Health Care Reform: Recent News & Events

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California’s Online Insurance Marketplace Launches - Monday, February 25, 2013
California’s Online Insurance Marketplace Launches

Source: Health Net. Click here for article.
California Health Benefit Exchange announces the standard benefit designs for all policies to be offered through the exchange known as Covered California.

This week Sacramento insurance officials rolled out the standard benefits that will be required for each California health insurance policy, including details on costs for all those eleigible for federal subsidies. The announcement coincided with the launch of its state consumer website,, which includes a cost-estimate calculator on its home page.

Pricing information was also made available as the California Health Benefit Exchange announced the standard benefit designs for all policies that will be offered through the exchange known as Covered California.

The actual market price for the plans to be offered through Covered California will not be finalized until the bidding process closes in June, but since premium levels for consumers who are eligible for subsidies are based on a percentage of income, it is possible now to determine how much they would pay for coverage.  Preliminary indications suggest the California exchange has received interest from 33 private health plans, including at least two in every region of the state. It is now in the process of negotiating contracts.

Covered California is the first among the 17 state-based health exchanges and the federal exchange. Estimates indicate that 2.6 million Californians will be eligible for subsidies through the exchange.

Details unfolding

Consumers shopping for individual policies — meaning those who do not receive group coverage through their employers — will be able to choose from among private plans offered in the following categories: platinum, gold, silver and bronze. The categories will differ in the cost of premiums, the amount of co-pays charged for specific services, the level of deductible expenses, and the maximum out-of-pocket costs consumers could pay. What will not change across plans is the benefits that are covered.

For example: A married couple with an annual income of $62,040 would pay $491 a month for a midlevel plan with a $2,000 deductible and $45 copays for doctor’s office visits. Premiums would be much lower for those with less income, ie., a couple with a combined income of $23,265 would pay $78 a month.

Under the Affordable Care Act, all those with incomes up to 400 percent of federal poverty guidelines will be eligible for sliding-scale subsidies to purchase insurance. That is the equivalent of $45,960 for an individual and $94,200 for a family of four.

The standard benefit designs will apply to all policies sold in California in the individual and small-group markets. To receive a subsidy, however, consumers will have to make their purchases through the exchange.


Covered California’s website.

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