Covered California is a state-run health insurance marketplace that offers affordable health insurance options to individuals and small businesses in California. It was established under the Affordable Care Act in 2014, and since then, it has helped millions of Californians gain access to quality healthcare.

Suppose you are a small business owner in California. In that case, Covered California for Small Business will verify your eligibility as a business owner before allowing you to offer health insurance coverage to your employees. If you are eligible, Covered California for Small Business will notify you in writing, confirming that you can participate. 

What are the Eligibility Criteria for Covered California for Small Business

To be eligible for CCSB, you must meet the following criteria:

  • At least one Employee must receive a W-2; the Employee cannot be an owner or spouse of an owner. 
  • Have a valid business license: You must have a valid business license issued by California.
  • Offer coverage to all eligible employees.
  • Meet minimum participation and contribution requirements: At least 70% of your eligible employees must enroll in your CCSB plan, and you must contribute at least 50% of the employee-only premium.

Will my Employees be automatically Eligible?

If you offer coverage to your employees, they become eligible to participate in Covered California for Small Business. Eligible employees can be added during the annual open enrollment period or if they experience a qualifying life event. Coverage always begins on the first of the month.

Can my part-time employees be Eligible for Covered California for Small Business?

Employees who work part-time between 20 and 29 hours per week may be considered eligible for coverage, subject to the employer’s discretion. However, part-time employees must be actively involved in the company’s business to be eligible. Conversely, employees who work less than 20 hours per week are not eligible for coverage.

What is the Verification Process for Covered California for Small Business?

Covered California for Small Business will verify your employees’ eligibility when you apply for coverage. CCSB will collect only the minimum information required to verify their eligibility and enrollment. After determining your employees’ eligibility, Covered California for Small Business will provide them with written notice and information about their right to appeal the eligibility determination.

What happens if my Employee appeals the eligibility determination?

Covered California for Small Business will notify you in writing if it finds any discrepancies between your company and your Employee’s application. You must resolve the issue within 30 days of the notice’s date. If you fail to respond within the 30-day period, CCSB will send a written denial notice for enrollment in the program. Your Employee can voluntarily waive coverage, but doing so will render them ineligible to enroll in your health plan until the next open enrollment period or during a special enrollment period triggered by a qualifying event.

Dependent Coverage Eligibility

If you provide coverage for dependents, both the enrollee and their dependents must enroll in the same health and/or dental plan. To be eligible for health coverage through CCSB, dependents must be under the age of 26. Dependents include adopted children, foster children, or those under legal guardianship. Disabled adult children, regardless of age, are also eligible dependents.

Must I offer Dependent Coverage?

You can provide health coverage to your employees without including their dependents. However, suppose you are an Applicable Large Employer and choose not to offer coverage to dependents because of your business size. In that case, your employees can purchase coverage for their dependents through Covered California’s Individual Marketplace. Dependents may also be eligible for financial assistance through the Covered California Individual Marketplace.


Covered California for Small Business provides an excellent opportunity for small business owners to offer their employees affordable and quality health insurance coverage. As a small business owner in California, you can take advantage of this program by ensuring that you meet the eligibility criteria and offering coverage to your employees. If you still need to figure out the program, feel free to contact our agents at Skyline Benefit for more information and guidance. Remember, your Employee’s health and well-being are crucial to your business’s success, and by providing them with access to quality healthcare, you’re investing in your business’s future.

Need Help with Group Health Insurance?

Skyline Benefit is an independent health insurance broker in Fullerton, CA that offers affordable and flexible group health insurance options.  Selecting the best group health insurance plans can be overwhelming; our mission is to simplify the process and help our clients every step of the way.

Schedule a consultation today. Call us at: (714) 888-5112

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