Group Health Insurance Coverage Types for California Employers
California employers have more group health plan design choices than virtually any other state. The coverage type you choose determines network structure, employee cost-sharing, referral requirements, and monthly premiums. Medical plans range from the low-cost Kaiser HMO to the flexible Anthem PPO; ancillary benefits (dental, vision, life, disability) round out a comprehensive employee benefits package.
Medical Plan Types
Ancillary Benefits
Choosing the Right Plan Mix
Most competitive California employers offer a dual-option medical plan (HMO + PPO or HMO + HDHP/HSA) paired with dental and vision. This gives employees choice while allowing cost-conscious employees to save. Adding group life and disability at modest cost rounds out a comprehensive package that competes effectively for talent across all industries.
The ACA requires all group health plans to cover ten essential health benefits, including emergency services, maternity care, mental health parity, preventive services at $0 cost-sharing, and pediatric services. California adds state-specific mandates including infertility diagnosis/treatment for large groups, chiropractic, and acupuncture in many plan types.
Sources
California Department of Managed Health Care — Knox-Keene Health Care Service Plan Act; IRS Publication 969 (HSA and Other Tax-Favored Health Plans); Affordable Care Act Essential Health Benefits; SHOP Exchange California (Covered California for Small Business); Kaiser Family Foundation 2024 Employer Health Benefits Survey.