Monday, September 15, 2014

Covered California Announces Community Outreach Campaign for 2015

New Grant Awards and Advertising to Support Renewal and Enrollment in 2015

SACRAMENTO, Calif. — Building on high enrollment in 2014, Covered California launched its community outreach campaign for 2015 on Monday, including new grants to community groups and a comprehensive advertising campaign aimed at attracting new consumers and encouraging them to enroll in the state’s health benefit exchange.

“Today we are sharing stories about real people whose lives have been changed by the coverage offered under the Affordable Care Act,” Covered California Executive Director Peter V. Lee said. “We are building on the partnerships across the state to provide new grants to community groups to engage people directly and help them get the coverage they need.”

The new series of ads, which feature real Californians who have health coverage as a result of the Affordable Care Act, will begin rolling out this week in markets statewide. The ads can be downloaded at

“Our campaign on the airwaves will support our community outreach campaign by making tangible the benefits of getting covered,” Lee said. “But even more importantly, we hope these ads will foster conversations at family dinners, in churches and in schools — where Californians will be talking about the benefits of having coverage and making sure no one who is eligible for coverage goes without it. Beyond these conversations, we will build on an expansive network of thousands of Certified Enrollment Counselors, Certified Insurance Agents and county eligibility workers helping people learn about insurance and enroll.”

The campaign includes $46 million in new statewide advertising and $14.6 million in new community outreach grant funding. This new funding, combined with approximately $33.4 million in funds that community outreach groups will spend in the coming months for renewal and enrollment, brings Covered California’s investment in this community outreach campaign to $94 million for 2015.

Selected organizations will receive between $50,000 and $750,000 in grants, based on their experience with special populations defined by common characteristics — such as language, ethnicity, geography and employment sector — and their ability to effectively educate and enroll Californians and help individuals with Covered California coverage renew their insurance.

The grant award period is from Oct. 1, 2014, through June 30, 2015. A list of grantees and amounts received is available at

Supported by the federal funding provided under the Affordable Care Act, new grants will support the existing Covered California Outreach and Education Program and in-person enrollment assistance programs.

Lee said that the experiences from the first year are guiding how community partners will go about reaching target populations in this renewal and open-enrollment period.

Informational materials that are culturally relevant and in multiple languages will be offered to specific communities to help improve the health literacy of those who have been uninsured and to explain the financial and practical importance of having health coverage.

“We learned some important lessons in year one,” Lee said. “We know how important it is for consumers to get one-on-one help from trusted sources in their communities where they live, work and play.”

Open enrollment begins Nov. 15, 2014, and continues through Feb. 15, 2015, but Covered California will be reaching out to those with insurance in October to get them ready for renewing their coverage.

Covered California anticipates a total enrollment of 1.7 million Californians by the end of the coming open-enrollment period — 1.5 million in subsidized coverage and 230,000 in unsubsidized coverage. This forecast represents an increase of about 500,000 in total enrollment (43 percent).

Covered California’s enrollment projection model considers experience to date and feedback from experts regarding expectations about future growth. The projection considers current enrollment, individuals who are eligible for subsidies but not enrolled, disenrollment and individuals who may transition to Covered California from Medi-Cal or employer coverage.

“We’ve come a long way in California,” Lee said. “Recent studies show California has dramatically reduced the number of uninsured people, but there’s more work to do. With these stepped up education and enrollment efforts, we will continue working to reach as many Californians as possible to give them the peace of mind that comes with having the coverage and care they need.”

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

Thursday, September 4, 2014

Covered California Reaches Out to Thousands of Consumers Who Have Limited Time to Clarify Their Lawful Presence in California

Agents, Counselors and Community Organizations Will Help Educate Enrollees That Citizenship and Immigration Documents Must Be Submitted, or the Consumers Risk Losing Coverage

Covered California is contacting about 98,000 families that must resolve eligibility inconsistencies in their 2014 enrollment documents.

The consumers will need to submit documents showing they are lawfully present in the United States as U.S. citizens, U.S. nationals or individuals with eligible immigration status, in order to continue their health insurance through Covered California. Notices are being mailed and emailed to consumers beginning this week. If proper proof is not provided by Sept. 30, 2014, these individuals risk termination of health coverage.

“We want to clear these inconsistencies so that our consumers can have a smoother renewal process without any interruption in their coverage,” said Covered California Executive Director Peter V. Lee. “We’re implementing a multi-touch, multi-channel outreach approach to notify individuals who risk losing coverage.”

Covered California has been working to clear inconsistencies. To date, more than 700,000 documents have been verified and processed.

Documents submitted by consumers will be treated confidentially and will be used only to determine the consumers’ eligibility for health insurance programs and will not be used for immigration enforcement.

Lee said some consumers may have previously provided Covered California the required documents, but the agency could not reconcile the information to verify citizenship or immigration status. For example, some documents were illegible, and in some cases two pieces of proof were needed, but only one document was sent, so the agency is requesting the documents be sent again.

The notices will provide consumers with a list of documents they can send to prove their lawful presence. The notices will be delivered in English and Spanish, and help is also available in other languages.

Consumers also will be instructed on how to upload the documents to their account, send them via U.S. mail or fax them to (888) 329-3700. Additionally, thousands of partners, including Covered California Certified Insurance Agents, Certified Enrollment Counselors, Service Center representatives and county eligibility workers, will be available to help consumers submit the necessary documentation.  

Lee stressed that consumers should act quickly to submit the requested documents.

“If we do not get your documents, Covered California must cancel your health insurance, along with any federal tax credit you may be receiving that lowers your monthly premiums,” Lee said. “If you have received tax credits, and your health insurance is canceled, you may have to repay those tax credits. If your health insurance is canceled, you may also have to pay a tax penalty.”

The following documents may prove eligible immigration status: a U.S. passport; a certificate of naturalization (N-550/N-570); a certificate of citizenship (N-560/N-561); a U.S. public birth certificate; a driver’s license issued by a U.S. state or territory; an identification card issued by the federal, state or local government; a school identification card; a foreign passport; and a green card. A complete list will be offered at

Thursday, August 21, 2014

Covered California Announces Appointments of Directors of Communications and Director of Individual and Small-Business Sales Team

Covered California Executive Director Peter V. Lee has named Amy Palmer as the director of Covered California’s Office of Communications and Public Relations and Kirk Whelan as the director of the Individual and Small Business Sales Division.

Palmer will oversee the agency’s media relations, public relations and all other external communications. Whelan will oversee Covered California’s sales strategy in both the individual and small-business markets, including meeting sales goals and designing future health insurance products. He will be responsible for consumer retention and renewal of health insurance plans, which will include a field sales program involving Covered California Certified Insurance Agents, Navigators and agency staff.

“Amy’s skills as a health care communicator will be key in guiding our media and public relations efforts,” said Lee. “Amy’s experience will help ensure we are effectively communicating with all Californians about the quality, affordable coverage available through Covered California.”

Palmer’s career in health communications includes serving as associate secretary of external affairs for the California Health and Human Services Agency. In that role, Palmer oversaw media outreach and was responsible for communicating a wide range of health and social service proposals, including health care reform advanced in 2007.

Prior to joining the Health and Human Services Agency, Palmer led communications for the California Department of Social Services, where she developed an award-winning statewide media campaign designed to explain new work rules in the state’s main public assistance program.

Palmer earned a Bachelor of Arts degree in political science from the University of California, Berkeley, and a master’s degree from the Medill School of Journalism at Northwestern University.

Whelan comes to Covered California from Kaiser Permanente, where he worked in a variety of positions since 1996. Most recently, he was the sales manager for Kaiser’s valley territory in Northern California, responsible for large- and small-business membership sales and was the leader of Kaiser Permanente’s California small-business strategy team. “Kirk’s years of experience in the California group employee benefit market will enhance our ability to effectively meet sales and renewal goals and will be an integral part of our future success,” said Lee. “His expertise working with insurance agents also will serve as a critical asset for Covered California.”

During his tenure at Kaiser Permanente, Whelan’s responsibilities included building partnerships with insurance agents to enhance sales. He led agent training and update programs for more than 10 years and was responsible for leading Kaiser Permanente’s statewide agent education program in 2013 to prepare agents and employers for the implementation of the Affordable Care Act. Whelan is also a past president of the Sacramento Association of Health Underwriters.

Whelan graduated from California Polytechnic State University, San Luis Obispo, with a Bachelor of Science degree in marketing and sales, agricultural business management.

The annual salary for Palmer’s position is $160,000, and the annual salary for Whelan’s new position is $170,000. Both Palmer and Whelan will report to Yolanda Richardson, chief deputy executive director for strategy, marketing and product development.

Wednesday, August 20, 2014

Covered California Plans to Offer Expanded Dental Services for Children and New Coverage for Adults

Pediatric Dental Care Embedded in Standard Plans for 2015; Also New in 2015 Are Optional Family Dental Plans That Will Offer Coverage for Adults

SACRAMENTO, Calif. — Covered California is offering new family dental plans to consumers who enroll in health insurance coverage in 2015. Additionally, all individual health insurance plans sold through the Covered California exchange will include pediatric dental benefits for members younger than 19.

“This is great news for families and children, because all children enrolled in Covered California will have dental coverage embedded in their comprehensive health plan,” Covered California Executive Director Peter V. Lee said. “They will be getting better coverage and more for their money.”

Additionally, Lee said, the family dental plan will offer adults the option of receiving dental coverage outside the general health plans at an additional cost. Some consumers also may be drawn to family dental plans if a provider they prefer for their child is not offered in their embedded coverage.

The optional stand-alone family dental plans, which offer coverage for adults, will not be available at the beginning of open enrollment, which starts Nov. 15, but are planned to be added in early 2015. Covered California will offer both dental health maintenance organization (DHMO) and dental preferred provider organization (DPPO) plans, giving consumers a choice in the type of plan that will work best for them. There is no financial assistance available for the optional adult dental benefits.

Lee emphasized that there is no requirement to enroll children in a family dental plan. The family dental plan is optional and is primarily intended to offer affordable dental coverage to adults that was not available in 2014. Families should consider that adding their children to a family dental plan will result in an extra cost for the same dental services they already receive in their standard health insurance plan. The most likely reason to enroll a child in the family dental plan is if a dental provider they prefer for their child is not offered through their embedded coverage.

Covered California is notifying enrollees to explain the availability of pediatric dental benefits in its health insurance plans, as well as to explain the newly available family dental plans that include dental benefits for adults.

Below is a list of the pediatric dental coverage embedded with Covered California’s health insurance plans.

Family dental plans are offered from the companies listed below.

A booklet containing more information about the new family dental plans is available online at

Thursday, July 31, 2014

Covered California Announces Rates for 2015; Rigorous Negotiations with Health Insurance Companies Keep Rate Increases Low and Choices Robust

Strong Enrollment for 2014 Prompts Balanced Risk Pool and Competition Between Health Plans; Average Statewide Rate Increase Kept to 4.2 Percent

SACRAMENTO, Calif. — The vast majority of Covered California consumers will see low increases in their health insurance premiums for 2015, and many consumers will see no increase or even a decrease. The statewide weighted average*  came in at 4.2 percent, with some plans offering weighted average rates that are 8.5 percent lower than current pricing.

“This is good news for Californians and an example of how Covered California and the Affordable Care Act are working to make health insurance affordable,” said Covered California Executive Director Peter V. Lee. “As we move into our second open enrollment and first renewal for many Californians, we are glad to see consumers have a real choice, with affordable options in all regions.”

Covered California’s role as an “active purchaser” brought in low rate increases while maintaining high quality. Covered California’s team of negotiators actively engaged in vigorous back-and-forth with insurance companies to keep increases at a minimum, deliver networks of doctors and hospitals that meet consumers’ needs and give them meaningful choice when shopping for the plan that is the best fit.

“Health care is regional, it’s local, and it’s personal. This means that the costs and options for each consumer in California are different,” Lee said. “The ‘average’ rate going up only 4.2 percent means that for some it will go up more and for some less, but all consumers now have the ability to shop. Consumers are not locked in to one plan; they can stay with their plan or change and can often find a lower-priced option.”

Covered California has selected 10 health insurance companies to be in the state health exchange in 2015. All 10 health insurance companies were in the exchange for 2014 and submitted bids to return to the exchange for 2015 coverage. The portfolio reflects a wide mix of large nonprofit and commercial leaders in the individual health insurance market, along with Medi-Cal and regional plans.

Covered California selected the following health insurance companies for the 2015 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.
  • Sharp Health Plan.
  • Valley Health Plan.
  • Western Health Advantage.

The rates submitted by the selected companies are tentative and subject to an independent reasonability review by the state’s regulators, with the California Department of Managed Health Care reviewing the rates of nine carriers and the California Department of Insurance reviewing the rates of one.

Additionally, 90 percent of consumers currently enrolled in health insurance plans through Covered California are receiving federal subsidies to help reduce their overall costs. In most areas of the state, the amount of subsidy that individuals receive will either increase or remain very close to 2014 subsidy amounts. This means that for many consumers, any increase in premium will be offset by an increase in subsidy.

All insurers submitted bids for products that include children’s dental plans, making it convenient and affordable for families to get dental care for their children.

In response to customer feedback, some health insurance plans will offer expanded provider networks so that Californians can choose from a wider selection of doctors.

The participating companies offer networks designed to meet the needs of consumers. In many cases health plans added doctors and hospitals to existing networks, in addition to providing essential health benefits such as prescription drug coverage and hospital stays. These benefits are identical for both consumers purchasing coverage through Covered California and consumers purchasing on the individual market outside the exchange.

Because of the Affordable Care Act, all health insurance companies in the individual market now offer guaranteed issue; no one is denied coverage because of a pre-existing condition. Consumers can select plans without worrying about gimmicks and gotchas that previously plagued the commercial market. Additionally, the law’s limits on out-of-pocket spending are helping Californians avoid financial ruin due to medical costs.
Consumers can now use the 2015 Shop and Compare Tool on the Covered California website, at, to look at plans and products in their area and to get a preliminary estimate of costs and premium assistance.

For more details on the plans in specific pricing regions, visit

The current list of insurers is for comprehensive individual health policies only. Covered California will later announce adult and family dental options available through Covered California, along with health insurance options for small businesses.

Monday, July 14, 2014

Covered California Announces Director of Plan Management and Chief Financial Officer Appointments

SACRAMENTO, Calif. — Covered California Executive Director Peter V. Lee announced the appointments of Anne E. Price as director of the Plan Management Division and James D. Lombard as chief financial officer.

Monday, July 7, 2014

Covered California Announces Promotion and New Appointment to Senior Leadership Team

Richardson Helped Lead New Health Insurance Exchange Through Its Historic First Enrollment Success; Johnsrud Brings Strong Financial Skills to Agency

SACRAMENTO, Calif. — Covered California Executive Director Peter V. Lee has announced the appointments of Yolanda R. Richardson as chief deputy executive director of strategy, marketing and product development; and Susannah C. Johnsrud as the new chief deputy executive director of operations.