The 4 Metals of Coverage offered by 13 Health Plans

As early as October of this year, we will all be investigating our health insurance options for 2014 when health insurance becomes mandatory.  We will be selecting benefits offered by one of the following 13 health plans providing coverage in 19 regions in California:

  •    Alameda Alliance for Health - serving Alameda region
  •    Anthem Blue Cross of California - serving all regions
  •    Blue Shield of California - serving all regions
  •    Chinese Community Health Plan - serving San Francisco and San Mateo regions
  •    Contra Costa Health Services - serving Contra Costa region
  •    Health Net - serving Napa, Sonoma, Solano, Marin, San Francisco, Contra Costa, Santa Clara, San Mateo, Santa         Cruz, Monterey, San Benito, San Joaquin, Stanislaus, Merced, Mariposa, Tulare, Kern, LA north, LA South, San     Bernardino, Riverside, Orange and San Diego regions
  •    Kaiser Permanente - serving all regions except Santa Cruz, Monterey and San Benito
  •    L.A. Care Health Plan - serving LA north and LA south regions
  •    Molina Healthcare - serving Sacramento, Placer, El Dorado, Yolo, LA north, LA south, San Bernardino, Riverside & San Diego regions
  •    Valley Health Planserving Santa Clara region
  •    Update- Ventura County Health Care Plan will not be participating the California Health Insurance Exchange as of 08/08/2013
  •    Western Health Advantage serving Napa, Sonoma, Solano, Marin, Sacramento, Placer, El Dorado and Yulo        regions   

We will be comparing the 4 Metals of coverage whether we choose to buy inside the Health Insurance Exchange called Covered California or outside of the exchange.  If you buy your coverage through the Health Insurance Exchange, not only could you be eligible for a subsidy to help you pay for those premiums, you will also have the option of considering a catastrophic plan if you are an individual under the age of 30.  The 4 Metals of coverage (represented by their actuarial value) is a percentage of benefits paid as a patient and are as follows:

  •    Bronze:  60% paid by health plan and 40% paid by the individual
  •    Silver:  70% paid by the health plan and 30% paid by the individual
  •    Gold:  80% paid by the health plan and 20% paid by the individual
  •    Platinum:  90% paid by the health plan and 10% paid by the individual 

The 10 Essential Health Benefits which are included in all plans (whether you buy inside or outside of the exchange) are as follows:

  •    Ambulatory patient service
  •    Emergency services
  •    Hospitalization
  •    Maternity and newborn care
  •    Mental health and substance use disorder services, including behavioral health treatment
  •    Prescription drugs
  •    Rehabilitative and habilitative services and devices
  •    Laboratory services
  •    Preventive and wellness services and chronic disease management
  •    Pediatric services

Some of the plan rates will be higher or lower depending upon region (rating area), age and the plan you choose. 

Contact us as early as October 2013 for more detailed information.  You can contact us by email at or by telephone at (800) 560-2443.

Shawn and Debbie Zenker
Zenker Insurance Agency, Inc. 
3868 W. Carson St, Suite 206
Torrance CA 90503
310.214.2444 | 800.560.2443
License# 0G76383

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Posted 10:00 PM

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