Open Enrollment
California residents can apply during open enrollment. It is the time of year reserved for you to make changes to your benefit selection, or apply for health coverage, if you are not insured. It usually starts in November and ends in January of the following year.
(The deadline for each state may different and please based on the state announcement of each year)
Qualifying life events for special enrollment, application must be received within 60 days (about 2 months) after a qualifying event:
1. Loss of health coverage
2. Having a baby or adopting a child
3. Changes in residence
4. Change in marital status
What is the difference between HMO, EPO, and PPO?
| HMO | EPO | PPO | |
|---|---|---|---|
| Primary Care Physician (PCP) required? | Yes | No | No |
| Referral to see a specialist. | Yes | No | No |
| Network limitations | Only within 15-30 Miles or residence | Limitation of radius from residential address | No limitations |
| Out-of-Network coverage? | No | No | Partial (highly recommended to choose an in-network provider) |
| Flexibility | Low | Medium | High |
What is the difference between the health plan metal tiers?
Choose the level of coverage that fits you the most.
| Bronze | Silver | Gold | Platinum | |
|---|---|---|---|---|
| Monthly Cost |
$ | $$ | $$$ | $$$$ |
| Percent of cost Coverage | 60% | 70% | 80% | 90% |
| Consider this tier if you… | Lower medical needs. Lower premium, higher out-of-pocket. |
Average medical needs. Lower monthly premium, higher out-of-pocket. |
Higher medical needs. Higher premium, no deductible | Often medical needs; highest premium, lowest out-of-pocket. |
