This dataset provides number of eligible individuals by selected subsidized or unsubsidized qualified health plans (QHPs) through Covered California during a reporting period. Covered California subsidized and unsubsidized QHPs data is derived from the California Healthcare Eligibility, Enrollment and Retention System (CalHEERS) and includes eligible individuals who selected and enrolled in a QHP, and paid their first premium. This dataset is part of public reporting requirements set forth by the California Welfare and Institutions Code 14102.5.

This dataset includes the number of eligible individuals selected and enrolled in a subsidized Covered California qualified health plans (QHPs) by Federal Poverty Level (FPL) range by reporting period. Covered California reported data is from the California Healthcare Eligibility, Enrollment and Retention System (CalHEERS) and includes eligible individuals who selected and enrolled in a QHP, and paid their first premium. This dataset is part of public reporting requirements set forth by the California Welfare and Institutions Code 14102.5.

This dataset provides number of eligible individuals by selected subsidized or unsubsidized qualified health plans (QHPs) through Covered California during a reporting period. Covered California subsidized and unsubsidized QHPs data is derived from the California Healthcare Eligibility, Enrollment and Retention System (CalHEERS) and includes eligible individuals who selected and enrolled in a QHP, and paid their first premium. This dataset is part of public reporting requirements set forth by the California Welfare and Institutions Code 14102.5.

This dataset includes the number of individuals who have filed an appeal for a subsidized Covered California Qualified Health Plan (QHP), Medi-Cal, or a combination of both eligibility determinations by year and quarter. Appeals may be filed by an appellant for determinations that resulted in a denial, eligibility, or discontinuance of coverage. A denial is defined as an eligibility determination at application that resulted in a denial of coverage. An appeal regarding an eligibility determination may be filed when the appellant disputes the type of program eligibility. A discontinuance is when an individual is no longer eligible for Medi-Cal or Covered California QHP. Appeals may be filed for cases involving mixed determinations, such as when household members applied for and/or had eligibility determinations made for the two programs (i.e., parents were eligible for Covered California and the child(ren) were eligible for Medi-Cal). Covered California and Medi-Cal eligibility appeals are processed and adjudicated by Administrative Law Judges and the California Department of Social Services (CDSS) staff who track appeals and hearing results. This dataset is part of the public reporting requirements set forth in California Welfare and Institutions Code 14102.5(a)(6).

This dataset includes the total number of newly eligible individuals by Insurance Affordability Program (IAP), by reporting period. IAPs include Medi-Cal, Covered California subsidized and unsubsidized Qualified Health Plans (QHP), and the Medi-Cal Access Program (MCAP). Covered California subsidized and unsubsidized QHP newly eligible data includes those who selected and enrolled in a QHP, and paid their first premium. This dataset is part of public reporting requirements set forth by the California Welfare and Institutions Code 14102.5.