Most Frequently Asked Health Insurance Questions

Below are answers to common questions about Covered California, individual health insurance, small business health insurance, and Medicare plans in California.

1. How much does health insurance cost in California?

The cost of health insurance in California depends on factors such as age, location, household size, and the type of plan you choose. Individuals purchasing coverage through Covered California may qualify for financial assistance that can significantly lower monthly premiums.

For small businesses, group health insurance costs depend on the number of employees, plan design, and employer contributions.

2. What does a health insurance broker do?

A health insurance broker helps individuals, families, and businesses compare plans from multiple insurance carriers so they can choose coverage that fits their doctors, budget, and healthcare needs.

Brokers also assist with enrollment, plan comparisons, and ongoing support throughout the year.

3. Does it cost more to use a health insurance broker?

No. There is no additional cost to work with a licensed health insurance broker.

Insurance companies include broker compensation in their plans whether you use a broker or enroll on your own. This means you receive expert guidance and support at the same price.

4. What is Covered California?

Covered California is the health insurance marketplace for California residents. It allows individuals and families to compare plans from multiple insurance carriers and determine whether they qualify for financial assistance that lowers monthly premiums.

5. Who qualifies for Covered California subsidies?

Eligibility for Covered California subsidies depends on household income and family size.

Many individuals and families qualify for premium tax credits, which can significantly reduce monthly health insurance premiums.

6. When can I enroll in health insurance?

Most people enroll during the annual Open Enrollment Period, which typically runs from November through January.

However, certain life events can trigger a Special Enrollment Period, including:

• Losing employer coverage

• Getting married or divorced

• Having a baby

• Moving to a new service area

7. Can self-employed individuals or 1099 contractors get health insurance?

Yes. Self-employed individuals, freelancers, gig workers, and 1099 contractors can purchase health insurance through Covered California or private insurance carriers.

Many self-employed individuals qualify for subsidies through Covered California.

8. What types of health insurance plans do you help with?

We help clients compare and enroll in several types of coverage, including:

• Individual health insurance plans

• Family health insurance plans

• Small business group health insurance

• Covered California plans

• Medicare plans when turning 65

• Dental insurance

• Vision insurance

• Life insurance

9. Can a broker help me enroll in Covered California?

Yes. Licensed brokers are certified to assist individuals and families with Covered California enrollment.

A broker can help ensure your application is completed correctly and help you compare available plans.

10. Can I keep my current doctor with a new health insurance plan?

Possibly. Each health insurance plan has its own provider network of doctors and hospitals.

Before enrolling, we help clients verify whether their preferred doctors, hospitals, and specialists are included in the plan’s network.

Small Business Health Insurance Questions

11. What is small business health insurance?

Small business health insurance refers to group health insurance plans offered by employers to their employees.

In California, businesses with 2–50 employees can offer group coverage through private insurance carriers or through Covered California for Small Business (CCSB).

12. Do small businesses have to offer health insurance?

Businesses with fewer than 50 full-time employees are not legally required to offer health insurance.

However, many employers choose to offer benefits to attract and retain employees.

13. Can small business owners include themselves on their group health insurance plan?

Yes. Small business owners can typically participate in the group health insurance plan offered to their employees, as long as the business meets eligibility requirements.

14. Can employees choose their own health insurance plan?

Some small business programs allow employees to choose from multiple plan options, while the employer contributes a fixed amount toward coverage.

15. What types of clients do you serve?

We work with a wide variety of businesses across Southern California, including:

• Small retail stores

• Restaurants

• Law firms and attorney offices

• Manufacturing companies

• Roofing and construction companies

• Psychotherapy and counseling practices

• Medical and dental offices

• Professional service firms

• Family-owned businesses

And many more.

Each business has different needs, and we help employers compare group health insurance options that fit their team and budget.

Medicare Questions

16. What happens when I turn 65?

Most individuals become eligible for Medicare at age 65. At that time, you will need to decide between several coverage options including Original Medicare, Medicare Advantage plans, Medicare Supplement plans, and prescription drug coverage.

17. When should I enroll in Medicare?

Your Initial Medicare Enrollment Period begins three months before your 65th birthday, includes your birthday month, and continues for three months after.

Enrolling during this time helps avoid coverage gaps or penalties.

Additional Health Insurance Questions

18. What is the difference between HMO and PPO health insurance plans?

HMO plans require members to use a defined network of doctors and hospitals and often require referrals for specialists.

PPO plans generally offer more flexibility when choosing healthcare providers, including out-of-network coverage.

19. Do health insurance plans cover dental and vision care?

Most health insurance plans focus on medical coverage, but dental and vision insurance can usually be added separately.

We help clients add dental, vision, and life insurance coverage alongside their health insurance plans.

20. What happens if I lose my employer health insurance?

If you lose employer-sponsored coverage, you may qualify for a Special Enrollment Period, allowing you to enroll in a new health insurance plan outside of Open Enrollment.

21. Do you help with health insurance renewals?

Yes. Each year we review available plan options and help clients evaluate whether their current coverage still meets their needs.