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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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Individual Family Eligibility & Enrollment

Can individuals enroll directly online without a Certified Insurance Agent?

Posted by

Yes.

Does moving into the State qualify as a qualifying event?

Posted by

Yes.

Can members of the same family be on different plans and metal tiers?

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Yes, however, currently the system will only allow one member of the family to get the premium assistance in advance. The other members of the family would have to receive the premium assistance at the end of the year when filing taxes.

What happens to someone who has a qualifying event outside of the special enrollment period, will he/she get coverage November 1st or December 1st?

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See the table with coverage effective dates for qualifying events on page 6 of the Eligibility for Individuals and Families participant guide.

On Covered CA it states a person may not get GI if the person misses the October-March enrollment period, please explain.

Posted by

Covered California applicants should apply during open enrollment, which is the period of time that usually happens once a year when consumers may select a health plan and enroll. However, certain qualifying events allow consumers to apply for coverage during special enrollment periods. For a list of qualifying events see page 6 of the Eligibility for Individuals and Families participant guide.

If an insured signs up after 1/1 is the insurance retroactive?

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See enrollment and effective dates in the tables on pages 5-7 of the Eligibility for Individuals and Families participant guide.

What is considered loss of minimum essential coverage?

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See the table on page 8 of the Introduction to the Affordable Care Act participant guide for examples of minimum essential coverage.

Loss of any of these coverage options would be considered loss of minimum essential coverage.

Will exhausting COBRA be considered a qualifying event to enroll under a special enrollment period?

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Individuals that lose Minimum Essential Coverage, including COBRA coverage, will qualify for a special enrollment period.

 

Will Covered CA paper applications be available in English & Spanish?

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Yes.

My son is 24 years old and my daughter is 21 years old. They are both in college. Can I buy a Covered California family health plan?

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Yes, if you meet the eligibility requirements.  See pages 12-13 in the Eligibility for Individuals and Families participant guide.

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.