2023 Small Group Special Enrollment Period: Carrier Guidelines

PRISM Login

To access the carrier product and rate information provided by PRISM, check the box below indicating you have read and agree to the license agreement. A button will then appear to access PRISM.

This site uses cookies to track your agreement option. If the terms of the license agreement change or if you clear the cookies from your browser, this page will appear once again during the PRISM login process.

Blue Shield - New Virtual Blue Plans

The Virtual Blue plans give members (small and large groups) the choice of virtual or in-person care. Virtual care includes $0 unlimited visits to primary care, behavioral health and specialty care through a new partnership with AccoladeCare. In-person care is available through the Tandem PPO network in California and via BlueCard when outside of the state.

The two Virtual Blue small group plans available in PRISM are the Virtual Blue Gold Tandem PPO 1500/45 and Virtual Blue Bronze Tandem PPO 7500/75. These can be identified by ‘Virtual Blue’ in the plan name.

When using the PRISM filter options for Narrow or Broad networks, select ‘All’ networks instead of ‘Broad’ only networks to generate plans for Blue Shield’s Virtual Blue, Trio HMO, and Tandem PPO plans.

If you need assistance, please contact our Quotes team at quotes@claremontcompanies.com or 800.696.4543.

2023 Small Group Special Enrollment Period: Carrier Guidelines

Oct 27, 2022, 2 Minute Read

By law, all carriers are required to offer the small group Special Enrollment Period (SEP) one time per year to allow employers to enroll in coverage with a $0 contribution requirement and no minimum participation requirement. The application period is from November 15 to December 15, 2022, for coverage effective January 1, 2023. Carrier administration of the SEP may vary slightly, including recertification at renewal.

The SEP provides several year-end sales opportunities and solutions for employers with unique needs, such as:

Small Business Owners Currently Enrolled in Individual Market Coverage
Group health benefits provide many advantages for small businesses. We can help you present these to your small business clients.
Dual-Carrier Groups
Small employers offering coverage from two carriers (aka dual-carrier groups) sometimes struggle to meet carrier participation requirements with one of the carriers. If you have dual-carrier groups such as these, then the SEP may be a good option for them.
Groups Preferring Lower Employer Premium Contributions Than Are Otherwise Required
Groups struggling to meet carrier premium contribution requirements may find the SEP a viable option. There is no employer premium contribution requirement when enrolling during the SEP.

Please note: the Special Enrollment Period is different than the relaxed participation promotions. These carrier promotions are usually offered for a specific time period and may be discontinued at any time.

Quickly compare carrier deadlines and details with our Carrier SEP Guide:

Special Enrollment Period for January 2023 Coverage – Small Groups 1-100, Medical Carriers

Carrier SEP Guide

Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.

Get The Latest News with Text Messaging!

Your success is important to us, and we’re actively working on new solutions to support you throughout the year. To get the latest news via text messaging in the future, simply provide your cell phone number here.