California Medical Insurance Company Information
|Anthem Blue Cross of California|
The California subsidiary of Anthem, Inc. the second largest health insurer in the United States, Anthem Blue Cross offers HMO, PPO, EPO, Health Savings Account (H.S.A.) compatible plans for individuals, small groups, large groups, and seniors. Anthem insures more PPO members in California than any other insurance company and their PPO networks are very extensive and include most doctors and hospitals.
|Blue Shield of California|
Blue Shield of California is the State’s third largest health plan (after Kaiser and Blue Cross.) It is a not-for-profit corporation that operates exclusively in California. Blue Shield offers coverage in the individual, small and large group markets as well as Medicare supplemental plans and Medicare Advantage plans. Blue Shield’s small group plans are well priced but employers can only offer a full network or narrow network option, not both networks.
Kaiser is by far the State’s largest health plan as measured in revenue and membership. It is a not-for-profit corporation that operates in California and eight additional states. Kaiser offers coverage in the individual, small and large group markets. Kaiser is a “staff model” HMO where the doctors, hospitals and insurance company are combined as one entity. While Kaiser offers small and large employer groups PPO plans, the company is really focused on offering a “comprehensive health care delivery system” through Kaiser providers.
Aetna is a national health insurance company and offers policies in all 50 states. In California, Aetna offers coverage to employers in the small and large group markets. Aetna group plans allow employers to offer full, medium and narrow network HMO networks to their employees at the same time. This degree of flexibility unusual in the California market.
|Health Net of California|
Health Net, has a large segment of California’s health insurance market. In 2015 Health Net agreed to be acquired by Centene. Health Net offers individual and small and large group health insurance plans through HMO and PPO plan designs. Centene is a Medicare-focused company and Health Net’s Medicare business is a good fit. Indications are that Health Net’s individual and group business will continue unchanged after the acquisition.
| ||United Health Care (formerly PacifiCare of California)|
United Health Care (UHC) is the nation’s largest medical insurance companies. UHC purchased Pacificare to expand its presence in California. UHC offers small and large group medical insurance plans but no coverage for individuals. UHC allows small employer groups to offer HMO, PPO and HSA plans with full, medium and narrow provider networks, which is more flexible than most other California insurers.
|California Individual Health Insurance|
California offers a wide variety of medical insurance plans for consumers and we’ve written a number of articles to help you understand your options. We can also help you select and enroll in a plan. Click on the link above to learn more about individual and family plans. Click here to obtain an individual quote and apply for coverage.
|California Small Group Health Insurance Rules|
California’s small group health insurance market is regulated by rules allow employers access to health coverage with standardized benefits and rates. The rules forbid insurance companies from cancelling coverage or raising rates if an employee or dependent gets severely sick or injured. The article in the hyperlink also describes what an employer must do to qualify for coverage. Click on the link above to read about the rules that apply to small business medical insurance. Click here to get a quote for small group health insurance.
|California Major Risk Medical Insurance|
The California MRMIP provides health insurance to Californians who are unable to obtain coverage through Covered California or in the individual insurance market. The Affordable Care Act (ACA) mandates that insurance companies must accept applicants regardless of pre-existing medical conditions. However, if someone either fails to enroll during the Covered California open enrollment period, or fails to pay for their individual coverage and loses coverage, MRMIP is an option.