Covered California for Small Business (CCSB)
Employers and employees may use this form to submit CCSB complaints. If filing a CCSB appeal, please
contact Customer Service at (855) 777-6782.
Case ID (optional)
Telephone Number (with area code)
If you are filing a complaint against a Certified Insurance Agent, please provide agent information:
Telephone Number (with area
What area is your complaint regarding?
Tell us what happened and how we can help you (use extra paper if needed):
Mail this form to: Email this form: Call us at:
Covered California for Small Business CCSB@covered.ca.gov (855) 777-6782
1601 Exposition Blvd.
Sacramento, CA 95815
What happens next? Covered California will review your complaint and respond to you as soon as