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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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Plans

Can carriers offer plans off the Exchange? If so, can the plan design vary from the standardized plans?

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Yes. Any plans in Covered California that are also offered outside of Covered California have to have the same benefits and premiums.

Are there Evidence of Coverage (EOC) documents on Covered California?

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Not yet.

Do people on dialysis qualify for a Covered California plan now?

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Health plans are banned from imposing pre-existing condition exclusion on children under age 19. In 2014, the ban on excluding coverage of pre-existing conditions is extended to adults as part of a broader set of 2014 insurance reforms.

Where do plans outside of Covered California fit in?

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Plans outside of Covered California are part of the range of options available to consumers.

Will groups be able to change carriers out of open enrollment outside of the Exchange?

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In the small group market outside the exchange, employers can cancel coverage at any time and also apply for coverage with another carrier at any time.

Is Covered California the only place to register for new health insurance? If not, what is the other place?

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No, the private market is also an option.

For what age is the pediatric dental and vision?

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Under age 19.

What are the eligibility requirements for catastrophic plans?

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To be eligible for a catastrophic plan/ minimum coverage plan, the individual must both:

AND

Is pediatric vision embedded in Covered California plans?

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Yes.

What is the AV of catastrophic plans?

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Catastrophic plans can have actuarial values less than 60%.

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.