California · Coverage Guide

California health plans for families and employers.

Covered California marketplace plans, employer-sponsored group coverage from level-funded to ICHRA, and Medi-Cal context — all under one CDI-licensed platform with broker-of-record support across all 58 counties.

ACA-compliant plans Group plans for employers No-cost consultation
Marketplace
Covered California
State-based exchange (operating since 2014). www.coveredca.com
Medicaid program
Medi-Cal
Administered by California Department of Health Care Services (DHCS). www.dhcs.ca.gov
Carrier regulator
California Department of Insurance (CDI)
Licenses carriers and brokers and reviews rate filings. www.insurance.ca.gov
Uninsured rate
6.4%
California non-elderly uninsured rate 2023 ACS, U.S. Census Bureau) National average ~7.6%.
What Benefitra covers in California

Four pillars. One platform.

Benefitra is the parent platform for benefits brokerage, HR SaaS, marketing, and decision-support tools. California employers can adopt one pillar or stack them.

Insurance

Health, dental, vision, life, disability. Individual, family, group.

Funding strategies →

Employee Benefits

Seven funding paths: fully-insured, level-funded, self-funded, ICHRA, PEO-integrated, captive, Taft-Hartley.

Compare paths →

Marketing & SEO

Lead-engine and rankings for growing employers. Page-2-to-page-1 in months.

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Business Tools / SaaS

586 free calculators: ACA, COBRA, ROI, valuation, projector.

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Coverage options in California

Affordable, compliant, and built for the way you actually buy.

California health plans give consumers and employers more options for dependable health insurance coverage. These options match different budgets and needs.

Individual and family plans. California operates its own state-based exchange — Covered California — the first SBE in the country, launched in 2014. Plans are ACA-compliant qualified health plans regulated by the California Department of Insurance (CDI) and the Department of Managed Health Care (DMHC). Coverage varies by household income, county of residence, and plan year — Covered California offers enhanced state subsidies on top of federal premium tax credits.

Qualified health plans and subsidies. Covered California plans cover the federal essential health benefits plus state-added benefits. Most California enrollees qualify for federal premium tax credits, and many also qualify for enhanced state-funded subsidies passed under AB 174 that close the affordability gap above 400% FPL. Open enrollment runs Nov 1 – Jan 31, longer than the federal window. Special enrollment periods apply to qualifying life events.

Medi-Cal: California's Medicaid. Medi-Cal is administered by the California Department of Health Care Services (DHCS) and covers about 14 million Californians — roughly one in three residents. California fully expanded Medicaid under the ACA effective January 1, 2014, raising the income limit for adults to 138% of the federal poverty level. California has since extended Medi-Cal eligibility to all income-eligible adults regardless of immigration status (full-scope, effective 2024).

Pairing a plan with an HSA. HSA-eligible high-deductible California health plans let employees pay eligible medical expenses with pre-tax dollars, with 2026 contribution limits at $4,400 individual / $8,750 family per IRS Rev. Proc. 2025-19. Supplemental plans (accident, dental, vision, disability) cover gaps the primary medical plan doesn't.

Employer group plans in California. California employers with 1 or more employees can offer group health insurance year-round (California guarantees small-group access at 1+ employees, more generous than the federal 2+ standard). Mid-market employers across the Los Angeles, San Francisco Bay Area, and San Diego metros increasingly use level-funded, self-funded, or ICHRA designs to control renewals in a high-cost state. Benefitra's Funding-Fit Discovery models the math across all seven arrangements.

Individuals

Individual & family plans

ACA-compliant plans with essential health benefits, network access, and subsidy eligibility based on income.

Employers

Group health insurance

Small-business and mid-market plans, level-funded and self-funded options, premium-stability strategies.

Public programs

Medicaid & Medicare

State-administered Medicaid for eligible California residents; Medicare access by age or disability.

What California clients say

Real outcomes, real California employers.

Sam worked with our California team to reduce health costs by nearly 50% without raising deductibles or limiting the network. He was always willing to take a call.

— California employer, professional services

Without changing payroll or going through underwriting, we saved over 50% while upgrading to a PPO. The savings funded dental, vision, and a new full-time hire.

— Bay Area small business

The Benefitra plan lowered my family's premium substantially while improving coverage. Friends and family have since joined the plan too.

— California family plan member
Frequently asked questions

California health insurance — answered.

Marketplace, Medicaid, group plans, and ICHRA. Common California-specific questions for families and employers.

Where do Californians enroll in ACA health plans in 2026?
Californians enroll through Covered California, the state-based exchange operating since 2014. Open enrollment runs Nov 1 – Jan 31 (a longer window than the federal Nov 1 – Jan 15). Plans are ACA-compliant qualified health plans, and most enrollees qualify for federal premium tax credits plus California's enhanced state-funded subsidies.
What is Medi-Cal and who qualifies?
Medi-Cal is California's Medicaid program, administered by the California Department of Health Care Services (DHCS). California expanded Medi-Cal under the ACA in 2014 (138% FPL for adults) and later extended full-scope coverage to all income-eligible adults regardless of immigration status. Roughly 14 million Californians — about one in three residents — are enrolled.
Who regulates California health insurance carriers?
California uniquely splits regulation between two agencies. The California Department of Insurance (CDI) regulates indemnity health plans and PPOs. The Department of Managed Health Care (DMHC) regulates HMOs and most Knox-Keene plans. Brokers and carriers register with the relevant agency depending on plan type.
Can a California small business offer group health insurance?
Yes. California guarantees small-group health insurance access at 1 or more employees — more generous than the federal 2-employee minimum. Small businesses (fewer than 25 FTEs, average wages under the federal threshold, contributing at least 50% of employee premium) may qualify for the federal Small Business Health Care Tax Credit through SHOP-eligible carriers.
What is ICHRA and is it allowed in California?
ICHRA (Individual Coverage Health Reimbursement Arrangement) lets California employers reimburse employees tax-free for individual ACA plans purchased through Covered California. ICHRA is federally permitted and fully available in California. It is increasingly used by California employers managing high-cost-of-living regions who want a defined-contribution benefits budget while giving employees plan choice across rating areas.

Find your California funding fit in five minutes.

Answer twelve short questions. We grade your fit across the seven funding arrangements — fully-insured, level-funded, self-funded, captive, ICHRA, PEO-integrated, and Taft-Hartley.

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