Private Exchange

Learn more about this full-service solution for individuals to purchase health coverage through an online marketplace.

California Health Insurance Exchange

California was the first state to pass legislation creating a health insurance exchange after the passing federal health reform. The exchange will be called “Covered California,” and is governed by a board of five members, each possessing expertise in key areas of health care such as individual or small group coverage, health benefits plan administration or health care finance. California’s exchange is defined by legislation as an “independent public entity, not affiliated with an agency or department.” The board will contract with carriers whose plans offer flexibility, value, quality and service. The Covered California exchange requires standardized benefits and cost-sharing across all participating health plans.

Essential Health Benefits

Under the Affordable Care Act, all non-grandfathered individual and small group plans sold in a state and through an insurance exchange must cover certain defined benefits or ‘Essential Health Benefits’ (EHB). Some of these minimum benefits include: prescription drugs, hospitalization, maternity care, pediatric services and more.

California Health Insurance Exchange Stats:

  • Total Residents: 37,370,000
  • Total Health Expenditures (in millions): $230,090
  • Exchange Decision: State-based exchange
  • Total Health Insurance Exchange Grant: $910,136,264
  • EHB Benchmark Plan Status: Recommended

California has an independent exchange called Covered California, which will be governed by five experts in separate areas of healthcare policy.

For more information about setting up a private exchange solution in California, contact a representative at GoHealth today.