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Covered California Qualified Health Plan Contract between Covered California, the California Health Benefit Exchange and ( Contractor ) List of Attachments to QHP Model Contract, 2nd Attachment 1.

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All you do is fill out the Covered California case number, name, estimated income, sign, and date. Carefully read the bullet points on the attestation. You are attesting to your income under penalty of perjury.

Open enrollment for Covered California starts in the fall. Even when open enrollment is over, individuals with qualifying life events can enroll at any time of the year. Medi-Cal enrollment is also year-round.

If you miss the enroll-by date, you might have to wait until the next open enrollment period — but there are some exceptions. If you go through a major life change, you may still be able to apply for health insurance with Covered California under special enrollment.

Low-Income Families: Those with an annual household income at or below 150 percent of the federal poverty level, who are not eligible for Medi-Cal, can enroll in coverage through Covered California any time of year.

Covered California will accept a clear, legible copy from the allowable document proof list from the following categories which you can click on for more details: Proof of Income, Proof of Citizenship or Lawful Presence, Proof of California Residency, and Proof of Minimum Essential Coverage.

Californians have 60 days from the date the state of emergency was declared — or through March 5, 2023 — to sign up for coverage.

Open enrollment is from Nov. 1 through Jan. 31. After you enter your information, you will find out whether you qualify for Medi-Cal or Covered California. Get Started.

You can apply online on CoveredCA.com. This single application will let you know if you qualify for coverage through Covered California or Medi-Cal. You can also apply in person at your local county human services agency or by phone by calling Covered California at (800) 300-1506, or use one of our certified enrollers.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232