The Covered California Eligibility System
The California Healthcare Eligibility, Enrollment and Retention System (CalHEERS) is the single, eligibility and enrollment system for all products and programs available through Covered California. CalHEERS is set up to make enrollment easy for employers, their employees and the Certified Insurance Agents who help them.
For applications submitted online, the SHOP Service Center will request and inspect the employer’s California business license and the employer’s reconciled DE-9C. Other documentation may be requested depending on the type of business (Sole proprietor, Partnership, Limited Partnership etc.).
WHEN TO APPLY FOR ELIGIBILITY
Once the SHOP opens on October 1, 2013, eligible small businesses can begin enrolling for a January 1, 2014 effective date. Small businesses also have the option to enroll throughout the year according to their policy’s renewal date or whenever they choose. This enrollment flexibility is unique to small businesses and not available in Covered California’s individual marketplace.
Upon employer enrollment, the employer coverage and premiums are guaranteed for 12 months from the employer’s coverage effective date. Employees added during the plan year (after the employer’s coverage effective date) are guaranteed the employer coverage and premiums until the end of the employer’s plan year.
APPLICATION PROCESSING TIMES
Covered California’s goal is to connect small businesses with health insurance as quickly and easily as possible. The processing timeframe varies by the way the application is submitted and whether or not it is complete or has inconsistencies.
Timeframe for complete applications:
- On-line at www.coveredca.com is real-time, within minutes.
- By phone, in person, by mail or fax is 10 calendar days.
For more information, call Warner Pacific at 800-801-2300.