Private PPO, off-exchange & Covered California plans for you, your spouse and your kids — compared side by side for 2027
▶Watch: Private PPO vs. ACA Marketplace — which is right for your family (50 sec)
Is your family overpaying for health insurance in California? If your household earns more than $132,000 (family of four), Covered California gives you no federal premium help for 2027 — and you pay full price for every person on the plan. That's where families overpay the most, and where comparing off-exchange PPOs and employer-level group coverage pays off. We compare every route for your whole family at once.
For 2027 coverage, federal premium tax credits stop completely once household income passes 400% of the federal poverty level. Find your household size:
| Household size | No federal premium help above |
|---|---|
| 2 (you + spouse, or parent + 1 child) | $86,560 |
| 3 | $109,280 |
| 4 | $132,000 |
| 5 | $154,720 |
| 6 | $177,440 |
Thresholds use the 2026 federal poverty guidelines, which apply to all 2027 marketplace coverage. Income means your household's projected 2027 modified adjusted gross income (MAGI).
ACA premiums are charged per person — each adult by age, plus each child under 21 (up to the three oldest). A family of four pays four premiums stacked together.
Below 400% FPL the subsidy shrinks your family premium to a share of income. Above it, the full sticker price lands on you — often the biggest bill in the household budget.
Many marketplace plans are HMOs with narrower networks. With kids, pediatricians, pediatric specialists and a children's hospital in-network matter more than almost anything else.
Usually the best value if your family is under the cliff and qualifies for a meaningful subsidy — or if your children qualify for Medi-Cal. We enroll you as a Covered California Certified Agency.
Over the cliff, the same carriers sold off-exchange can cost less for an equal or better plan — and some of the strongest Blue Shield PPOs are sold off-exchange only.
True group coverage for the self-employed, contractors and small-business owners that covers your spouse and children. Nationwide PPO networks such as Aetna, First Health and Multiplan/PHCS, pre-existing conditions covered, and year-round enrollment. Subject to eligibility.
Before you enroll, we confirm your pediatrician, specialists and nearest children's hospital are in-network. Start with your area:
Children's Hospital Los Angeles, Cedars-Sinai, UCLA Mattel Children's.
CHOC, Hoag, UCI Health, MemorialCare.
Rady Children's, Sharp, Scripps, UC San Diego Health.
UCSF Benioff Children's, Stanford's Lucile Packard Children's.
UC Davis Children's Hospital, Sutter, Mercy.
Loma Linda University Children's Hospital, Riverside Community.
Ages of you, your spouse and each child, your ZIP code, and your estimated 2027 household income.
Your pediatrician, family doctor, specialists and preferred hospital — checked against every network we quote.
Covered California, off-exchange private plans, and employer-level group PPO options — total family cost, deductibles and networks on one page. One call, one comparison, no cost to you.
It depends on each family member's age and your pricing region — California has 19, and the same plan can cost hundreds more a few counties over. Each adult is priced by age and each child under 21 is charged a premium (up to the three oldest). Covered California's preliminary average rate increase for 2027 is 9.9%. We quote your exact family at your ZIP code across every carrier and route.
Only if your household income is at or below 400% of the federal poverty level: $86,560 for two, $109,280 for three, $132,000 for four, $154,720 for five, and $177,440 for six. Above that, no federal premium tax credit is available for 2027 coverage.
Yes. ACA plans let you cover your spouse and children up to age 26 on one family policy, and employer-level group plans cover your spouse and dependent children. Sometimes it is cheaper to split family members across plans — we check both ways.
Every ACA-compliant plan covers pre-existing conditions with no medical questions, and employer-level (ERISA) group plans cover pre-existing conditions as well, just as with any employer coverage.
Often, yes — it's one of the main reasons families choose a PPO. We check your pediatrician, specialists and preferred children's hospital against each plan's network before you enroll.
Covered California open enrollment runs November 1, 2026 through January 31, 2027 — pick a plan by December 31 for coverage starting January 1. A new baby, adoption, marriage or loss of coverage opens a 60-day special enrollment window, and employer-level group plans enroll year-round for those who qualify.
No. Premiums are identical with or without an agent — carriers pay us, not you. The family comparison and enrollment help are free.
Get Your Family's 2027 California Health Quote
Free side-by-side comparison from a licensed advisor — Covered California, off-exchange and employer-level PPO options for your whole household.
Get My Family's Options Call (800) 939-3330
Prefer to talk first? Book a 15-minute family plan review.
Subsidy thresholds use the 2026 HHS poverty guidelines, which apply to 2027 coverage. The 9.9% figure is Covered California's preliminary 2027 weighted average, subject to final regulatory review. Employer-level group plan availability subject to eligibility requirements. Premiums vary by age, ZIP code, and household size.
