Life changes such as marriage, a new baby, divorce, a child turning 26, or gaining other coverage can affect your Covered California account. Reporting changes promptly helps avoid premium issues, tax repayment surprises, or gaps in coverage.

Use the form below to request assistance adding or removing a dependent. A licensed agent from California Benefits Insurance Center will review your information and advise you if documentation or verification is required.

Submission of this form does not automatically update your coverage. Changes are not complete until processed and confirmed by Covered California.

There is no cost for assistance, and keeping your household information accurate helps ensure your premium and financial assistance remain correct.