How is insurance marketed in California?
Health insurance coverage is marketed to consumers through individual policies or group policies. Individual health insurance coverage should be pursued when your employer does not offer health insurance as a benefit of employment, when you cannot be named as the dependent on another person’s insurance policy, or when you are not a member of a professional or trade association that offers group coverage.
Many consumers are self-employed, contract employees, or work for small employers and do not have access to a group policy secured by an employer. Individual coverage can be obtained by contacting a licensed health insurance agent or broker.
You will need to complete an application that includes your medical history, which will be reviewed by a medical underwriter at the health insurance company. If you meet the underwriting qualifications and are issued a policy, the company may not cover preexisting conditions up to one year after the effective date of the policy.
However, if you have been previously insured under an individual or group policy without a break in coverage of more than 62 days, your new insurance company must apply the prior creditable coverage towards any waiting period for preexisting conditions. Individual health insurance companies may reject your application based on your medical history.
State Sponsored or Administered Health Coverage
The state of California offers specialty programs and/or assistance programs to those who do not qualify for health insurance due to preexisting conditions or income restrictions, and for small employers of 2 to 50 workers.
Access for Infants and Mothers Program (AIM)
P.O. Box 15248
Los Angeles, CA 90015
Phone: 800-433-2611
Web site: www.mrmib.ca.gov/MRMIB/AIM.html
California Association of Health Underwriters (CAHU)
P.O. Box 1071
Fresno, CA 93714
Phone: 800-322-5934
Web site: www.cahu.org
U. S. Department of Labor
Employee Benefits Security Administration (DOL-EBSA)
Southern California
1055 E. Colorado Blvd., Suite 200
Pasadena, CA 91106-2341
Phone: 626-229-1000
Phone: 866-444-3272
Northern California
71 Stevenson Street, Suite 915
San Francisco, CA 94105
Phone: 415-975-4600
Phone: 866-444-3272
Web site: www.dol.gov/ebsa
Department of Managed Health Care (DMHC)
980 Ninth Street, Suite 500
Sacramento, CA 95814-2725
Phone: 888-466-2219
Web site: www.dmhc.ca.gov
Healthy Families Program
P.O. Box 138005
Sacramento, CA 95813-8005
Phone: 800-880-5305
Web site: www.healthyfamilies.ca.gov
Managed Risk Medical Insurance Program (MRMIP)
P.O. Box 9044
Oxnard, CA 93031-9044
Phone: 800-289-6574
Web site: www.mrmib.ca.gov
The California HealthCare Foundation
California HealthCare Foundation
476 Ninth Street; Oakland, CA 94607; Tel: 510.238.1040; Fax: 510.238.1388
website: www.chcf.org
Pacific Health Advantage (PacAdvantage)
3013 Douglas Blvd., Suite 200
P.O. Box 619027
Roseville, CA 95661-9027
Phone: 877-735-5742
Web site: www.pacadvantage.org
