Blue Shield Reduces Participation

From May 1, 2014 through July 1, 2014, Blue Shield of California is relaxing the participation requirement for groups with five or more enrolled employees to 25%. This is less than Blue Shield’s already low requirement of 65%, and among the lowest in the industry. Although most businesses often want to purchase two plans – an HMO from one carrier and a PPO from another – relatively smaller businesses typically can’t meet minimum participation requirements. This limited-time promotion lets your clients purchase a PPO plan from Blue Shield alongside another carrier’s HMO. With the relaxed participation requirement, you can deliver to your clients what they want – flexibility and choice. The relaxed participation requirements are available for new medical small business clients with effective dates of May 1, 2014 through July 1, 2014*. The promotion applies to off-exchange plans only. New groups with fewer than five employees enrolling with Blue Shield do not qualify. Groups must meet the definition of a qualified small employer group. All normal eligibility and enrollment documents are required. Refusals are required for all eligible employees not enrolling in the Blue Shield plan(s). Be on the lookout for information about our specialty products promotion coming soon. *Blue Shield reserves the right to cancel this program at any...

ACA Impact on Group Dental

The Affordable Care Act (ACA) has brought with it sweeping changes to benefits for small employers with 50 or fewer lives. One of the lesser highlighted changes made includes mandated requirements dental insurance. Essential Health Benefits (EHB) must include pediatric services, including oral and vision. “Qualified” health plans for small groups must include 10 Essential Benefits in order to be deemed compliant. One of the Essential Health benefits includes pediatric oral care for children up to age 19. The pediatric oral care EHB requirement can be fulfilled on and off exchange by a stand-alone dental plan. EHB requirements for pediatric oral care include: Separate, “reasonable” OOP maximum per child for stand-alone dental plans (federal is set at $700) Must include medically necessary orthodontia Medical carriers can exclude pediatric oral care from the list of EHBs, as long as there is an exchange-certified dental plan covering the requirements....

Covered California Deadline Extended

Important Message About Open Enrollment Covered California has extended deadline thru February 6 Applicants must use Certified Agents (like us) to enroll after January 31st. Enrollment via coveredca.com no longer available. San Diego based agency with knowledge of all major networks and carriers in Caliifornia. HOW TO ENROLL: Check your pricing and plan availability using the Covered California Shop & Compare Tool Call us to enroll at (858) 376-7606 Information Regarding Covered California: Record-setting numbers of people trying to sign up for Covered California™ health insurance plans overwhelmed the system on January 31, the final day of open enrollment, prompting the exchange to allow consumers who had trouble enrolling by the deadline to work with a Certified Insurance Agent to finish their application by February 6.  Because of the staggering demands on the system, Covered California announced the following policy this afternoon: Consumers who were unable to create an online account or start their online application because of technical difficulties can contact a Covered California Certified Insurance Agent  to explain that they attempted to get through on January 31 and experienced difficulties. Those consumers will have until 11:59 p.m. February to work with the Certified Insurance Agent to complete their application and choose a plan.  Consumers who created an online account and completed the first page of the application by 11:59 p.m. January 31, 2016, will be able to complete their application for the open-enrollment period, either by themselves online or with the help of a Certified Insurance Agent. Consumers must complete the application and select a plan by 11:59 p.m. February 6, 2016. Those enrollees will receive coverage effective March 1, 2016.  Certified Insurance Agents who are...
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