Financial Reports

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    Payment to Agency Reports – Form 801

    Financial Information about Covered California

    Pursuant to Title 45 Code of Federal Regulations § 155.205, Covered California (the Exchange), provides the following financial information:

    • The average costs of licensing and regulatory fees required by the Exchange are included in the monthly Participation Fees paid by the Qualified Health and Dental Plan Issuers (Contractor).

      • Individual Market Qualified Health and Dental Plan Issuers: The Participation Fee payable to the Exchange shall be equal to four (4) percent of the gross premium attributable to each Enrollee in Contractor’s Qualified Health and Dental Plans for each month of contract year 2018.
      • Small Business Market Qualified Health and Dental Plan Issuers: The Participation Fee payable to the Exchange shall be equal to five-point-two (5.2) percent of the gross premium attributable to each Enrollee in Contractor’s Qualified Health and Dental Plans for each month of contract year 2018.

    • Any other payments required by the Exchange:

      • Small Business Market Qualified Health and Dental Plan Issuers shall pay a fee specified by the Exchange for Agent and General Agent compensation (Distribution Cost). In 2019, the Distribution Cost is seven-point-zero (7.0) percent of premiums for Qualified Health and Dental Plan Issuers.
      • Administrative costs of the Exchange: These costs can be found in the yearly Budget Reports on this webpage under “Financial Reports”.
      • Monies lost to waste, fraud, and abuse: $0
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