Covered California

What Covered California does

Covered California is California's state-based health insurance marketplace established under the Affordable Care Act (operational since 2013, with founding tied to 2011 legislation), headquartered in Sacramento. It functions as the exclusive state channel through which California residents can access ACA financial assistance to lower individual health insurance premiums, serving 1.9 million enrollees in the 2026 plan year and historically reaching over 16 million residents. The organization connects consumers with private health plans from eleven carrier partners (Anthem, Blue Shield, Kaiser Permanente, Sharp, Health Net, Molina, Valley Health, Balance, IEHP, LA Care, Western Health) across four metal tiers (Bronze, Silver, Gold, Platinum) in HMO and PPO structures, with optional dental and vision add-ons and a separate small business product line (CCSB).

The core technology platform is CalHEERS (California Health Insurance Eligibility and Enrollment System), shared with Medi-Cal. In April 2026, Covered California expanded its partnership with Google Public Sector and Deloitte Consulting to deploy Google Cloud's Document AI within CalHEERS, automating verification across 25 document types and reducing processing time from up to 72 hours to under 5 seconds, with a 54% automation rate and an estimated 24,000 hours of annual service center savings. The platform is FedRAMP-certified and includes fraud detection. Distribution is multi-channel: a self-service online portal, a phone service center supporting 13+ languages, paper applications, county Medi-Cal offices, and a statewide network of 11,000 certified enrollers providing free in-person assistance.

Covered California is a California state government agency; it generates revenue through carrier participation fees (marketplace commissions) and does not charge consumers for enrollment assistance. It jointly sponsors the CoveredCA.com platform with the California Department of Health Care Services (DHCS), enabling unified enrollment across Covered California plans and Medi-Cal. In May 2026, Covered California entered a multipayer primary care payment reform initiative with CalPERS and DHCS, collectively covering nearly 45% of California residents. For 2026, the state allocated $190 million in California-funded premium subsidies following the expiration of enhanced federal ACA subsidies.

Name

Covered California

Legal name

Covered California

Website

https://coveredca.com

Company type

Private

Founded year

2013

Operating status

Operating

Headcount range

1,001–5,000 employees

Short description

Covered California is California's official state-based ACA health insurance marketplace, connecting 1.9 million residents with subsidized private health plans, dental and vision coverage, Medi-Cal integration, and small business options across eleven carrier partners.

Ownership category

akta.pro rank

Product category

Health Insurance Marketplace

NAICS

Insurance Agencies and Brokerages (524210), Agencies, Brokerages, and Other Insurance Related Activities (5242), Insurance Carriers and Related Activities (524)

SIC

Hospital & Medical Service Plans (6324), Insurance Agents, Brokers & Service (6411)

akta.pro primary industry

ACA Marketplace (On-Exchange) Individual Plans (FSAIAEAA)

akta.pro secondary industries

Small Group Health Insurance (2–50/100) (FSAIAFAD), Fully Insured Small Group Plans (HLAEAAAB)

Keywords

• Health insurance marketplace
• ACA exchange
• Subsidized health coverage
• Medi-Cal integration
• Enrollment services

Headquarters

HQ city

Sacramento

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2C

Offering type

Digital Commerce or Content

Cost components

Personnel, Technology or R&D, Operations, Marketing or Sales

Revenue model

1. Health Insurance Carrier Fees: Covered California functions as a government-established marketplace where health insurance carriers pay fees to participate and offer plans. The marketplace does not charge consumers for enrollment assistance.

Pricing tiers

Go-to-market motion2 records

Distribution channels6 records

Marketing channels6 records

Core offering

Covered California operates California's state-based health insurance marketplace under the Affordable Care Act, providing individuals and families access to qualified health plans from multiple participating insurance carriers. It aggregates metal-tier plans (Bronze, Silver, Gold, Platinum), dental and vision coverage, the Covered California for Small Business (CCSB) program, and integrates with the Medi-Cal public program while administering federal Advanced Premium Tax Credits and the state-funded California Premium Subsidy.

Product overview

Covered California is a state-based health insurance marketplace established under the Affordable Care Act. The core offering is the Covered California Health Insurance Marketplace, which connects California residents with private health insurance plans from partnered carriers (Anthem, Blue Shield, Sharp, Kaiser Permanente, Health Net, Molina, Valley Health, Balance, IEHP, LA Care, Western Health) and provides access to financial assistance including Advanced Premium Tax Credits and state-funded subsidies. The platform offers metal-tier plans (Bronze, Silver, Gold, Platinum) in HMO and PPO network types, with optional add-on dental and vision coverage. A companion program, Covered California for Small Business (CCSB), serves small business employers. The underlying CalHEERS system, developed in partnership with Google Public Sector and Deloitte, provides eligibility determination and enrollment processing, augmented in 2026 with AI-powered document verification that reduced verification time from 72 hours to under 5 seconds across 25 document types, achieving 54% automation.

Differentiator

Problem solved

Functional benefit

Products and services

• Covered California Individual Health Insurance Marketplace California's state-based ACA marketplace offering qualified individual and family health plans from participating carriers across Bronze, Silver, Gold, and Platinum metal tiers, with federal Advanced Premium Tax Credits and state-funded California Premium Subsidy for eligible California residents.
• Medi-Cal Eligibility Integration

Quantifiable outcome

• 1.9 million enrollees maintained for 2026 despite 10% premium increases and subsidy changes
• +2 more outcomes

Named customers1 record

Segments4 records

Ideal customer profiles2 records

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration2 records

AI capability4 records

Feature3 records

Partnerships

Five partnerships are on record, tiered flagship and core.

• CalPERSflagshipStrategic or Co-development Partner · 29 May 2026Covered California, CalPERS, and California DHCS formed a collaborative initiative leveraging collective coverage of nearly 45% of state residents to drive primary care investment. The three largest public health purchasers are working together on multipayer primary care payment reform.
• California Department of Health Care Services (DHCS)flagshipStrategic or Co-development Partner · 29 May 2026DHCS, Covered California, and CalPERS collectively cover nearly 45% of California residents and are aligning efforts to strengthen primary care delivery across over 18 million Californians through shared payment reform frameworks.
• Google Public SectorcoreTechnology or Integration · 22 April 2026Expanded partnership to implement Google Cloud's Document AI technology into CalHEERS, California's health insurance eligibility and enrollment platform. The AI system automates document verification across 25 document types, reducing manual tasks by 40% and cutting verification time from up to three weeks to real-time processing.
• Deloitte Consulting LLPcoreImplementation/ SI/ Consulting Partner · 22 April 2026Deloitte serves as implementation partner for the Google Cloud Document AI integration into CalHEERS. The solution has achieved 54% automation rate and 24,000 hours annual savings. Deloitte has since applied this replicable solution to other government programs including Maryland's childcare subsidy and Nevada's timesheet verification.
• California Department of Health Care ServicescoreStrategic or Co-development Partner · 6 September 2024Joint sponsorship of CoveredCA.com where both organizations collaborate to support health insurance shoppers in getting coverage and care that is right for them. Shared enrollment application connects consumers with both Covered California plans and Medi-Cal programs.

Scale indicators11 records

Recent moves5 records

Expansion highlights5 records

Emerging players

• Stride Health: Digital enrollment platform for individual health insurance including ACA plans, with a focus on gig workers and self-employed consumers. Comparable as an emerging digital alternative for ACA enrollment targeting similar individual buyer segments.
• Wellthie: Digital broker and enrollment technology provider focused on individual health insurance shopping and decision support. Comparable as an emerging technology-enabled enrollment intermediary addressing the same individual ACA buyer journey as Covered California.

Broad incumbents

• eHealth: Public-traded private health insurance exchange and brokerage offering individual, family, and Medicare plans from multiple carriers. Operates adjacent to Covered California's marketplace model but as a private commercial intermediary rather than a state entity.
• HealthCare.gov: The federal ACA marketplace serving states that did not establish their own exchanges. Functions as the broad incumbent alternative to state-based marketplaces like Covered California, with similar eligibility and enrollment mechanics at national scale.

Direct peers

• Connecticut Access Health CT: Connecticut's official ACA marketplace. Comparable as a smaller state-based exchange providing individual health plans, premium tax credits, and carrier fee revenue through a state-chartered entity.
• Massachusetts Health Connector: Massachusetts' state-based ACA marketplace with a comparable operating model: state-established exchange, individual/SHOP plans, premium tax credits, and carrier fee revenue. Closely mirrors Covered California's structure.
• Maryland Health Connection: Maryland's state-based health insurance marketplace. Direct peer in operating model and scale; notably, Deloitte has already replicated the CalHEERS-style AI verification solution into Maryland's childcare subsidy program via the same partnership.
• Washington Healthplanfinder: Washington state's ACA marketplace offering individual and family health plans with subsidy administration. A direct state-based peer with similar enrollment, eligibility determination, and carrier participation mechanics.
• NY State of Health: New York's official state-based health insurance marketplace operating under the ACA. Directly comparable as a state-established exchange offering individual and small-group plans with financial assistance and carrier fees.

Others

• GetInsured: Technology vendor that builds and operates state-based health insurance exchange platforms (including for several state marketplaces). Comparable as the underlying SaaS infrastructure provider that powers exchange experiences similar to Covered California's CalHEERS.

Market position

Strengths1 record

Weaknesses1 record

Competitive moat5 records

Key risks5 records

Key highlights7 records

Customer concentration

• Xx.com/CoveredCA
• YouTubeyoutube.com/user/CoveredCA
• Facebookfacebook.com/CoveredCA
• LinkedInlinkedin.com/company/coveredca
• Instagraminstagram.com/coveredca/?hl=en
• TikToktiktok.com/@coveredca

Compliance1 record

Revenue estimate

Valuation estimate

Number of profiles

Profiles5 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Covered California