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.

Tuesday, July 1, 2014

Covered California Accepting Applications for $16.9 Million in Grants for New Enrollment and Education Program

‘Navigators’ Will Inform and Help Consumers Enroll in Quality, Affordable Health Insurance Plans

SACRAMENTO, Calif. — Covered California™ has announced its intent to award up to $16.9 million in grants for the launch of its Navigator Program, the next phase in the agency’s outreach, education and enrollment efforts.

Wednesday, May 21, 2014

Covered California's Executive Director: We're Open for Business

“We’re open for business and enrolling thousands of Californians every day.” That’s what I say when people ask what Covered California is doing now that our historic first open-enrollment period has come to an end. We need you to get the message out that Covered California is still very “open for business.”

Thursday, May 15, 2014

Covered California Creates Limited Special-Enrollment Period for Those Covered by COBRA

COBRA Enrollees Have 60 Days to Switch to an Exchange Plan; Move Is Expected to Save California Consumers Money on Health Insurance

SACRAMENTO, Calif. — Beginning Thursday, May 15, Covered California will launch a limited-time special-enrollment period for people who have COBRA health insurance and would like to switch to an exchange plan.

People who have health coverage through COBRA (the Consolidated Omnibus Budget Reconciliation Act) will be eligible to shop for and buy coverage through Covered California from May 15 through July 15, 2014. The two-month window mirrors a U.S. Department of Health and Human Services (HHS) ruling announced May 2 that allows COBRA enrollees to buy plans through the federal exchange until July 1.

The federal policy for the COBRA special-enrollment period was approved amid concerns that notifications did not give consumers clear information about options in the new marketplace. HHS encouraged state exchanges to follow suit.

“COBRA coverage has given vital protection for nearly three decades to people who lost coverage from their employers, especially those who couldn’t get affordable insurance because of their age or a pre-existing condition,” said Covered California Executive Director Peter V. Lee. “Since the passage of the Affordable Care Act, plans in the individual market could be preferable to COBRA coverage because of premium assistance and cost-sharing reductions, available only through the exchanges. For some people who have COBRA coverage, purchasing a plan in the Covered California marketplace during this special-enrollment period could save thousands of dollars a year.”

Wednesday, May 7, 2014

Central Coast Enrollment Figures through March 31 Released by Covered California and Department of Health Care Services

Enrollments Nearly Triple Initial Projections; Enrollment Data for All Counties Now Available

SACRAMENTO, Calif. — Covered California™ and the California Department of Health Care Services (DHCS) announced today that from Oct. 1, 2013, to March 31, 2014*, under the Patient Protection and Affordable Care Act, 95,499 consumers in six Central Coast counties enrolled in subsidized and non-subsidized Covered California health insurance plans. The new total represents a 55 percent increase from the 61,474 enrollments recorded through Feb. 28.