California Health Insurance · Licensed Agent · Costa Mesa
🛡️ California Health Insurance That Fits Your Life.
Clear options for your family, your business, or yourself, with a licensed agent beside you.
I’m Matthew Reilly, a licensed California agent and Certified Covered California Enroller here in Costa Mesa. Helping people sort out their coverage is what I do every day, and I pick up when you call.
Most people I talk with already know who they want covered. What they’re looking for is a clear view of their options. What would it mean to you to have that settled?
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Every Subsidy Checked: I look at the state and federal premium help you may qualify for.
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Coverage That Fits: Health plans built around you, with optional supplemental cash-benefit protection.
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No Sales Pressure: Clear recommendations shaped by your doctors, your needs and your budget.
From Covered California individual and family plans to group benefits for your team, I lay your options out side by side so you can choose with confidence.
My help comes at no cost to you. No obligation, and your conversation stays confidential. Choose an option above to get started, or text me if that’s easier.
California Health Insurance Coverage · Start Here
🧱 Where Do I Actually Start?
Straight answers to the questions that come up most — for employers setting up group coverage and for individuals and families shopping on their own. Nothing here is a quote; it’s the groundwork so a conversation starts further along.
📖Want the full library of guides, not just the starting points? See all resources →
🧙 Should I start with the business side or the individual side?Start Here
If you’re setting up or reviewing a group plan for employees, start with “small group or large group” and “what does the group have to agree to” below. If you’re shopping for yourself or your family, jump to “when is open enrollment” and “which program am I” below. Either way, nothing on this page is a quote — it’s the groundwork so a real conversation starts further along.
🏢 Am I “small group” or “large group”?Group Size
In California, 1–50 employees is small group and 51+ is large group — the rules, rate structure, and plan options differ between the two. Sole proprietors and businesses with only one health-plan-eligible employee generally don’t qualify for small-group coverage and are usually better served by individual or family coverage instead.
📋 What does the group actually have to agree to?Group Rules
Carriers typically require two minimums to be met before a small-group plan can be issued:
Participation requirement: roughly 70% of eligible employees enrolled Employer contribution requirement: roughly 50% of employee premium paid by the company
Both figures can shift slightly by carrier and by year, so they’re always confirmed against the current plan documents before a group is quoted.
📅 When can we actually switch plans or carriers?Group Rules
Most groups can shop and switch carriers at renewal, which usually means a 45–60 day window before your plan year ends. Starting that comparison early is what actually gives you leverage — waiting until the last couple of weeks limits you to whatever quotes can be turned around in time.
📊 Is benchmarking our current plan actually worth the time?Group Value
Usually, yes. A benchmark compares your current plan’s cost and coverage against what’s actually available in the market right now — it doesn’t commit you to switching anything. Some employers confirm the plan they have is still the right fit, and others find options worth a closer look; the only way to know is to actually run the comparison.
📅 When is open enrollment?Enrollment
Open enrollment for individual & family coverage runs November 1 – January 31 each year.
Enroll by December 31 and coverage starts January 1.
Enroll between January 1 – 31 and coverage starts February 1.
Outside that window, a 60-day Special Enrollment Period opens after qualifying life events (job loss, marriage, a new baby, moving, and similar). Medi-Cal enrollment is year-round — there’s no deadline if you qualify.
🧱 Covered California, Medi-Cal, or off-exchange — which one am I?Fit
It comes down to income. Generally, household income at or below 138% of the Federal Poverty Level qualifies for Medi-Cal (no premium). Above that line, Covered California is where subsidies (premium tax credits) are available based on income. Off-exchange, bought directly from a carrier, makes sense mainly if you don’t qualify for a subsidy or want a plan that isn’t sold on the exchange.
💰 Does a subsidy actually change if my income changes mid-year?Subsidy
Yes — your subsidy is based on estimated annual income, so a raise, a new job, or a drop in hours should be reported to Covered California when it happens, not just at tax time. Reporting changes as they happen avoids a larger reconciliation bill (or a missed credit) when you file your taxes the following year.
🛡️ What about life insurance — is that a separate conversation?Life
Yes — health coverage and life insurance are priced and underwritten completely separately, so they’re always discussed as two distinct decisions, never bundled into one quote. Many clients handle both with the same conversation simply for convenience, not because the policies are connected in any way.
Legal & Compliance Disclaimer
This page is general information, not a guarantee of eligibility or plan availability — exact figures (contribution minimums, FPL percentages, enrollment deadlines) are set annually and should be confirmed before you rely on them for a specific decision. No premium, rate, or price information is included or implied.
