California Health Exchange Releases Standard Plans

The February 15th CalChamber Alert newsletter reported that Covered California, the state-run program that oversees implementation of the Affordable Care Act, this week released the standards for benefit plans that will be made available to Californians who do not rely on employer-provided insurance or Medi-Cal for health care coverage. Four plan levels will be available: bronze, silver, gold and platinum. The percentage of coverage to be paid by the health plan ranges from 60 percent for bronze to 90 percent for platinum. More than 2.6 million Californians will be eligible for subsidies, according to Covered California.

Households earning less than 250 percent of the federal poverty level can receive financial help if they enroll in a silver plan; the less income they earn, the more financial assistance they can receive.

For example, individuals earning between 150 percent and 250 percent of the federal poverty level can expect to pay $20 to see their primary care physician, while those earning 100 percent to 150 percent would pay $4.

To be eligible for financial assistance, consumers must purchase plans from Covered California’s marketplace.

The state is requiring that all carriers offer these same standard designs to all individuals and small businesses, whether inside or outside of Covered California.

Higher-income individuals choosing one of these plans would not be eligible for financial help, but would be assured that the plan contains the same essential health benefits offered, and the same benefit design so they can make true comparisons.

Examples of benefits, their costs, and typical premium costs are available on the newly launched Covered California website, www.CoveredCA.com.

A fact sheet for small business and another explaining the small business tax credit also are available.

The site includes a cost calculator to help consumers estimate the potential financial support for which they are eligible and the estimated cost of insurance. Fact sheets are available in both English and Spanish. Additional fact sheets and translation of the materials in 11 more languages is expected to be added.

The open enrollment period begins this fall for coverage that starts January 1, 2014.

Covered California also announced it has launched a social media presence on Facebook, Twitter, YouTube and Google+.

Covered California identified critical next steps as selecting insurance carriers that will be allowed to participate in Covered California, and determining plan pricing.