California Health Insurance Marketplace Grants Awards List
California has received five grant awards to build its Health Insurance Marketplace - Opens in a new window . This includes a Planning Grant, two Level One Establishment Grants, and two Level Two Establishment Grants.
Summaries of California's applications for each grant are provided below:
Establishment Grant Level Two Application Summary
Administrator: California Health Benefit Exchange
Award Amount: $673,705,358
Award Date: January 17, 2013
Application Due Date: November 15, 2012
Level of Funding: Level Two
Administrative Supplement Award Amount: $155,076,686 (January 22, 2014)
Summary: The California marketplace (Exchange), Covered California, is receiving a Level Two Establishment grant to: (1) Build the marketplace administrative and operational infrastructure, including a multi-site customer service center; (2) Refine, test and bring online the California Healthcare Eligibility, Enrollment and Retention System (CalHEERS), an information technology system that will serve as consolidated support for marketplace programs and referrals to counties for Medi-Cal (California's Medicaid program); (3) Establish, through a vendor, the California SHOP marketplace for small employers and their employees; (4) Evaluate, select, certify and contract with QHP issuers for the individual and SHOP marketplaces; (5) Refine and implement comprehensive outreach, marketing, public education and consumer assistance programs; (6) Collaborate with state partner agencies to maximize coordination and integration; (7) Enroll and begin providing subsidized and unsubsidized health coverage to eligible Californians; (8) Implement a multi-year evaluation strategy; and (9) Maintain effective financial management and oversight systems, including implementation of the long-term sustainability plan.
Award Supplement: $155,076,686 (January 22, 2014)
Summary: Supplemental funding to the state’s Level Two grant will support California’s 2014 program activities and ensure that the Marketplace can successfully accomplish its mission and effectively implement the full promise of the ACA. Funding will assist with marketing efforts and further expand their outreach to eligible populations throughout the state. In addition, funding will help support an expansion of the call center in order to meet client demand. Additional funds will also support Information Technology (IT) infrastructure, organization and human resources, as well as plan management and eligibility and enrollment activities.
Establishment Grant Level One Application Summary
Administrator: California Health Benefit Exchange
Award Amount: $39,421,383; $196,479,629
Award Date: August 12, 2011; August 23, 2012
Application Due Date: June 30, 2011; June 29, 2012
Level of Funding: Level One
Summary: California will engage in planning, research and early implementation as appropriate in all 11 core areas identified in the federal Department of Health and Human Services application. This funding will help the state develop policy goals for the California Exchange as well as secure staff consultants and expert resources and actively engage stakeholders to inform and support Exchange planning and implementation activities. Level One resources will provide the information, data and consideration of options to support the states preparation and submission of a Level Two Exchange grant in spring 2012, leading to full implementation and operation of the Exchange by 2014.
California will use its second Level One Establishment Grant for funding to: (1) coordinate with state agencies in health coverage programs as well as consumer assistance and insurance oversight; (2) design policies for enrollment and eligibility; (3) refine and begin implementing a public education and outreach program;(4) begin selecting and certifying qualified health plans for participation in the individual and SHOP Exchanges; (5) submit the Exchange Blueprint to secure federal certification for a state-based Exchange; (6) develop and execute a plan to evaluate Exchange programs; and (7) enhance financial management and business operations in the Exchange.
State Planning Grant
Awarded September 30, 2010
Administrator: California Health and Human Services Agency
Amount Awarded: $1,000,000
- Establish an Exchange Board and recruit key staff.
- Analyze the current public and private insurance markets.
- Convene stakeholders and the general public to gather input.
- Develop a multi-year plan for Exchange planning tasks.
- Collect data on the demographics of the current and projected population, profiles of insurance markets offering coverage in California and estimates of how the Affordable Care Act will change the number of uninsured Californians.
- March 5, 2020 Information Related to COVID–19 Individual and Small Group Market Insurance Coverage
- March 12, 2020 FAQs on Essential Health Benefits Coverage and the Coronavirus (COVID-19)
- March 18, 2020 FAQs on Catastrophic Plan Coverage and the Coronavirus Disease 2019 (COVID-19)
- March 24, 2020 FAQs on Availability and Usage of Telehealth Services through Private Health Insurance Coverage in Response to Coronavirus Disease 2019 (COVID-19)
- March 24, 2020 Payment and Grace Period Flexibilities Associated with the COVID-19 National Emergency
- March 24, 2020 FAQs on Prescription Drugs and the Coronavirus Disease 2019 (COVID-19) for Issuers Offering Health Insurance Coverage in the Individual and Small Group Markets
- April 11, 2020 FAQs about Families First Coronavirus Response Act and the Coronavirus Aid, Relief, and Economic Security Act Implementation
*This document was updated on April 15, 2020, to correct an error in footnote 10 regarding the current end date of the public health emergency related to COVID 19.
- April 13, 2020 Postponement of 2019 Benefit Year HHS-operated Risk Adjustment Data Validation (HHS-RADV)