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Covered California

As a result of health care reform in the United States USF students will now have new health insurance options through the establishment of the California Health Insurance Exchange.

Open enrollment for the California Health Insurance Exchange will begin on October 1, 2013 with coverage beginning on January 1, 2014. For specific questions regarding enrollment, eligibility, and/or costs please visit www.coveredca.com or call Covered California at 800-300-1506.

California Health Insurance Exchange Overview

What is covered California?

Covered California is the name of California's Health Insurance Marketplace. Covered California will make it simple and affordable for students to purchase high-quality health insurance and access financial assistance to pay for coverage. You can shop online, over the phone, or in person to find the right health insurance option for you.

In the San Francisco area, 5 medical carriers will be participating in the exchange:

  • Anthem Blue Cross of California
  • Blue Shield of California
  • Chinese Community Health Plan
  • Health Net
  • Kaiser Permanente

Eligibility

Legal residents of California without access to affordable health insurance through their employer or another government program will be eligible to purchase health coverage through Covered California(California Health Insurance Exchange).

  • International students will not be eligible to participate in the California Health Insurance Exchange.
  • Students who reside in another state but are attending classes at USF are only eligible to participate in the exchange in their own state. (Coverage may extend to California, however benefits may be limited to emergency only or may have a limited network of providers in the San Francisco area).

Available Plans

Bronze plan,Silver plan, Gold Plan, and Platinum Plan as compared to USF plan: Covered California Insurance Plans

Click here to shop and compare plans through the California Health Insurance Exchange: Shop and Compare

Note: The Bronze Plan is not comparable to the student health insurance plan and will be not be accepted in place of the USF sponsored health insurance plan provided through Aetna. 

Cost of Insurance Plans

Premiums for plans available through the California Health Insurance Exchange are paid on a monthly basis and are based on each covered individuals age. Individual rates increase the month following movement to another age bracket.

Rates by plan for 25 YO (USF avg. age is 23) USF 2013/14 Platinum 2014 Gold 2014 Silver 2014 (unsubsidized) Bronze 2014
Annual Cost $2,136 $4,500-$4,944 $4,056-$4,440 $3,060-$3,696 $2,316-$3,240
% Difference   111% to 131 higher 90% to 108% higher 43% to 73% higher 8% to 52% higher

Through Covered California premium assistance (rate subsidies) may be available for students falling into specific income brackets relative to the Federal Poverty Level. Subsidies are available on a sliding scale, and those eligible for a subsidy will have enhanced Silver Plan benefits also based on a sliding scale.

Federal Subsidies

The Affordable Care Act sets a monthly maximum that people will pay for health care, based on where their income falls in relation to the Federal Poverty Level. Students with household incomes less then 138% of the Federal Poverty Level may be eligible for Medi-Cal coverage. Students with household incomes between 138% and 400% of the Federal Poverty Level may be eligible for Federal Subsidies if they do not have access to affordable health insurance through their employer or another government program.

Subsidies are provided on a sliding scale based on income (see chart below)

The following table outlines the maximum contribution, as a percent of income, students will be responsible for toward the cost of monthly premiums on the exchanges:

Federal Poverty Level Up to 150% 200% 250% 400%
Percent of Income 4% 6.3% 8.05% 9.5%
Maximum Monthly Portion Up to $57 Up to $121 Up to $193 Up to $364

The difference between the plan premium and the individual's subsidized portion of the total cost is considered a Tax Credit and can be applied to the cost of the health plan when a student enrolls.  This tax credit should be adjusted throughout the student's coverage period to represent the current household income.

Credits that are not adjusted correctly throughout the year are accounted for when filing taxes in the following year. If a student received tax credit he or she was not eligible for, the student will pay them back in additional taxes.

Sliding Scale Benefits

In addition to the tax credits that reduce the monthly premium payments, a student may be eligible for cost-sharing subsidies that reduce the amount a student pays when receiving medical care. Eligibility for subsidies is also based on income level and family size. A summary of the benefits adjusted by income (sliding scale) shown below:

Sliding Scale Benefits


Please Note: This page was created to provide students with a very general overview of the California Health Insurance Exchange. For the most accurate and up to date information please visit www.coveredca.com or call Covered California at 800-300-1506.