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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 or 800.696.4543.

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Individual Family Eligibility & Enrollment

If a couple has no income, can they qualify for Covered California?

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If the couple’s household income for the taxable year is below 138% of the federal poverty level, which it probably will be if they have no income, they may be eligible for Medi-Cal if they also meet the other eligibility requirements.

See pages 8-12 in the Eligibility for Individuals and Families participant guide.

If the couple is eligible for Medi-Cal they will not be able to receive premium assistance or a cost-sharing reduction through Covered California. However, they can buy a Covered California plan at full cost.

My clients enrolled in Covered California individual plans have questions about access to care starting Jan 1. What can I tell them?

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Covered California FAQs.

My clients with cancelled individual plans have questions about the recently announced eligibility for catastrophic plans. What can I tell them?

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See below a link to a recent Covered California FAQ on eligibility for catastrophic (aka minimum coverage) plans.

What can I provide to clients who are eligible for Medicare, but are interested in Covered California?

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See below a link to a Covered California Medicare FAQ:

How can clients find out the status of their individual applications?

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See below a link to a Covered California Application Status FAQ:

An employee wants a different metal tier than is available to him through his employer’s Covered California for Small Business plan. Can he opt out and buy an individual Covered California plan?

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Yes, the employee can decline his employer’s coverage and purchase a Covered California individual plan. Agents should bear in mind:

Can an individual change the plan they are enrolled in mid-year?

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Plan changes can only be made during open enrollment, or during special enrollment periods after certain qualifying events.

For a list of qualifying events see page 6 of the module: “Eligibility for Individuals and Families” participant guide.

Are undocumented immigrants who file taxes eligible for Covered California?

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No, not unless they are a U.S. citizen, national or lawfully present.

If an individual enrolls in COBRA, can the individual switch to Covered California?

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If the individual enrolls in COBRA coverage and the special-enrollment period lapses, the individual cannot cancel the COBRA coverage and enroll in a Covered California health plan until 1) the COBRA coverage is exhausted, 2)  the individual has a different qualifying life event for special enrollment, or 3) the next annual open-enrollment period.

If the individual stops paying the COBRA premium and loses coverage (or if the employer has agreed to pay for a limited time and the individual does not continue the payments), the individual will not be eligible for special enrollment through Covered California. The individual will only qualify for special enrollment if:

  1. Someone else responsible for sending the COBRA premium payments (for example, the former employer) fails to do so on a timely basis.
  2. The individual moves out of the plan coverage area, and there is no COBRA continuation coverage available.
  3. The individual reaches the plan’s lifetime limit for benefits.

If none of these reasons apply, the individual will have to wait until the next Covered California open-enrollment period to cancel the COBRA plan and sign up for a Covered California health insurance plan, unless there is another qualifying life event for special enrollment. It’s also important to know that if the individual decides to drop or forgo COBRA and enroll in a Covered California plan, the individual cannot go back to COBRA.

If the parents stay overseas and the children live in California, how can the parents apply for Covered California?

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In order to enroll in a Covered California plan, the individual must reside in California.

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