MEMORANDUM
Date:
February 11, 2015
From:
Susan Torres, Benefits Analyst -- Human Resources
Subject:
“Covered California” Coverage Option
Introduction:
Key parts of the health care reform law took effect in 2014 and there is a new way to buy private individual health
insurance via Covered California. To assist you as you evaluate options for you and your family, this notice provides
some basic information about Covered California. This notice is informational only.
What is “Covered California”?
Covered California is designed to help you find private individual health insurance that meets your needs and fits
your budget. Covered California offers the opportunity to find and compare private health insurance options. You
may also be eligible for a new kind of tax credit that lowers your monthly premium. Open enrollment for health
insurance coverage through Covered California began in October 2014 for coverage starting January 1, 2015.
Can I Save Money on my Health Insurance Premiums through Covered California?
You may qualify to save money and lower your monthly premium, but only if your employer does not offer
insurance coverage, or offers coverage that doesn't meet certain standards. Potential insurance premium savings
depends on your household income.
Does the Employment-Based Health Coverage Cabrillo Offers to You Affect Your Eligibility for Premium
Savings through Covered California?
Yes. If Cabrillo offers health coverage that meets certain standards, you will not be eligible for a tax credit through
Covered California and you may prefer to enroll in Cabrillo’s health plan, if you are eligible. (This Covered
California notice does not imply eligibility.) However, you may be eligible for a tax credit that lowers your monthly
premium or a reduction in certain cost-sharing, if Cabrillo doesn’t offer coverage to you or doesn’t offer coverage
that meets certain standards. If the cost of employee-only coverage under Cabrillo’s health plan is more than 9.5%
of your household income for the year, or if our health plan does not meet the "minimum value" 1 standard set by the
Affordable Care Act, you may be eligible for a tax credit.
Note: If you purchase a health plan through Covered California instead of accepting Cabrillo’s health plan coverage
based on District eligibility requirements, then you may lose Cabrillo’s contribution (if any) to your coverage under
the District’s health plan. Also, Cabrillo’s contribution—as well as your employee contribution—may be excluded
from income for Federal and State income tax purposes. Insurance payments for coverage through Covered
California are made on an after-tax basis.
1
An employer-sponsored health plan meets the "minimum value standard" if the plan's share of the total allowed benefit costs covered by the
plan is no less than 60 percent of such costs.
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How Can I Get More Information About Covered California?
Covered California can help you evaluate your coverage options, including your eligibility for coverage and its cost.
Please visit coveredca.com for more information, which includes an online application for health insurance
coverage.
Information About Employer-Provided Health Plan Coverage
If you decide to complete an application for coverage via Covered California, you will be asked for information
about Cabrillo’s health plan coverage. The information below can help you complete your application for coverage.
1. General Employer Information:
Employer name:
Employer Identification Number (EIN):
Employer street address:
Employer phone number:
Employer city:
Employer state:
Employer ZIP code:
Who can we contact about employee health coverage at
this job?
Phone number (if different from above):
Email address:
Cabrillo College
77-0385111
6500 Soquel Drive
(831) 479-6182
Aptos
California
95003
Susan Torres, Benefits Analyst
Human Resources Department
(831) 479-6182
sutorres@cabrillo.edu
2. Eligibility -- You may be asked whether or not you are currently eligible for Cabrillo’s health plan coverage or
whether you will become eligible for coverage within the next three months. In addition, if you are or will become
eligible, you may be required to list the names of your dependents that are eligible for coverage under Cabrillo’s
health plan.
If you would like information about the eligibility requirements for Cabrillo’s medical insurance plan, please read
the eligibility provisions described in the Summary Plan Description. You can obtain a copy of the Summary Plan
Description by contacting Susan Torres, Benefits Analyst in Human Resources at (831) 479-6182 or via email at
sutorres@cabrillo.edu.
3. Minimum Value -- If you are eligible for coverage under Cabrillo’s medical insurance plan, you may be required
to check a box indicating whether or not Cabrillo’s plan meets the minimum value standard. The District’s health
insurance coverage meets the minimum value standard.
4. Premium Cost -- If you are eligible for coverage under Cabrillo’s health insurance plan, you may be asked to
provide the amount of premiums you must pay for employee-only coverage under the lowest-cost health plan that
meets the minimum value standard. If you had the opportunity to receive a premium discount for any tobacco
cessation program, you must enter the premium you would pay if you received the maximum discount possible for a
tobacco cessation program.
If you would like information about the premiums for employee-only coverage under Cabrillo’s lowest-cost medical
insurance plan, please contact Susan Torres at (831) 479-6182 or via email at sutorres@cabrillo.edu.
5. Future Changes --You may also be asked whether or not Cabrillo will be making certain changes to its health
insurance plan coverage for the new plan year (October 1, 2014 – September 30, 2015). As usual, the District will
notify you about future changes to its health insurance plan coverage. If you are not sure how to answer this
question on your application, please contact Covered California at 1-800-300-1506 or via their website at
www.coveredca.com.
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