Add or Remove a Delegated Enroller

You can add or remove an agent by calling our service center at (800) 300-1506.

Fill out an HBEX 403 Form to add an agent. To remove the agent, communicate to him or her that you wish to cancel your authorization. You may cancel or limit your authorization in writing at any time.

Delegated enrollers, such as Certified Enrollment Counselors and licensed insurance agents, provide clients with information about their health insurance choices. This is to help you apply for and enroll in a health or dental plan through Covered California or Medi-Cal. When you add an agent, you give them permission to access the personally identifiable information that is necessary to determine eligibility for insurance and to enroll in a plan. They may request amendments to consumers' personal information that Covered California creates or maintains.