UNDERSTAND THE CALIFORNIA SMALL GROUP RAF’S (RISK ADJUSTMENT FACTOR)
UPDATE: New ACA Group Plans no longer have a RAF adjustment since Jan 2014. Grandfathered Plans will keep their RAF. You can quote the new ACA Group Rates Here
You can always run your quote here:
What Is The Risk Adjustment Factor?
Each carrier has to “publish” their standard California Small Group health plan rates with the Department of Insurance or Department of Managed Care.
By law, they are allowed to increase or decrease a given companies’ medical plan rates by 10% from this standard rate based primarily on the health of the group.
This only applies to pre-ACA Group plans. There is no RAF for newer ACA (Affordable Care Act) plans.
This is to protect a company from increasing a certain small group’s health plan rates by an exorbitant rate (say 40% or 100%) based on the health of the group.
Other state’s health plans are not governed by this law and they can increase the rates by such high percentages based on the group’s health.
When Is The Risk Adjustment Factor Applied Or Changed?
The RAF is initially set when the company is approved for Small Group health insurance with the carrier. The company will receive notification of their specific factor.
This rate can be changes or updated at renewal (12 months following original effective date) each year based on the claims of the prior year.
Some carriers such as Blue Shield of California and Health Net automatically apply the extra 10% for smaller groups (typically less than 5 employees).
Other health insurance carriers such as Anthem Blue Cross will actually look at the health of the group even for companies with as little as 2 people.
The RAF will be re-evaluated each renewal period.
What Does The RAF Look Like?
It will look like 1.0 (standard rate), 1.1 (extra 10% above standard rate); .90 (10% discount off the standard rate).
Some carriers will only have one of the three above ratings while others such as Anthem Blue Cross allow for more flexibility such as 1.05 or .94.
When you request a California Small Group health quote, you will see the RAF on the quote.
If you have information regarding the health of the group or wish to err conservatively, we can request the 1.1 rating.
We recommend this so that their no surprises when the underwriting process is complete.
This is especially true if the employees are picking their own plan such as with Anthem Blue Cross’s Employee Elect.
They are making a decision based on their out of pocket expense so it is important not to have 10% increase after the fact.
RAF Guarantees And Group Size
On average, the larger the group, the better an RAF your California small company will receive. Essentially, they are able to “average” a few employee’s bad health among a larger pool of people.
In fact, most carriers will start to offer guaranteed RAF’s of 1.0; .95; or .90 for certain number of employees.
These guaranteed RAF’s usually start at 10 employees. A new company usually locks in a current rate for 12 months as well even if their is rate increase in the interim.
We can let you know of current rate guaranteed available on the market based on your group size when you run your California group health quote.
Health Reform And California Group RAF
The RAF in California will largely go away Jan 1st 2014 with the new Health Exchange plans.
The carriers will not be allowed to “tier” rates as of that date.
We expect all carriers rates will go up as a result but the effect will hopefully be around 10% as a result.
Obviously, larger groups (say 8-50) will bear the brunt of this since they’re more likely to received the discounted RAF currently.
You can request the online application here:
Other Useful Resources For California Small Group Health Insurance
RAF ending for California group health plans
How to choose a Group health plan in California
Guide to Understanding group health coverage
Why purchase a health plan for your California company
You can quickly Request your Group Health Bid for all options and we’ll get right to work.
Call 800-320-6269 with any questions!
Your Calhealth Advantage
Our online tools, free quotes and licensed agents are here to help you find a plan.

ON THE BLOG
Featured Articles
How Do I Set Up a Small Group Health Plan in California
How and When to Enroll in Medicare Supplements
California Individual Vision Insurance
California Health Reform Subsidy
California Health Insurance Resource List
California Health Insurance Rate Increases
California Health Insurance Office Copay
California Health Insurance Maternity and Individual
California Health Insurance Individual Versus Cobra
California Health Insurance Individual Underwriting
California Health Insurance Group Value Dental Vision
California Health Insurance Group Kaiser
California Health Insurance Definitions
California Health Insurance Coverage Rescission
California Health Insurance Continuing Education
California Health Care Rights
California Blue Shield Vital Shield
Best California Health Insurance Plan
Affordable California Health Insurance
Understand Senior California Health Insurance
Covered California for Small Business
Individual California Health Insurance If Declined
Individual California Health Insurance Application Questionnaire
Health Net California Application Center
GURU Which Plan Should I Go With
GURU Subsidy If Offered Group Coverage
Do HSA Funds Roll Over
Compare and Contrast Alieracare Health Sharing Plan Benefits
California Vision Insurance Group
California Individual Dental Insurance
California HSA Plans and Health Reform
California Health Insurance Simplified
California Health Insurance Hospital Plans
California Health Insurance College Plan
California Health Insurance Cancel Individual Group Insurance
California Health Exchange Platinum Plan
California Health Exchange and Non Exchange Plans
Bronze California Health Plan
Covered California Open Enrollment How To
Covered California Open Enrollment
Covered California Early Pre Enroll
Small Business Tax Credits Covered California
GURU What If I Miss Open Enrollment Period
Free Assistance Covered California Enrollment
Covered California Enrollment After Open Enrollment
Comparing Deductible and Out of Pocket
California PCIP Health Insurance
California Medi-cal
California Health Insurance Group How to Choose
Avoid Bad Health Insurance Plan
Anthem Blue Cross California Application Center
How to Quote United Health National Restaurant Association
Hold On to Grandfathered Health Plans
Health Insurance for Engineering Firms
GURU What Income Period Do They Look At
Carriers
California Health Subsidy Calculator
California Health Reform Penalty
California Health Insurance Group Guaranteed Issue
Are Health Care Sharing Ministry Plans Worth It
Travel Medical Insurance
Term Life Insurance in California
Health Reform Rebates California Health Insurance
GURU Do I Use Business or Personal Gross Income
Guide Continuation of Coverage
Federal Poverty Level and California Health Insurance
California Individual Family Delta Dental
California Health Insurance Exchange
California Health Insurance Discount Plans
California Health Insurance Coinsurance
California Health Insurance Agencies
California Family Health Insurance
Obamacare Health Insurance for Gig Economy
Complaints California Health Plan
California Health Insurance Copays
Anthem Blue Cross Covered California Plans Rates Networks
Short Term Health Insurance
Short Term Insurance
Kaiser Covered California Rates Plans
California Health Insurance Individual Split Policy
Blue Shield of California
HSA Versus PPO Health Plans California
GURU What Effective Date Can I Pick
California Individual Family VSP Vision
California HSA HRA Health Insurance
California Health Insurance Dental Networks
California Health Insurance Concept
Pros and Cons of Health Sharing Plans Like Alieracare
Health Sharing Plans for Short Term Health in California
Embedded Deductibles in California Health Plans
United Health Group Rates Save Employers
Sharp Health in Covered California Reviews Plans Rates
Senior Supplement Best Value
California Health Insurance Negotiated Rates
AlieraCare CarePlus Advantage Catastrophic Health Sharing Plan Review Quote Comparison
Kaiser Through Covered California
TrumpCare HSA and Obamacare Covered California
Guide High Risk Pools
Common Questions Pre-existing and Options
California Restaurant Association United Health Plan
California Health Insurance Payment Options
California Group Health Insurance Eligibility
Current Individual HSA Health Insurance Options
Critical Illness Insurance Review Rates Plans
California Special Enrollment Periods SEP
California Health Insurance Life Time Max
California Health Insurance Claims Processing
Understand Group California Health Insurance
Student Health Insurance California
GURU Whats Difference Between In Out Exchange Plans
Are Health Sharing Plan Payments Deductible
Small Business Penalty Paying Individual Plans
Small Business Penalty Paying Individual Plans
California Health Insurance Primary Care Physician
Moving to California Covered California
California Small Business
California Health Insurance Sick Rates Change
Aetna Leaves California Individual Health Market
Covered California Tax Penalty
What is Best Health Sharing Ministry Plan
United Health Insurance National Restaurant Association Employees
Pacificare of California
La Care Health Plan Review Rates Networks
Covered California Compare Bronze Silver Plans
California Medicare Supplement Center
Basic PPO Blue Cross California
Critical Illness Insurance California
California Small Group RAF
Health Net In Covered California Reviews Rates Plans
California Insurance and Alternative Health Care
What Is Health Sharing Ministry And Plan
Covered California Versus Short Term Health Insurance
California Health Emergency Urgent Care
Smart Sense Blue Cross California
Kaiser Short Term Health Insurance
California On Exchange Application Terms Conditions
Guide Group Health Insurance
Free Assistance Covered California Enrollment
By Major Insurance Company
Blue Shield California Plans Rates Reviews
California Health Insurance Group New Company
Covered California Tax Credit
Health Insurance by State
California Health Insurance Out of Network
Anthem Blue Cross Leaving California Market 2018
Losing Health Insurance After Divorce
Cobra
California Health Insurance Max Out Of Pocket
United Health versus Anthem Blue Cross California
Short Term Health Insurance Between Jobs
Cheap California Health Insurance
California Health Insurance Group Size
California Health Insurance Broker Agent
Anthem Blue Cross Covered California
California Health Insurance Group Premium Only Plan POP
California Health Insurance Deductibles
Alternative to Obamacare Health Insurance
Health Sharing Versus Covered California
Current Catastrophic Health Insurance Options
California Health Insurance Rates Based On
Covered California Open Enrollment Changes
California Health Carrier Comparison
Missed Health Insurance Open Enrollment Deadline
What are Medicare Excess Charges
How to Apply for Aliera Care Health Sharing Plans
Medicare Supplement versus Medicare Advantage Comparison
Major Medical California Insurance
Immediate Health Insurance In California
Individual Health Insurance Between States
How to Pay Covered California Premium
Already Pregnant California Health Insurance
Health Insurance for High Earners California
Obamacare Health Insurance Versus Health Sharing Comparison
California On Exchange Application
Is Western Health Advantage PPO or HMO
Health Insurance Between Retirement And Medicare
California Retirement Health Insurance Options
California Health Insurance Group 1099
California Health Insurance Blue Card
California Health Insurance Acupuncture
Are Health Sharing Plans Like Alieracare Tax Deductible
Guide California Health Doctor Network
Health Savings Account
GURU What If I Move To California
Blue Cross Blue Shield Short Term Health Insurance
Calcobra Extension
Oscar California Health Insurance Review Rates Plans
Losing Health Insurance at Age 26
California PPO POS Health Insurance
California Health Reform 400 Poverty Level
Covered California Login Issues
California Health Insurance High Deductible Plan
GURU Medi Cal for Children
California Health Pre Existing Condition
Obamacare Income Guidelines in California
How to Designate Covered California Agent
How to Quote AlieraCare for Short Term Coverage
California Health Insurance Full Time Student
Do Health Insurance Plans Cover CBD
Catastrophic Health Insurance California
California Health Insurance Out Of State Employees
Covered California Marketplace Tax Credit
Health Insurance For Larger Family Of 4 5 6 Or More
Common Questions Individual Contract
Can You Have HSA Account With Health Sharing Plans
Blue Cross Senior Smart Choice
GURU What If My Income Changes
California Health Insurance Carrier Comparison
Self Employed Health Insurance California
Health Insurance for 1-2-3 Months
How to Apply for Covered California
Kaiser Versus Western Health Advantage Comparison
California Health Insurance Chiropractic
Covered California Versus Cobra Comparison
California Los Angeles Medi Medi Anthem Mediblue Health Plan
How to Quote Aliera Care Health Sharing Rates
California Health Insurance Dependent Children
GURU Tax Filing Status and Covered California
California Health Insurance HMO Versus PPO
GURU Difference Between EPO And PPO
California Health Insurance Group Part Time
Comparing Covered California Plans
Covered California Self Employment Income
Health Net Versus Anthem Blue Cross Comparison
Common Questions Time to Process Application
GURU What Type Of Income
Kaiser Versus Sharp Health Plan Review Comparison
How To Pick Best Covered California Health Plan
Anthem Blue Cross Versus United Health Comparison
Kaiser Versus PPO
Aliera Care Health Sharing Plan Review Rates Plans
Health Care Sharing Ministry Comparison Review
Emergency Health Insurance California
Secular Non Religious Health Sharing Plan
Blue Shield California Versus United Health Comparison
Kaiser Versus Health Net Comparison Reviews
Health Net Versus Blue Shield California
Blue Shield Versus Anthem Blue Cross California
Blue Shield California Individual Rate Increase
Does A Company Have To Offer Health Insurance California
Kaiser Versus United Health Comparison Reviews
Kaiser Versus Anthem California
Blue Shield California Versus Kaiser Comparison Review
Blue Shield California Individual Rate Increase
Holiday
California Health Insurance Law
Blue Cross Smart Sense Individual
Blue Cross May Focal Renewal Group
Blue Cross Group Rates
Blue Cross California Individual Rate Increase
Blue Cross California Individual Rate Increase
Blue Cross Anthem Name Change
SCHIP Status
Immunizations
HSA Guideline Update
Blue Shield HIPAA Approach
Blue Cross Urgent Care Network
Blue Cross Small Group Rate Increase
Blue Cross Rate Increase Individual
Blue Cross Rate Increase Client
Blue Cross New Consumer Driven Plan
Blue Cross Healthy Living
Antibiotic Power
Holiday
California Mental Health Parity Bill
California Mental Health Parity
Blue Shield Rate Increase Individual
Blue Shield of California
Blue Cross Transfer To Colorado Nevada
Blue Cross Lawsuit
Blue Cross Billing Fee
Blue Shield New Individual Plans
Blue Cross Core 5000
Two Decades Of Helping Californians Find Affordable Health Insurance
Kaiser Versus Blue Shield Of California
See All Reviews on the Blog
See All Reviews on the Blog
- Over 500,000 Quotes
- 10’s of 1000’s Enrolled
- Guaranteed Best Rates
- Referenced for finding affordable
- California Health Inurance

20 years of experience in the California health insurance market has taught us one thing… Competent and experienced guidance is INVALUABLE
We are licensed Covered Ca agents with in-depth knowledge of their plans, process, and tax credits.
This website is owned and operated by Goodacre Insurance Services, which is solely responsible for its content. This site is not maintained by or associated with Covered California, and Covered California bears no responsibility for its content. The email address and phone numbers that appear throughout the site belong to Goodacre Insurance Services, and cannot be used to contact Covered California.