Resources for Participating Employers
Welcome to Covered California for Small Business! You have made an important step toward making your business better by providing your employees with access to quality, affordable coverage. Below are lists of resources available to make it easy for you to manage your responsibilities as a plan sponsor. These resources include forms for reporting changes to your business, adding/terminating employees or dependents, administering COBRA (Consolidated Omnibus Budget Reconciliation Act) notifications and more. Step-by-step instructions are included with each form, but feel free to reach out to us at the numbers provided below if you should need assistance. We’re here to help.
- 2017 Change Request Forms (Employer form in English, employee form in English and employer form in Spanish).
- 2017 Change Request Forms (English employer and employee forms).
- 2016 Change request forms (English employer and employee forms and Spanish employer and employee form).
- COBRA forms (COBRA election form, COBRA cancellation form, simple COBRA termination notice and COBRA rights document).
- Small-business appeal form.
- Small-business complaint form.
2017 Health Plan Resources
- View the 2017 Health Plan Benefits Summary, which provides a summary of benefits that are offered by each health insurance company for each metal tier.
- View the 2016 Health Plan Change Summary and 2017 Health Plan Change Summary for a year-to-year comparison of the health benefits available by each health plan and metal tier. (Recommended printing size: 11 by 17 inches.)
- Health and dental plan contact information.
- Summaries of health benefits and coverage.
What Changed in the 2016 Small Business Marketplace
- Service Center: (855) 777-6782
- Call the Covered California for Small Business sales team at (844) 332-8384 or reach out directly to your small business sales representative.
- Office of the Patient Advocate: (866) 466-8900.
- Department of Managed Health Care (DMHC): (888) 466-2219.
- California Department of Insurance: (800) 927-4357.
Submit Premium Payments by Mail
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Bank of America Lockbox Services
Covered California for Small Business