Health Insurance Companies in California Information
Employer sponsored medical coverage
The California subsidiary of Elevance Health, the second largest health insurer in the United States, Anthem Blue Cross of California offers HMO, PPO, EPO, Health Savings Account (H.S.A.) compatible plans for 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.
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.
United Health Care (UHC) is the nation’s largest medical insurance companies. UHC offers small and large group medical insurance plans but does not offer individual coverage in California. 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. UnitedHealthCare offers coverage in all 50 states and is a good fit for an employer with employees who reside in different states.
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 popular because they have a large number of doctors, hospitals and other medical providers in their preferred PPO network and their HMO network.
Health Net, has a large segment of California’s small group health insurance market. Health Net owned by Centene Corporation, a large national health insurance company . Health Net offers small and large group health insurance plans through HMO and PPO plan designs. Centene is a Medicare-focused company and Health Net’s Medicare commercial employer sponsored health plans provide some diversity.
Covered California for Small Business (CCSB) is a government run “exchange” that bundles Kaiser HMO plans, Blue Shield PPO and HMO plans. CCSB includes other, regional companies, such as Sharp in San Diego and Western Health in the Sacramento area. An employer can offer all the insurance companies to employees. It’s a good choice if some employees love Kaiser and others don’t. Small employers can also apply for the Federal Small Business Medical Insurance Tax Credit when they offer coverage through CCSB.
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. With a few exceptions, Aetna small group plans have not been price-competitive for many years.
Cigna+Oscar was a combination a new medical insurance company (Oscar Health) and one of the oldest medical insurance companies (Cigna). Their partnership promised to use the Oscar high-tech options for administration and combined with the large Cigna PPO provider network. Unfortunately, after a few years, Cigna+Oscar shut down in California and no longer offers coverage.
CalChoice is a privately owned company that combines a list of different insurance companies into one offering for employees. The medical plans come with no-cost discount dental and vision plans along with a range of employee paid options for dental and vision coverage. It is a good fit for a company that wants to offer Kaiser and non-Kaiser medical plans. California Choice offers full network PPO plans with Anthem Blue Cross. HMO plans include Kaiser, Health Net, Sharp and United HealthCare (UHC).
California’s small group health insurance market is regulated by rules that 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. Our comprehensive article on California’s rules for offering group health insurance coverage goes into great detail on an your obligations and opportunities as an employer.
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