Covered California for Small Business

Tuesday, April 2, 2024 12:29 Posted by Admin
Taylor Benefits Insurance Agency offers employee benefit packages in the state of California

Covered California is California’s health exchange, which allows individuals and small businesses to shop for brand-name health insurance coverage at rates that are federally subsidized. The marketplace has two distinct programs: Individual Health Plans and Covered California for Small Business. For small businesses in California looking to provide their employees with medical coverage options, CCSB is highly advantageous.

Continue reading to learn all there is to know about Covered California for Small Business, including who is eligible, the available health insurance companies and health plan options, and how the program can benefit your business and your employees.

What is Covered California for Small Business?

Formerly called the Small Business Health Options (SHOP) program, Covered California for Small Business (CCSB) is one of Covered California’s two programs. Through this program, small businesses in California are able to utilize a competitive marketplace to find health insurance for their employees that fits both their and their employees’ budget.

Covered California offers a number of services and advantages to small business in California, including:

  • Assistance with controlling insurance costs and decreasing administration overhead.
  • Give employees the option to choose a health plan and network that suits them best.
  • Multiple insurance and health plans, providing employees access to a wider choice of physicians and hospitals not offered through individual insurance.
  • The convenience of a single monthly bill, even when buying coverage from several carriers.
  • Tax credits, which can help offset the cost of providing health insurance to your employees.

Who is Eligible for Covered California for Small Business?

In order to be qualified to shop for and purchase group health insurance coverage through Covered California for Small Business, your business must meet the following guidelines:

  • Your business must have between one and 100 eligible employees that meet specific participation and contribution requirements.
  • Your business needs to have no less than one employee that receives a W-2.
  • The majority of eligible employees must reside in California.

In other words, you are eligible for CCSB if your small business has 100 or less full-time-equivalent employees. Though, you must have at least one full-time-equivalent employee. So, what exactly is a full-time equivalent employee?

A full-time-equivalent (FTE) employee is technically not an actual employee, but rather a calculation that focuses on hours worked instead of number of employees. So, if an employer has a 40-hour work week, employees that work 40 hours a week are deemed one full-time equivalent employee. However, you could have three physical employees, but only one FTE depending on the hours they work.

If you are a sole-proprietor, meaning you are the owner and the only employee of your small business, you are not eligible for Covered California for Small Business. Instead, you’ll want to look into obtaining coverage through Covered California’s individual marketplace.

If you have more questions about CCSB eligibility, don’t hesitate to get in touch with one of our experienced, professional insurance brokers.

What Health Insurance Companies are Available?

If you qualify for Covered California for Small Business, there are six health insurance companies to choose from, offering year-round acceptance in the small business program. Your employees are able to compare and choose health plans at a range of price points, which helps ensure that they get the coverage they need at a rate they can afford.

The six health insurance companies available through Covered California for Small Business are as follows:

  • Blue Shield of California is a not-for-profit health plan based in California, with the mission of providing California residents with convenient access to the best health care at the most affordable rates.
  • Kaiser Permanente, or more commonly known as just ‘Kaiser,’ is an integrated managed care consortium based in Oakland California. The Kaiser umbrella consists of Kaiser Foundation Hospitals, Kaiser Foundation Health Plans, and Permanente Medical Groups.
  • Health Net is a subsidiary of Centene Corporation, a health insurance provider and Fortune 500 company based in Woodland Hills, California. The team at Health Net believes that everyone deserves to have an affordable safety net for their health, regardless of their income, age, current health conditions, and employment status.
  • Sharp Health Plan is a not-for-profit organization that has operated in both southern Riverside and San Diego counties for nearly 30 years. The organization is a subsidiary of Sharp HealthCare, the leading health care provider in all of San Diego.
  • OSCAR Health Plan of California began in 2012 with the mission to create a health insurance company that is accessible and affordable for all. Oscar is available to employers with employees that are located in Orange County and Los Angeles County.

Keep in mind that the plan selection options for each of the aforementioned companies varies based on the region in California.

What are the Health Plan Options?

With Covered California for Small Business, there are four levels of coverage for employers to choose from: Bronze, Silver, Gold, and Platinum. Each level also has numerous plan options. As the employer, you choose the level(s) of coverage that you want to offer and then your employees are free to select any health plan within those levels. By offering multiple levels, you make it easier for your employees to find a health plan that suits their needs and their budget.

Sometimes referred to as “metal levels” the categories of coverage are based on how costs are split between the insurance company and the insured. For each level, the plan covers a specific percentage of the total annual costs for care, and your employee is responsible for the rest.

  • Bronze: The health plan covers 60% of annual care costs.
  • Silver: The health plan covers 70% of annual care costs.
  • Gold: The health plan covers 80% of annual care costs.
  • Platinum: The health plan covers 90% of annual care costs.

Health plans that are a part of the Coverage California for Small Business marketplace must offer at least one plan from the four coverage levels.

Why Covered California for Small Business?

Covered California for Small Business is an incredibly helpful way for qualified employers to find the best health insurance for their employees. Once you find out that your small business is eligible for CCSB, you choose the level of coverage and how much you want to contribute to your employee’s premiums. Then, both you and your employees get to choose the ideal health plan.

CCSB gives you the option to choose from a range of PPO and HMO plans from Kaiser Permanente, Oscar, Blue Shield of California, Sharp Health Plan, and Health Net. The program delivers access to the most comprehensive network of physicians and hospitals in the state of California.

Advantages for Your Business:

  • Billing is easy, as all of your employee’s health insurance premiums are compiled into a single monthly payment. For added ease and convenience, you can pay your bill online through the MyCCSB portal.
  • MyCCSB not only enables you to pay your bill, it also lets you finalize the initial enrollment process, control your account, make changes to your plan, update employee data, restore coverage, and more – all online.
  • Federal tax credits are available to small business that qualify, which can help offset the cost of insurance coverage.

Advantages for Your Employees:

  • Financial protection and peace of mind, knowing that they are covered in the event of a health emergency.
  • The ability to compare a broad selection of health insurance plans, physicians, hospitals, and costs.
  • Keep insurance costs as low as possible, by selecting a plan that fits their unique needs and budget.

Have more questions about Covered California for Small Business, whether or not you qualify, and what options are available to you? We can help. Contact us now to get in touch with one of our experienced, professional insurance brokers!

Written by Todd Taylor

Todd Taylor

Todd Taylor oversees most of the marketing and client administration for the agency with help of an incredible team. Todd is a seasoned benefits insurance broker with over 35 years of industry experience. As the Founder and CEO of Taylor Benefits Insurance Agency, Inc., he provides strategic consultations and high-quality support to ensure his clients’ competitive position in the market.

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