“We know buying insurance is really complicated. We want to make it as easy as buying a book on Amazon,” said Peter Lee, executive director of the California Health Benefit Exchange.

But as the state has worked to create the actual application for health insurance, the idea of a one-click purchase is far from the reality.

“This is a brand new law and it’s complicated,” says Sam Karp, vice president of programs at the California HealthCare Foundation (CHCF). “It’s reasonable to expect the implementation will take not just a year. It will take a few years.”

Karp says CHCF has been working on modernizing enrollment in health and social service programs for the last 15 years. Recently they partnered with others to create a model, called UX2014, that can be used as a standard for online health insurance enrollment.

The contract for California’s application was awarded to Accenture last summer. While a draft of the federal application was just released, stakeholders have yet to see a version of California’s application, which, like the federal model is being based on the UX2014 work.

The new federal draft application is 15 pages long for a 3-person family. A single applicant is only required to fill out 6 pages. Meanwhile a YouTube video shows what to expect from the online federal version:

Karp says after early promises that this would be like buying an airline ticket online, it’s important to set the right expectations.

“The law says we should have a consumer friendly process … it should be better than what people are experiencing today and we should go to lots of lengths to make it easier for people,” Karp says.

The law requires the application be available online, in person, by mail or by telephone.

Karp says he has a few concerns about California’s process so far.

“I’m concerned the premiums will be high and people will have sticker shock,” says Karp. And he says unlike the federal system which will be a streamlined workflow, California will be integrating its application with some county websites and program.

“Service may not be as smooth as it could be because of this hand off to counties,” says Karp.

Elizabeth Landsberg, director of legislative advocacy for the Western Center on Law and Poverty, says she has been involved in some of the recent talks about the application flow. She says there are some aspects of the proposed California application she applauds.

“If you’ve gone through this whole process of applying for health benefits,” she says, “you can have the information transferred to get other public benefits too – including CalWorks and Cal Fresh [food stamps].”

But she says she’ll be keeping an eye on certain aspects of its development.

“The income is going to be especially tricky for people. People have different ideas about this. Certain income counts and certain other things don’t,” says Landsberg. “I think very few of us know what our adjusted gross income is. So there is going to have to be a lot of help and guidance to define these terms and give accurate information.”

Landsberg says she also thinks the proposed application organization requires a social security number too soon.

“We have a lot of families with mixed immigration status,” Landsberg says. “We may have a parent without a social security number applying for child who does have a social security number… You can’t require a non-applicant to give a social security and it might dissuade someone from moving forward.”

Landsberg says a draft of the California application is expected in April, to allow group testing in the spring and summer.

The application is due to go live online in October.

By Pauline Bartolone, Capital Public Radio

Don't worry -- "avocado" was rejected. (Image: Kaiser Health News)

As states work to comply with the federal health care law, many are designing their insurance exchanges, where people will be able to shop for coverage.

But just the word “exchange” sounds to many like off-putting government-speak, and some states are eager to come up with a more appealing name for these new marketplaces.

Peter Lee, who directs California’s Health Benefit Exchange, says it’s up for a new name, and he says they want it to sound fresh, dynamic and innovative.

“What we’re trying to figure out is what’s a name that’s going to stick, that’s going to grab hold, that all Californians are going to say ‘Boy, that’s where I go to find healthcare,’ ” Lee says.

The exchange will have a website where people can buy private health insurance, and many consumers will have government subsidies to help them purchase the insurance. Planners hope at least 3 million California customers will enroll for benefits starting in 2014. But that 3 million is a diverse bunch — so organizers want a name that will graball of them.

“Almost half of the people that are going to be eligible for subsidized coverage in the exchange are Spanish-speaking,” Lee says. “But that’s not the only market. We have about 600,000 people that speak Asian-Pacific Islander languages. Some of them speak Mandarin; some speak Hmong.”

Lee and his team solicited names in California and got hundreds of suggestions. Among them: Avocado, Ursa, Eureka — names or concepts uniquely Californian. They tested them with focus groups.

The name Avocado got laughs but is now out of the running. Other names were borrowed from Spanish, like Calvida and Beneficia. They considered Healthifornia and Wellquest.

Claudia Caplan, a marketing expert with the RP3 Agency in Maryland, has done everything from naming fast-food hamburgers to marketing for a freight rail carrier. She says a name for a new health marketplace should have humanity but shouldn’t be too cute.

“This is a whole new world for people in terms of how they’re going to access insurance, and it might be wise to give them a name that makes them feel metaphorically wrapped in some nice, warm arms that are going to take care of them,” Caplan says.

Still, a name isn’t as important as what you build around it, she notes. “It’s going to be such a turnoff if you give it this great, nurturing name and it just turns out to be the DMV all over again,” Caplan says.

California’s exchange staff is sharing notes with counterparts in other states. Maryland just came up with its name and logo.

Dr. Joshua Sharfstein, Maryland’s Secretary of Health and Mental Hygeine and chairman of that state’s exchange, says they tossed around action names. “We had some that had verbs in them like ‘Cover Me Now Maryland,’ ‘Cover Insure Maryland,’ ‘Get Health Care Maryland,’ those sorts of things,” Sharfstein says.

He says one person even suggested “www.icantbelieveitsthiseasytobuyhealthinsurance.com.” But the Maryland planners went with something safe and trustworthy: Maryland Health Connection.

“We thought it was simple,” says Sharfstein. “It illustrated the importance of connecting: connecting with insurance brokers, producers, connecting people to insurance products as well as connecting people to health care and health.”

California is expected to release its new name and logo in November. The frontrunners? Eureka, a reference to the gold rush (and the state’s motto), and Ursa, which is Latin for bear and a symbol on California’s state flag. Condor is off the table. While uniquely Californian, it is a vulture that almost went extinct.