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Health Net Is Exiting the California Group Market
Health Net will no longer offer small or large group coverage in CA. In-force groups terminate February 28, 2027. Your Claremont team is ready to help find alternatives. Call 800.696.4543 or email quotes@claremontcompanies.com.
On April 2, 2026, the Centers for Medicare and Medicaid Services (CMS) finalized new rules affecting how employer group health plans determine Medicare Part D “creditable coverage” status, effective for plan years beginning on or after January 1, 2027.
The change
Starting in 2027, the Simplified Determination Method is retired. Group health plans that do not participate in the Retiree Drug Subsidy (RDS) program may only use the Revised Simplified Determination Method or a full Actuarial Equivalence determination.
Under the Revised Simplified Determination Method, a plan is creditable if it:
That threshold rose from 72% in 2026 and 60% in prior years.
What’s different from 2026
2026 was a transition year — plan sponsors could choose between the Simplified Determination Method and the Revised Simplified Determination Method. That choice ends in 2027: only the Revised Simplified Determination Method (at the higher 73% threshold) or an actuarial certification will be accepted.
Separately, the final rule also exempts account-based plans (HRAs, ICHRAs, and health FSAs) from the creditable coverage disclosure requirement altogether.
Why it matters
Plans that comfortably met the 60% or 72% thresholds under the Simplified Determination Method may not automatically meet the 73% threshold under the Revised Simplified Determination Method. Groups with leaner prescription drug benefits should have their plan design reviewed before their 2027 renewal to confirm creditable coverage status — losing that status can expose Medicare-eligible plan members to late-enrollment penalties. We will monitor the carriers and provide updates when creditable plans for 2027 are announced.
Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.
Covered California for Small Business (CCSB) has rolled out new flexibility for brokers navigating the Health Net exit, plus a deadline extension that applies to every new small group.
Simplified Documentation
CCSB now accepts a prior Health Net bill (showing at least one enrolling subscriber) in place of a DE-9 or payroll report. Employees not listed on that bill can be verified with a paystub or offer letter. Owner-only and husband-and-wife groups remain ineligible.
Extended Deadlines — All Groups
Submission deadlines are extended to the 15th of the month for effective dates October 2026–March 2027, regardless of current carrier. CCSB expects high application volume through March, so early submission each month helps avoid delays.
CCSB Fundamentals
Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.
In addition to California’s most comprehensive access to doctors and hospitals, CCSB health plans offer choice and control, with:
As a trusted CCSB partner since its 2014 launch, we are a top-producing general agency in our sales territory. From agent certification and quoting to assessing new group eligibility and resolving post-enrollment issues, our CCSB experts will provide guidance and support every step of the way.
Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.
Join Covered California for Small Business’s Dan Tyler and Shawn Rutledge for a webinar highlighting some exciting developments for 2027 including:
When: Tuesday September 22, 11:00 a.m.
In addition to California’s most comprehensive access to doctors and hospitals, CCSB health plans offer choice and control, with:
As a trusted CCSB partner since its 2014 launch, we are a top-producing general agency in our sales territory. From agent certification and quoting to assessing new group eligibility and resolving post-enrollment issues, our CCSB experts will provide guidance and support every step of the way.
Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.
Covered California for Small Business (CCSB) is pleased to announce that Western Health Advantage is rejoining the small business exchange for the 2027 plan year!
The return of Western Health Advantage will bring greater employer and employee choice and affordability to the Greater Sacramento and North Bay regions. By expanding carrier options in these markets, Covered California for Small Business continues to strengthen access to competitive, quality coverage for small businesses and their employees. Western Health Advantage plans will be available for quoting beginning in October for January 1 effective dates.
This announcement comes as CCSB continues to experience steady, incremental growth. CCSB currently serves 9,700 enrolled employer groups and roughly 80,000 total members. With the addition of Western Health Advantage, CCSB now has partnerships with four health carriers: Blue Shield of California, Kaiser Permanente, Sharp Health Plan, and Western Health Advantage.
CCSB is excited about the additional value this returning carrier will bring to brokers and employer groups, and looks forward to sharing more information about 2027 plans and availability in the months ahead. Thank you for your continued partnership and for the important role you play in connecting California small businesses with coverage that meets their needs.
In addition to California’s most comprehensive access to doctors and hospitals, CCSB health plans offer choice and control, with:
As a trusted CCSB partner since its 2014 launch, we are a top-producing general agency in our sales territory. From agent certification and quoting to assessing new group eligibility and resolving post-enrollment issues, our CCSB experts will provide guidance and support every step of the way.
Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.
With the Covered California for Small Business (CCSB) bonus program, agents who place new small group business from July 1, 2026 – January 1, 2027, can earn up to a $9,000 bonus per group, in addition to standard commissions. To qualify for the first bonus tier of $500, agencies must submit a minimum of three groups with five enrolled employees.
See the CCSB flyer for more details.
Qualification: Write 3 or more groups during the bonus period to qualify.
Enhanced Bonus: Write 6 or more groups and earn a 50% increase on all bonuses.
Eligibility: Business acquired through a partnering General Agency is included.
In addition to California’s most comprehensive access to doctors and hospitals, CCSB health plans offer choice and control, with:
As a trusted CCSB partner since its 2014 launch, we are a top-producing general agency in our sales territory. From agent certification and quoting to assessing new group eligibility and resolving post-enrollment issues, our CCSB experts will provide guidance and support every step of the way.
Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.
With tax deadlines approaching, eligible small businesses can qualify for federal tax credits of up to 50% on health insurance premiums–available exclusively through Covered California for Small Business (CCSB).
To be eligible, businesses must:
The tax credit is calculated on a sliding scale—smaller businesses with lower average wages qualify for higher credits. Employers can apply the credit directly to their Federal Tax Return. Use the CCSB Tax Credit Calculator to estimate potential savings.
To learn more, download the Small Business Tax Credit flyer and the How to Apply For The Tax Credit flyer.
Since 2014, thousands of small businesses have trusted CCSB for quality, flexible health coverage. With consistent double-digit membership growth, here’s why CCSB stands out:
Employee-Only Coverage
CCSB provides flexibility for employers to apply their full budget to employee coverage while dependents can access separate coverage and subsidies on the individual marketplace.
No Admin or Late Fees
Every dollar goes directly toward employer premiums.
Streamlined Onboarding
Quick quoting, simplified applications, and easy invoicing. Start-up groups need just two weeks of payroll, with monthly ACH payments accepted.
Fast Certification
No testing or annual re-certification—just a one-hour course to get started.
Multi-Carrier Portfolio
Employers and employees can choose from the top-tier PPOs and HMOs with affordable access to the broadest network of physicians and hospitals in California. Multi-state coverage is available for groups with employees out of state.
Exclusive Tax Credit
Eligible small businesses can qualify for federal tax credits up to 50% on premiums to help pay for the cost of providing quality health coverage for employees. (Contact us for help in determining employer eligibility.)
MyCCSB Portal
Employers and brokers can enroll employees, update plans, manage renewals, and more—all within 24 hours.
With California’s most comprehensive access to doctors and hospitals, CCSB offers flexibility, control, and convenience, including:
Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.
Covered California for Small Business (CCSB) serves as an administrator for the participating Health Plans and is therefore not subject to RxDC data collection requirements on behalf of employer groups. However, CCSB has been actively engaged with participating Health Plans to understand their approach to meeting the RxDC reporting requirements. Below find a summary of approaches taken by the three Health Plan Issuers. If you have further questions, CCSB recommends to reach out to the Health Plan directly.
Blue Shield of California issued a Broker Alert detailing instructions for the submission of group data via an intake form. The deadline for the submission of this form is Friday, April 10, 2026.
The following information is required to complete the form:
Kaiser Permanente is compiling and submitting the required data on behalf of their employer groups.
Sharp Health Plan will be contacting their employer groups directly to obtain the required information. In addition, they will be sending a broker and employer alert informing all brokers and CCSB employers of the RxDC reporting requirement.
Questions?
Contact our CCSB expert team at 800.696.4543 or info@claremontcompanies.com.
Covered California for Small Business (CCSB) now offers a simplified eligibility process for new small groups with 3+ enrolling employees, effective immediately.
As a reminder, CCSB’s “A Partnership that Pays” broker bonus program is in place for new group business placed July 1, 2025 – January 1, 2026. Get the details.
Questions?
Contact our CCSB expert team at 800.696.4543 or info@claremontcompanies.com.
CCSB received recent reports of phishing scams targeting Covered California for Small Business (CCSB) enrollment partners. These emails attempt to trick recipients into clicking a “secure” link to verify or update personal information. Do not click any links—these messages are fraudulent.
Official emails from Covered California for Small Business will always come from an @covered.ca.gov address. Before opening any message, please confirm the sender’s full email address, not just the display name. Many phishing attempts use familiar names paired with fake email addresses.
CCSB is here to help. If you receive a suspicious message or believe your information may have been compromised, please report it immediately to CCSB:
Information Security: InformationSecurity@covered.ca.gov
Privacy Office: PrivacyOfficer@covered.ca.gov
Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.
With the Covered California for Small Business (CCSB) bonus program, agents who place new small group business from July 1, 2025 – January 1, 2026, can earn up to a $12,000 bonus per group, in addition to standard commissions. To qualify for the first bonus tier of $1,000, agencies must submit a minimum of three groups with five enrolled employees. Best of all, the bonus is per group with no maximum number of groups!
See the CCSB flyer for more details.
In addition to California’s most comprehensive access to doctors and hospitals, CCSB health plans offer choice and control, with:
As a trusted CCSB partner since its 2014 launch, we are a top-producing general agency in our sales territory. From agent certification and quoting to assessing new group eligibility and resolving post-enrollment issues, our CCSB experts will provide guidance and support every step of the way.
Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.