Canceling your coverage

We’re sorry to see you go.


How to cancel your plan

To cancel your plan, complete the termination form below. If we receive your cancellation notice on or before the last day of the month, your termination is effective at midnight on the last day of the month.

NOTE: If you would like to cancel coverage for one or more members of your family, refer to the information here.

Download the form   Complete the online form
  • Covered California® - If you're insured through Covered California, you must also cancel your plan by logging into your Covered California account.
  • Employer Coverage - If you're insured through your employer, contact your human resources department. You do not need to submit this form.