Health Insurance Companies in California Information
Employer sponsored medical coverage
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.
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 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 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.
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.
Cigna+Oscar is a combination of a relatively new medical insurance company (Oscar Health) and one of the oldest medical insurance companies (Cigna). This is a partnership that uses the Oscar high-tech options for administration and uses the large Cigna PPO provider network.
Covered California for Small Business (CCSB) is a government run “exchange” that bundles Kaiser, Blue Shield, Health Net and other companies into one offering. 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.
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.
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 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. UnitedHealthCare offers coverage in all 50 states and is a good fit for an employer with employees who reside in different states.
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.
