Does each person/agent within a company need to be appointed with a carrier or can appointments continue with the company/agency?

Are agents compensated for renewals?

Individual Marketplace – Commissions are set by each carrier in the exchange.

Covered California for Small Business – Yes.

What is the commission on Covered CA individual plans?

Commissions are paid by each health insurance company according to the Agent’s active commission schedule at the time of enrollment.  Certified Insurance Agents must be directly appointed by each of the health insurance companies in Covered California to receive commissions from the health insurance company.  The commission rate is the same rate as non-exchange business.  

What is the commission on Covered California for Small Business plans?

Covered California for Small Business commissions are paid by Covered California. See commission schedule: https://www.claremontcompanies.com/wp-content/uploads/2015/12/CCSB-2016-Agent-Commission.pdf

Certified Insurance Agents must be appointed by Covered California to receive commissions. Agents do not need to secure appointments with each of the carriers in Covered California for Small Business. Agents will be appointed under the Covered California for Small Business Master Agent Agreement and agents will then have sub-appointments with all participating Covered California for Small Business carriers. The Certified Insurance Agent Agreement includes full vesting language with familiar terms. Agents can be assured that business sold during the year is secured under the agreed-upon commission rate.

Are commissions based on pre-subsidy/credit premium?

Commissions are based on the gross premium and not the net premium.

Will agents be compensated for Medi-Cal enrollments?

Certified Insurance Agents (CIAs) receive $58 for each approved Medi-Cal application when:

• Medi-Cal applicants are newly eligible for coverage pursuant to the federal Patient Protection and Affordable Care Act, or
• Applicants have not been enrolled in the Medi-Cal program during the previous 12 months prior to making the application
• Each application may be for several individuals

How will commission splitting be handled?

Certified Insurance Agents are permitted to split or share commissions provided the other agent is also a Certified Insurance Agent authorized to sell through Covered California. The Covered California for Small Business system does not automatically allow for commission splits but agents can make their own split arrangements until such a feature is made available in Covered California for Small Business. In the individual marketplace, since commissions will be paid by each health insurance company how commissions will be split will depend on the health insurance company’s policies and procedures.

If the enrollment is online or mail how will Covered CA know I’m the agent for the commission payment?

There will be a field in the application to designate the agent.

If the applicant forgets to include our agent information when submitting the online application, is there a process for the agent to show proof that we assisted applicant?

Yes, the applicant can send a letter to Covered California designating their agent.

Does each person/agent within a company need to be appointed with a carrier or can appointments continue with the company/agency?

Individual Marketplace – Since commissions will be paid by each health insurance company it would depend on the health insurance company’s policies and procedures. However, each agent must be certified with Covered California to transact business with Covered California.

Covered California for Small Business – Each agent must be certified with Covered California to be appointed by Covered California. Agents do not need to secure appointments with each of the carriers in Covered California for Small Business. Agents will be appointed under the Covered California for Small Business Master Agent Agreement and agents will then have sub-appointments with all participating Covered California for Small Business carriers.