Covered California Individual & Family Health Insurance

Covered California plans provide comprehensive health insurance that meets the Affordable Care Act's Minimum Essential Coverage (MEC) requirements. All Covered California plans cover pre-existing conditions, include the ten Essential Health Benefits, and do not impose annual or lifetime maximum benefit limits.

Unfortunately, some plans advertised online, by phone, or on the radio are not true major medical insurance and may contain significant coverage limitations, potentially leaving policyholders responsible for thousands—or even hundreds of thousands—of dollars in medical expenses. California residents who do not maintain MEC coverage and do not qualify for an exemption may also be subject to a state tax penalty.

As a Covered California Certified Insurance Agent (CIA), Benefit Packages can help you enroll through the Covered California marketplace and determine whether you qualify for premium assistance through Advanced Premium Tax Credits (APTCs). Covered California is the only place where eligible Californians can receive these premium subsidies.

Depending on your household income, you may also qualify for one of Covered California's Enhanced Silver Plans, which can significantly reduce your deductible, copayments, coinsurance, and maximum out-of-pocket costs.

Many self-employed individuals and families have income that fluctuates from year to year based on business revenue and expenses. Covered California eligibility is based on your projected household income for the year. Sometimes even a small change in projected income can affect whether you qualify for Enhanced Silver benefits, Advanced Premium Tax Credits, Medi-Cal, or whether your children qualify for premium assistance.

We take the time to discuss your situation, explain your options, and help you achieve your coverage goals whenever possible. For example, some families are surprised to learn their children qualify for Medi-Cal instead of premium assistance. Others ask to have their children removed from Medi-Cal so they can enroll them in a private health plan, only to discover that Covered California generally will not provide Advanced Premium Tax Credits (APTCs) for those children unless the family's income is high enough that the children are no longer eligible for Medi-Cal. We can help you understand your options and determine the best approach for your family's situation.

Of course, you'll want to make the best estimate possible of your projected household income. If you underestimate your income and receive more Advanced Premium Tax Credits (APTCs) than you're entitled to, you'll simply repay the difference when you file your federal income tax return. Conversely, if your income ends up being lower than projected, you may qualify for additional tax credits.

Diverse group in medical setting

Important Questions to Consider

Before selecting a health plan, it's important to understand:

  • Are your doctors, specialists, and hospitals contracted with the plan?
  • Are your prescriptions covered on the carrier's formulary?
  • Would an HMO or PPO better fit your needs?
  • Would an HSA-compatible High-Deductible Health Plan (HDHP) provide valuable tax advantages?

We take the time to explain health insurance concepts such as deductibles, copayments, coinsurance, and out-of-pocket maximums in plain English so you can feel confident in your coverage decisions.

Having Benefit Packages assist with your enrollment does not increase your premium or cost you anything additional. We are compensated directly by the insurance carriers, and our guidance often helps clients save money while making the enrollment process easier and less stressful.

Ongoing Service After Enrollment

Our service doesn't end after enrollment.

Clients often contact us after receiving an Explanation of Benefits (EOB) and need help understanding what the provider billed, what the insurance company allowed, and what they may owe. We can also help identify potential issues such as duplicate claims, billing errors, or missing information that could delay or affect claim payments.

Health insurance can be complicated, but we're here to make it easier.

Carriers We Represent

  • Anthem Blue Cross (Elevance)

  • Aetna

  • Alignment Health Plan

  • Beam

  • Blue Shield of CA

  • Cigna

  • Delta Dental

  • Health Net

  • HealthSpring

  • Humana

  • Kaiser

  • Imperial Health Plan of California

  • LA Care

  • Medico/Wellabe

  • Molina

  • SCAN

  • Sutter Health

  • UCLA Health Medicare Advantage

  • United Concordia

  • UnitedHealthcare / AARP

  • VSP

  • WellCare / Centene

Speak With a Covered California Expert

Get personalized guidance and assistance with Covered California and Individual & Family Health Insurance.