1. Leandro Segura, Senior Advocate
Community Engagement Department

2. The Molina Story

3. What is Covered CA?
 In 2010, California was the first state in the nation to enact legislation to implement
the provisions of the federal Affordable Care Act by creating a health care
marketplace—Covered CA
Key Points
 Ensure that consumers have access to high-quality, affordable health coverage
 Online website for consumers to view, compare and purchase insurance from
Qualified Health Plans (QHPs)
 Cannot be denied for pre-existing conditions
 Childless adults are now eligible
 Medi-Cal Expansion (Income up to 138% of FPL)

4. Eligibility & Benefits Through Covered CA
Eligibility for
Coverage

5. Regions and QHP’s for the Region
Regions Qualified Health Plans (QHPs)
Region
15/16
• Anthem
• Blue Shield
• Health Net
• Kaiser Permanente
• L.A. Care
• Molina Healthcare
• Oscar EPO

6. Important Enrollment Periods
 Special Enrollment Period (SEP) – On-going
• Change in income
• Had a baby
• Adopted a child
• Marriage or divorce
• Loss of health coverage (job based, COBRA expiration, losing eligibility for Medi-
Cal due to higher income)
• Moved to a new zip code, county, or state
• Must enroll within 60 days of life changing event
 Re-Enrollment – October 13th to November 15th, 2015
• Current enrolled members
• Reminder notices being sent – first letters went out mid-August
 Open Enrollment Period
• November 1th 2015 to January 31st, 2016
 Medi-Cal Enrollment
• Open year-round for those with qualifying incomes

7. Covered CA – How do I know if I qualify?
Income Guidelines
Covered CA Shop & Compare Tool

8. Covered CA—How do I apply?

9. Questions…