Covered California reviewed their proposed 2018 – 2019 budget at their May 2018 Board Meeting. Based on predictions from studies done by Pricewaterhouse Cooper (PwC) and the CalSIM team, the 2018 – 2019 fiscal year budget forecasts an enrollment decrease from 7% to 18% from FY 2017-18 and premium increases from 9% to 13%.
Lower Enrollment But Increased Revenue For Covered California in 2019
Even though Covered California assumes declining enrollment in their health plans, because of the increased premiums they predict their gross revenues will increase anywhere from $12.4 to $27.9 million.
The increased revenue is also in light of reducing health plan assessment from 4% of the gross premiums down to 3.75% for the individual and family plan market. The proposed operating budget for FY 2018-19 is $340.2 million. This represents a 6.55 increase over the FY 2017-18 budget or an increase of $20,686,242.
2018 – 19 Budget Adds Staff
The proposed budget includes
- Consumer Experience Division to measure consumer satisfaction and experience
- A new leadership academy for Covered California managers
- $107 million for marketing and outreach
- Adding staff to the Plan Management Division
- Funding a capital projects reserve of $10 million
- Covered California expects to have 1,399 positions in its organization supported by the proposed budget.
Agent Enrollment Is Largest Service Channel For Covered California
Previous to reviewing of the budget at their May meeting, Peter Lee’s Executive Director’s Report was given. Through early March 2018, 37% of enrollments were done by individual consumers, 47% of enrollments were entered by agents, and Navigators accounted for 5% of the enrollments.
There is a proposal to change how the Navigators are funded. Currently payments to Navigators are based on performance with possible adjustments in the next contract year. The new Performance Grant Model has payments based on reported performance by the grantee. The new model accounts for assistance to consumers where there might not be final enrollment.