“Covered California” Releases Standardized Benefit Plans

One of the key features of the Affordable Care Act (ACA) is the creation of healthcare exchanges, which are government-regulated online marketplaces where individuals and small businesses can compare and purchase private health insurance. (Think Travelocity for health insurance.) The goal of the exchanges is to expand coverage to people previously without coverage. The exchanges are available to individuals without employer-sponsored or government-sponsored coverage, and to small businesses with fewer than 50 full-time equivalent employees. California was the first state to enact legislation after passage of the ACA to create an exchange. California’s healthcare exchange, which opens on October 1, 2013, is called Covered California.

Covered California recently released its Standardized Benefit Plans. It offers four levels of coverage based on the overall percentage of cost-sharing of the plan:  platinum level at 90%, gold level at 80%, silver level at 70%, and bronze level at 60%, as well as a catastrophic plan for individuals under 30 years old.  Each level will have both a copay and coinsurance plan. The individual insurance companies will establish the premiums for the standardized benefit plans.

For more information about Covered California, please contact your Trust Fund counsel.

By Kristina Zinnen

Legal Developments