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Covered California for Small Business –
New Blue Shield Plans

Starting July 1, Covered California for Small Business (CCSB) is offering new Blue Shield plans, providing more options for enrollees. These plans include the Access+ HMO Network with Platinum, Gold, and Silver metal tier options, as well as the Bronze Trio HMO 7000/70. The two most popular Blue Shield High Deductible Health Plans (HDHP), Silver Full PPO Savings 2300/25% and Bronze Full PPO Savings 7000 plans, are also now available.

All of these plans offer benefits such as Wellvolution, Teladoc Mental Health, Nurse Help 24/7, LifeReferrals 24/7, and the Blue Card program for when members are outside of California.

For assistance, please contact our Quotes team at quotes@claremontcompanies.com or 800.696.4543.

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Agent Concerns

I’ve been told that Covered California for Small Business is an option only for employers eligible for the Small Business Health Care Tax Credit. Is this correct?

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No, that’s incorrect. Covered California for Small Business is a health insurance marketplace that offers any California small business (1-100 employees) a choice of quality, affordable health insurance from multiple trusted carriers.

A wide range of California employers benefit from the many advantages offered by Covered California for Small Business. Discover the advantages here.

Can Claremont assist agents with clients eligible for the Covered California for Small Business market?

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Claremont Insurance Services is authorized to represent Covered California for Small Business.

As an authorized Covered California for Small Business general agent, Claremont offers you:

Can I update my Covered California agent profile to indicate I only serve employers (i.e. not individuals?)

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Yes. To update your profile, simply select ‘Employers’, and de-select ‘Individuals/ Families’ in the ‘Clients served’ section.

I can’t access my Covered California agent portal. Help!

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A number of agents have reported that they can’t access their agent portal. Many of them, it turns out, created two accounts for some reason. There can only be one “certified” account per agent/license #. These agents have been trying to access their clients through a non-certified account. Here’s what to do to check if this is the problem that’s impacting you:

Determine if the account is “certified” by looking at the Certification Status screen. See the screenshot in the link here:
https://www.claremontcompanies.com/wp-content/uploads/2014/01/CoveredCA-Agent-Certification-Status-Screenshot.png

If Certification Status indicates “Certified,” then that’s the account you should use and to avoid confusion you should call the service center (1-877-453-9198) and have the other account deleted.

If Certification Status indicates “Eligible”, as in the screen shot, then that account is not valid, but you shouldn’t delete this “Eligible” account until you have confirmed you have a “certified” account.

If you don’t know the username and password for an account, you will need to call the service center to get the username and get a password reset.

How does an employer make an Agent-of-Record change in Covered California for Small Business?

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The employer group must write a letter to Covered California and state who their current agent is and who they want their new agent to be. The letter should be dated and signed by an employee of the group who is authorized to make the decision. The letter should be mailed to:

Covered California
P.O. Box 7010
Newport Beach, CA 92658

Do certified enrollment counselors have E&O coverage?

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No.

What is the broker of record (BOR) process in Covered California for Small Business?

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Covered California uses the term agent of record (AOR). A new agent of record is assigned when Covered California receives a notice in writing from the employer designating the new agent of record. Notices should be sent to Agents@covered.ca.gov.

On slide 17 of the Compliance Standards section of the training manual, at what point does advising become coaching?

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What slide 17 of the Compliance Standards section of the training manual is explaining is that agents are not allowed to coach the consumer to provide inaccurate information on the application regarding income, residency, immigration status and other eligibility rules.

Who should the agent contact to get pre-approval for marketing materials?

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Review and approval of advertising materials should be submitted to Covered California at agents@covered.ca.gov.

Agents should allow at least 10 business days from the date of the request for Covered California to review any materials submitted. When submitting required materials for approval, indicate the following in the subject line: Advertising Approval Request – Agent name and material type. When submitting revised material, indicate so in the body of the email and include the original submission date of the material. Do not bundle multiple materials in the same submission email. Send a separate email for each material. The only exception is translations. Translations may be sent in one email along with the corresponding English version if available.

If customer service representatives assist with employee enrollments and changes do they need to be a Certified Insurance Agent?

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Anyone using the CALHEERs system to enroll and maintain groups will need to be a Certified Insurance Agent.

In our library, you’ll find carrier forms, applications, enrollment kits, broker bonuses, marketing resources, and more (video tutorial). However, not all carrier forms are available online.

If you don’t find what you are looking for, contact our team for help at 800.696.4543 or materials@claremontcompanies.com.