Fourth Quarter Health Renewals

What to Expect from the Carriers Each carrier is treating the new Grandmothering legislation differently. If your business is up for renewal in the fourth quarter of this year (October, November, or December), then this guide will outline how your current California carrier is handling Grandmothered plans. For those who do not know, Grandmothering allows businesses with fourth quarter renewals the option to continue with their pre-2014 plans for one more year as long as they meet the Minimum Essential Coverage Guidelines from the Affordable Care Act. Carriers: Aetna – Will not be offering the Grandmothering options. Businesses wishing to renew with Aetna will have to enroll in a 2014 plan. Anthem – Will be allowing fourth quarter groups to Grandmother. To do so, groups must notify the carrier by the 10th of the month before the date of renewal. Blue Shield – Grandmothering will be allowed with Blue Shield groups. These groups must notify the carrier that they would like a Grandmothered plan by the end of their renewal month. Husband and wife groups will be eligible for a Grandmother renewal. Health Net – Will be offering the Grandmothering plan options. Just as Blue Shield, these groups have until the end of the month of renewal to notify the carrier to opt-in to a Grandmother plan. Kaiser – Will be allowing Grandmothering options. October renewal groups were required to opt-in by 8/15. November and December renewal groups are required to opt-out by 30 days prior to their renewal effective date. Sharp – Not participating in Grandmothering plans at this time. United Health Care – Will be Grandmothing plans...

Why to Transition Away From a PEO and How to Do It

Professional Employer Organizations (PEOs) have attracted many small to mid sized employers in California as an affordable solution to HR, liability, and managing the cost of health and workers’ compensation insurance. However, are PEOs as beneficial to businesses as they once were? Some companies are a great fit for PEOs, but it takes a specific type of company to mesh with the PEO niche. For many businesses in California, providing the benefits of a PEO outside of the PEO structure results in a higher quality of service at a lower cost to the company. If you are an employer considering a transition out of your current PEO relationship, the following questions will be important in your analysis. Sometimes calculating the cost/benefit analysis of a PEO can be difficult, and it can be very beneficial to reach out to a company that understands the nuances of PEOs and the alternatives. New City Insurance is well suited to help California businesses determine whether or not their PEO is the best option for them.  What to consider when evaluating your PEO 1. Is similar or better health coverage at a comparable or reduced rate available to my business outside my PEO? 2. Am I able to obtain workers’ compensation and employers practice liability insurance at comparable coverage levels and cost outside of my PEO? 3. Is the HR service from my PEO so valuable that I would have to hire my own HR personnel to replace it? 4. Will my State Unemployment Income (SUI) rate increase or decrease by leaving my PEO?   If you are uncertain about any of these questions,...

How to Handle a Workers’ Compensation Audit

A workers’ compensation audit can be a very frustrating process and can result in increased end of the year premiums if not handled correctly. This article will address the typical problems associated with increased end of the year premiums from workers’ compensation audits and how to avoid these problems. The Three Major Causes for End of the Year Premium Increases The three major causes for increased end of the year premiums are (1) the payroll for the given year was higher than projected, (2) the insured company did not have someone who understood the auditing process work on the audit with the insurance auditor, and (3) the effect of using contractors without workers’ compensation. 1. Higher Than Expected Payroll Projections To avoid issues with reason 1, it is important to give as accurate a projection as possible at the beginning of the year. Many businesses will not spend enough time making estimations, resulting in low projections and high end of the year premiums. It is also important to pay attention to payroll projections throughout the year. An insurance agent, business owner, or employee can compare actual payroll with expected payroll as often as each quarter. This will allow the business sufficient time to make adjustments in the workers’ comp premium throughout the year. 2. Business Does Not Utilize Someone Educated in Workers’ Compensation For reason 2, it is important to have someone who understands how class codes work when rating employees. Different class codes for different positions have different premiums associated with them. The insurance auditor may rate an employee as a higher class code if the business is...

Workers’ Compensation Rate Increase

Workers’ compensation rates in California will be expected to increase by 6.7% in 2015 As recommended by the California Workers’ Compensation Insurance Rating Bureau (WCIRB), the state’s pure premium workers’ compensation will increase by 6.7% beginning in 2015. The WCIRB has submitted rate filing to the California Department of Insurance to request that pure premium rates increase from $2.68 per $1,00 of payroll in January of 2014 to $2.86 per $100 in January of 2015. According to the WCIRB, these insurance cost increases are necessary due to increased medical costs, high levels of indemnity claims (for example, Los Angeles County indemnity claims have increased by 19% in the last 3 years) , and lower than expected California wage growth. [Also Read: How to obtain Mid to Large Size Group Health Insurance Quotes] How to Avoid Major Cost Increases for Your Business’ Workers’ Compensation Policy If you notice that your premiums are set to increase at renewal for your workers’ compensation insurance, then it is a good idea to shop around. There are plenty of workers’ comp insurance carriers in California, and some will provide better coverage for your cost than others. Which insurance carrier is best for your company depends on the specific risks associated with your business. It is a good idea to reach out to a competent insurance agent who handles workers’ comp. As long as the agent is independent (not associated with any one insurance carrier) he or she will be able to help you look at pricing from all the carriers at the same time. This reduces the time and energy it would take for...

Health Quotes for Mid to Large Size Businesses

How to obtain Mid to Large Size Group Health Insurance Quotes in California: 2014, 2015, and 2016 Quoting mid sized and large sized groups for health insurance requires much more information and turnaround time compared to small sized groups. Mid sized groups have between 51-99 full time employees, while large sized groups consist of 100 or more full time employees. Due to the Affordable Care Act (ACA), both mid and large sized groups in California will be required to provide minimum essential coverage to their employees. For large groups, this will need to be implemented by the beginning of 2015, while mid groups are required to offer coverage by the beginning of 2016; otherwise, companies could face steep penalties. The penalty for large groups is scheduled to be $2,000 per full time employee minus 80 employees, while the penalties for mid-sized groups is set for $2,000 per full time employee minus 30 employees. As a result of the ACA, many employers that have never previously offered health coverage will now be required to offer minimum essential coverage. [Also Read: Anthem Mid-Size Plus Update] What information is needed to run mid to large sized group quotes? All insurance companies are going to want similar information from the company to rate the risk of the company and price plans accordingly: Does the business currently offer coverage, and if so, what are the benefits, current premiums, and renewal premiums of this current coverage? Has any full time employee received medical benefits in excess of $15,000 in the last 12 months? Are there any disabled full time employees? (and a variety of other risk assessment questions) What is the...

Anthem Mid-Size Plus Update

Anthem Blue Cross has product portfolio named Elements Choice EQ to help employers with 51+ employees to meet the requirements of the Affordable Care Act (ACA). The Elements Choice EQ specifically targets businesses that have not previously offered health care to employees working 30-39 hours per week. The portfolio consists of six new plans, including two HMOs, two PPOs, and two HSAs. These plans meet the ACA requirements of 60% minimum value coverage. There is no minimum participation and no minimum enrollment for these plans. This allows employers of 51+ employees to remain in compliance with ACA guidelines without having to alter the plans and risk pool associated with their 40+ hours/week employees.  [Also read: Premium-Only-Plan (POP...
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