California Health Benefit Exchange

State of California

Official Website: https://hbex.coveredca.com/

The purpose of state health insurance exchanges is to make health insurance more affordable and easier to purchase for small business and individuals.

Forms & Documents

Browse all California Health Benefit Exchange government forms

1 - 20 of 52 forms

Form Title Topics
2021 Special Enrollment Toolkit Certified Enrollers
ADVANCE NOTICE OF ADOPTION OF EMERGENCY REGULATIONS
A/Form FTB 3895 Job Aid for Certified Enrollers
Agent Book of Business Transfer Form Covered California for Small Business
Agent of Record Policy Covered California for Small Business
Appendix 2 to Attachment 7: Measurement Specifications Measures 9 and 10: ICD-10 codes for numerator - admissions for any cardiovascular diagnosis
Appointment of Authorized Representative
APPOINTMENT OF REPRESENTATIVE
Appointment of Representative-Spanish
Approved Voter Registration Regulations 10-02-14
April Briefing from Covered California
AUTHORIZATION FOR ENROLLMENT ASSISTANCE
Authorized Representative Standard Agreement for Organizations
Community Outreach Network Interest Form & Agreement
Countable Sources Income
Covered-California-Procurement-and-Contract-Manual
Covered California Tribal Premium Sponsorship Interest Form February 6, 2014
Dear Partners, Your strong efforts during this unprecedented Special
February Briefing from Covered California
Form FTB 3895 Quick Guide Certified Enrollers

Contact Information & Office Locations

1 contact point

Main Office

Phone numbers:
  • (800) 300-1506

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