What Are Health Insurance Marketplaces and Exchanges?
Exchanges or marketplaces are services that enable enrollment in insurance either through a public or private forum. These forums are accessible through multiple portals and websites. California has created its own state-run exchange called Covered California.
California Private Exchanges vs Public Exchanges
Private Exchanges
The private exchange is designed to be used by employers to allow employees the ability to enroll in whichever pre-selected plan the employers chose. The private exchange also is where individuals and small businesses shop and enroll for coverage during the open enrollment window. Consulting firms or brokers typically run the private exchange utilized by an employer. If you decide to enroll in a private exchange, you forfeit the right for subsidies.
California also has a set Private Exchange for employers to utilize called California Choice.
Public Exchanges
The public exchange for California, Covered California, is run by the Department of Health Care Services at the state level. The state-run exchange negotiates directly with carriers to negotiate rates, networks, and benefits and is the only one in the country that also implemented standardization across the benefit levels with the exception of premiums, drug formularies, and provider networks. When using the public exchange, your application will also verify if you qualify for Medicaid, CHIP, or other discounts based on income level.
The following carriers are available on the California public exchange:
- Anthem Blue Cross of California
- Blue Shield of California
- Chinese Community Health plan
- Health Net
- Kaiser Permanente
- LA Care Health Plan
- Molina Healthcare
- Oscar Health Plan of California
- Sharp Health Plan
- Valley Health Plan
- Western Health Advantage
Small Business Public Exchange
In addition to the individual public exchange, California also has a Small Business Health Options exchange (SHOP) for owners of businesses with less than 100 employees to set up coverage and enroll at any time during the year.
California Marketplace and Exchange Facts
