-five percent say health insurance is worth the cost, which is up from 58 percent in the first survey conducted before Covered California’s first open-enrollment period.
Forty-two percent report feeling more financially secure with health insurance provided by Covered California, which is higher than those who have employer-sponsored insurance.
The survey also showed the importance of continuing to spread the word about the financial help available only to Covered California consumers, as 76 percent of the remaining uninsured said they would be likely to get insurance in the future, if they could buy it for less than they thought. However, only 49 percent of the remaining uninsured said they were aware of the available financial assistance.
“This financial help is allowing nearly 200,000 Covered California consumers to pay less than $25 per month for their coverage, and 759,000 consumers to pay less than $100 per month,” Lee said. “Consumers need to know there is money on the table to help them protect themselves and their family.”
Lee noted that some elements of the survey underscored that further work is needed to ensure affordability of Covered California plans – 47 percent of respondents said they lack insurance because it is too expensive. The report also underscored the need to continue to reach out to underserved communities who remain uninsured, especially the Latino community. Of critical importance is allaying the Latino community’s fears that purchasing insurance through Covered California or accessing Medi-Cal will not affect their or their family’s immigration status.
“We want everyone to know that when you apply for health insurance through a health insurance marketplace like Covered California, all of your information is kept private and secure,” Lee said. “It will not be shared with or used by any immigration agency to enforce immigration laws. All information you submit is used strictly to determine your eligibility for health insurance programs available under the Affordable Care Act.”
The new Kaiser Family Foundation study reinforces Covered California’s own data that suggests consumers move through different coverage options, such as employer-based coverage, Medi-Cal and Covered California. This is the new reality of creating the fabric of coverage in California and nationwide.    
Covered California’s next open-enrollment period begins Nov. 1 and runs through Jan. 31, 2017. In the meantime, special enrollment for those who experience a change in life circumstances, such as moving, getting married or having a baby, continues year-round.
For more information on Covered California’s special-enrollment period, and to find out who is eligible, visit www.CoveredCA.com/individuals-and-families/getting-covered/special-enrollment. Medi-Cal enrollment and Covered California for Small Business enrollment also continue year-round.
About Covered California
Covered California is the state’s marketplace for the federal Patient Protection and Affordable Care Act. Covered California, in partnership with the California Department of Health Care Services, helps individuals determine whether they are eligible for premium assistance that is available on a sliding-scale basis to reduce insurance costs or whether they are eligible for low-cost or no-cost Medi-Cal. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget.

Small businesses can purchase competitively priced health insurance plans and offer their employees the ability to choose from an array of plans and may qualify for federal tax credits. Covered California is an independent part of the state government whose job is to make the new market 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 Announces Rates and Plan Expansions for 2017

Click for Español

  • Statewide weighted average increase is 13.2 percent
  • Three-year average increase of 7 percent is lower than pre-Affordable Care Act trends
  • Nearly 80 percent of consumers will pay less or see a rate bump of no more than 5 percent if they switch plans
  • Insurers are expanding to compete in new communities
  • New benefit changes help consumers save when they access
    health care



SACRAMENTO, Calif. — Covered California unveiled its rates for 2017 on Tuesday and announced that some health insurance plans will be expanding into new areas throughout the state to compete for consumers in California.

The statewide weighted average change will be 13.2 percent, up from approximately four percent in each of the last two years. However, most consumers will see a much smaller increase — or pay less next year — if they switch to another plan.

“Shopping is going to be more important this year than ever before,” Covered California Executive Director Peter V. Lee said. “Almost 80 percent of our consumers will either be able to pay less than they are paying now, or see their rates go up by no more than 5 percent, if they shop and buy the lowest-cost plan at their same benefit level. That’s the power of shopping.”

Downloadable comments from Executive Director Peter V. Lee (Video).

Lee said the opportunities to shop and save show that California has succeeded in building a competitive marketplace for health insurance, with rate increases that are still below trends in the individual market before the Affordable Care Act was passed.

“This is a new era of health care, where the consumer is in the driver’s seat with the power to look easily for a better deal, and where subsidies help absorb the impact of rate changes,” Lee said. “These options did not exist before the Affordable Care Act.”

Some consumers who choose to keep their plan will see a significant increase in their premium for 2017, while others will see a more modest increase, depending on where they live and what insurance plan they have. Consumers will begin receiving notices in October, when they will have an opportunity to review their new rates and change plans for their 2017 health coverage.

For many of those insured, the bulk of the premium increase will be absorbed by the subsidy paid by the government to help enrollees buy health insurance. Approximately 90 percent of Covered California enrollees get help to pay for their premiums. The average subsidy covers roughly 77 percent of the consumer’s monthly premium, and while premiums will rise, the subsidies will rise as well.

“Even though the average rate increase is larger this year than the last two years, the three-year average increase is 7 percent — substantially better than rate trends before the Affordable Care Act was enacted,” Lee said.



Lee said the average rate increase reflects the cost of medical care for consumers, not excessive profit.

“Under the new rules of the Affordable Care Act, insurers face strict limits on the amount of profit they can make selling health insurance,” Lee said. “So, while all plans are experiencing different cost pressures, we can be confident their rate increases are directly linked to health care costs, not administration or profit, which averaged 1.5 percent across our contracted plans.”

For consumers who get a tax credit to lower their costs — which is about 90 percent of those who sign up through Covered California — the amount they pay is impacted not only by the premium choice, but by changes in their tax credit. While the average rate increase is higher than past years, Covered California’s risk mix — the ratio of consumers who are healthy vs. sick — remains one of the best in the nation according to the Centers for Medicare and Medicaid Services (https://www.cms.gov/CCIIO/Programs-and-Initiatives/Premium-Stabilization-Programs/index.html).

Other reasons for rate increases include:
  • A one-year adjustment due to the end of a funding mechanism in the Affordable Care Act known as reinsurance, which was designed to moderate rate increases during the first three years when exchanges were being established. The American Academy of Actuaries estimates this will add between 4 percent and 7 percent to premiums for 2017.
  • Special enrollment by some consumers who may be enrolling in health insurance only after they become sick or need care, which seems to have had a significant impact on rates for two insurance plans.
  • The rising cost of health care, especially specialty drugs.
  • Pent-up demand for health care now being accessed by those who were locked out of the health care system before the Affordable Care Act was enacted.
Lee said Covered California is working to address some of these issues on multiple fronts. The exchange is aggressively marketing to attract healthy consumers year-round, and it is working to ensure special enrollment is available only to those who meet qualifying circumstances. It is also sampling the special enrollment population to better understand how to make any further improvements needed.

“We work hard to build a robust exchange that drives competition by attracting as many consumers as possible,” Lee said. “Now, consistent with the vision of the Affordable Care Act, we will redouble our efforts to make sure our consumers and potential consumers understand the importance of signing up during open enrollment and remaining covered throughout the year.”

Lee said Covered California’s 11 health insurers are competing across the state for its 1.4 million members.

“The sheer number of enrollees and their overall health means consumers in the individual market are benefiting from competition,” Lee said.

Below is the complete list of the companies selected for the 2017 exchange:
  • Anthem Blue Cross of California
  • Blue Shield of California
  • Chinese Community Health Plan
  • Health Net
  • Kaiser Permanente
  • L.A. Care Health Plan
  • Molina Healthcare
  • Oscar Health Plan of California
  • Sharp Health Plan
  • Valley Health Plan
  • Western Health Advantage
Rate details by pricing regions can be found in “Covered California’s Health Insurance Companies and Plan Rates for 2017,” posted online at: http://coveredca.com/news/pdfs/CoveredCA-2017-rate-booklet.pdf

The preliminary rates are subject to a 60-day public comment period and regulatory review by the California Department of Managed Health Care. In addition, the California Department of Insurance will review Health Net’s EPO.

Some insurance carriers will be increasing their coverage areas in 2017:
  • Oscar will be entering the market in San Francisco, Santa Clara and San Mateo counties.
  • Molina will expand into Orange County.
  • Kaiser will be available in Santa Cruz County.
With the expansion of its current carriers, almost all consumers (92.6 percent) will be able to choose from three or more carriers, and all will have at least two to select from.

In addition, more than 93 percent of hospitals in California will be available through at least one Covered California health insurance company in 2017, and 74 percent will be available in three or more plans.

Covered California also is improving its patient-centered benefit designs by increasing a consumer’s access to care by reducing the number of services that are subject to a consumer’s deductible. 

Starting in 2017, consumers in Silver 70 plans will save as much as $55 on an urgent care visit and $10 on a primary care visit. In addition, consumers in Silver, Gold and Platinum plans will pay a flat copay for emergency room visits without having to satisfy a deductible, which could save them thousands of dollars.

These improvements build on features already in place that ensure most outpatient services in Silver, Gold and Platinum plans are not subject to a deductible, including primary care visits, specialist visits, lab tests, X-rays and imaging. In addition, some Enhanced Silver plans have little or no deductible and very low copays, such as $3 for an office visit. Even consumers in Covered California’s most affordable Bronze plans are allowed to see their doctor or a specialist three times before the visits are subject to the deductible.

In addition, the contract with health insurers for 2017 ensures consumers select or are provisionally assigned a primary care physician within 60 days of effectuation so they have an established source of care.

“Health care reform isn’t just about making insurance affordable, it’s about doing things to make it easier for consumers to get the right care at the right time,” Lee said.

In May, the Centers for Disease Control and Prevention announced that California’s uninsured rate had fallen to 8.1 percent at the end of 2015, down from 17 percent at the end of 2013, right before the Affordable Care Act began offering coverage.

“We can all be very proud of the extraordinary gains we have made in reducing California’s uninsured rate to a historic low,” Lee said.

About Covered California
Covered California is the state’s marketplace for the federal Patient Protection and Affordable Care Act. Covered California, in partnership with the California Department of Health Care Services, helps individuals determine whether they are eligible for premium assistance that is available on a sliding-scale basis to reduce insurance costs or whether they are eligible for low-cost or no-cost Medi-Cal. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget. Small businesses can purchase competitively priced health insurance plans and offer their employees the ability to choose from an array of plans and may qualify for federal tax credits.

Covered California is an independent part of the state government whose job is to make the new market 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.

New Survey Shows California's Uninsured Rate Falls to Another Record Low

SACRAMENTO, Calif. — A new survey from the Centers for Disease Control and Prevention (CDC) revealed that California’s uninsured rate had fallen to 8.1 percent at the end of 2015, a full percentage point lower than the national uninsured rate of 9.1 percent.

Covered California Announces Agreement With Eyemed Vision Care

EyeMed Vision Care Is the Second Vision Carrier Chosen to Showcase Its Offerings on CoveredCA.com

SACRAMENTO, Calif. — Covered California now has a second pathway to vision plans under an agreement with EyeMed Vision Care.

“We’re excited EyeMed is on board to offer another vision care path for consumers to choose from,” Covered California Executive Director Peter V. Lee said. “EyeMed Vision Care is a proven leader in the vision service community, and we believe it will bring added value to consumers shopping at CoveredCA.com.”

Beginning today, visitors to CoveredCA.com can access EyeMed Vision Care via a link, which will take the consumer to EyeMed Vision Care’s website. Once there, consumers will work directly with EyeMed Vision Care to shop for vision benefits and see what coverage options are best for their situation.

“EyeMed is pleased to join CoveredCA.com and provide a pathway for Californians shopping for vision coverage,” EyeMed Vision Care President Lukas Ruecker said. “Whether it’s our wide choice of providers, exam technology or eyewear solutions, we look forward to providing consumers access to digital, 21st-century tools they need to navigate their choices with confidence.”

As part of the agreement with Covered California, EyeMed Vision Care will conduct annual consumer surveys to ensure a positive consumer experience. In addition, EyeMed Vision Care will provide quarterly enrollment reports to Covered California based on those who have accessed EyeMed Vision Care through CoveredCA.com.

Covered California is committed to providing access to a wide range of options for consumers and serving as a one-stop shopping location for all their health care needs. In addition to the health plans offered through the exchange, Covered California also has dental options available. The addition of EyeMed Vision Care to the Covered California platform creates one more option for consumers.
Adult vision care is not an essential health benefit under the Patient Protection and Affordable Care Act, and coverage is handled directly through EyeMed Vision Care. Vision services for children are an essential health benefit and are included in all health plans purchased through Covered California. Enrollment with EyeMed Vision Care into vision plans is available year-round, and there are no open enrollment dates.

The link to EyeMed Vision Care from CoveredCA.com can be found here: www.CoveredCA.com/individuals-and-families/getting-covered/vision.

About Covered California
Covered California is the state’s marketplace for the federal Patient Protection and Affordable Care Act. Covered California, in partnership with the California Department of Health Care Services, was charged with creating a new health insurance marketplace in which individuals and small businesses can get access to affordable health insurance plans. Covered California helps individuals determine whether they are eligible for premium assistance that is available on a sliding-scale basis to reduce insurance costs or whether they are eligible for low-cost or no-cost Medi-Cal. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget. Small businesses can purchase competitively priced health insurance plans and offer their employees the ability to choose from an array of plans and may qualify for federal tax credits.


Covered California is an independent part of the state government whose job is to make the new market 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.