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Why Choose Health Net?
✔ Lowest rates in the market – Affordable options without compromising quality.
✔ Robust PPO network – Competes with major carriers like Anthem and Blue Shield.
✔ Flexible HMO options – Networks to fit nearly every group statewide and every budget.
✔ Simplified underwriting – Only 25% participation required for groups with 5+ enrolling. No DE9C or prior carrier bill needed.
✔ Easy-to-sell benefits – $0 deductible HMO plans + four years of rate stability.
✔ Nationwide coverage – Cigna network access for out-of-state employees + state plurality rules for group qualification.
Start Including Health Net in Your Quotes Today!
Need guidance on networks, plan designs, or have questions? We’re here to help!
Call us at 800.696.4543 | Email us at info@claremontcompanies.com.
Login To PrismSmall businesses need insurance solutions that are straightforward, flexible, and affordable. Reliance Matrix’s SmartChoice® program delivers exactly that, with comprehensive options designed specifically for groups with 2 to 19 employees.
SmartChoice’s dental coverage uses the Ameritas Classic PPO network, one of the nation’s largest dental networks with:
The 2025 SmartChoice Premier Producer Program offers additional earning potential:
These bonuses are paid in addition to standard commissions of 10-15% first-year and 10% renewal commissions across all product lines, creating significant earning potential for brokers who grow and maintain their SmartChoice book of business.
For small businesses looking for comprehensive, flexible insurance coverage, SmartChoice delivers value without complexity. The program combines essential protections with administrative simplicity, making it easy for both employers and employees to get the coverage they need.
To learn more, view these resources:
Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.
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Join CAHIP – Golden Gate for an insightful exploration of how technology is transforming healthcare and extending human longevity at the 2025 Symposium. Connect with industry professionals while earning valuable continuing education credits.
Complimentary breakfast and lunch will be provided, offering excellent networking opportunities throughout the day.
Don’t miss this opportunity to stay ahead of industry trends and enhance your professional knowledge. Register today to secure your spot! To learn more, visit cahip-gg.org or contact CAHIP-GG at 800.488.2506 or info@ggahu.org.
Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.
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Article last updated: March 4, 2025.
Most of your clients have upcoming deadlines under the federal prescription drug benefits reporting (RxDC) requirements. Here’s a summary of the requirements, carrier support initiatives, and critical submission deadlines to ensure timely compliance.
Under Section 204 of the 2021 Consolidated Appropriations Act (CAA), insurance companies and employer-based health plans must submit information regarding prescription drug benefits and health care spending. The information must be submitted to the Centers for Medicare and Medicaid Services (CMS) by June 1st of each year for the prior year’s coverage.
The CMS requires the following information be submitted by insurance companies and employers:
Anthem will follow the same process as in prior years and will file on behalf of their fully insured and ASO clients for the benefits they administer and maintain. This includes ASO groups who opt-in to the D1 reporting. To submit all required information and ensure reporting accuracy, they will request some information from their clients.
Week of February 17th – Large Group, Small Group, and National Account clients were notified about required RxDC filings and necessary actions.
Early June 2025 – RxDC Filing Confirmation
For more information, please visit Anthem’s CAA/Transparency Resource Center.
Blue Shield will collect D1 Premium Contribution data from groups between February 19, 2025 and April 19, 2025. Blue Shield will also submit D2 for all groups and D3-D8 for groups with prescription drug benefits under a Blue Shield health benefit plan. If a group does not have prescription drug benefits with Blue Shield, they should coordinate submission of D3-D8 with their pharmacy/prescription drug benefits carrier.
Key Details
Who Needs to Submit The Survey?
Any group (or broker/delegate on behalf of the group) who would like Blue Shield to submit D1 Premium data on their behalf to the CMS. This includes:
Third-Party Administrators (TPAs) and Pharmacy Benefit Managers (PBMs) may assist in reporting. Groups that miss the deadline will not be included in Blue Shield’s filing and may be subject to non-compliance if they do not report the required data directly to the CMS by the June 1, 2025 deadline.
Other Details
Information Requested
Health Net will not require any data from employer groups to complete Plan List (P2) and Data File (DI) submissions with the CMS on behalf of their clients. No action or any fees are required by employer groups or brokers. This includes groups with members enrolled in Health Net through CaliforniaChoice.
Fully insured employer groups will need to complete the Kaiser Permanente RxDC data collection form by March 31, 2025.
Information Requested
Self-funded groups: Kaiser Permanente representatives will reach out to each self-funded group, via email, with instructions and offline forms that will be prepopulated with the group’s information along with blank fields for the group to complete and return to Kaiser Permanente.
Specific CA Small Groups: Covered California for Small Business (CCSB) and CaliforniaChoice groups do not need to complete the form as these exchanges will be providing the needed data for all the employers they serve, aggregated at the exchange level, to Kaiser Permanente.
Kaiser Permanente plans to submit all applicable reports and required responses for all employer groups to CMS by the June 1, 2025 deadline. To learn more, view the Kaiser Permanente RxDC FAQs.
Sharp Health Plan will request employer contribution data via a Request for Information (RFI) survey and will file on behalf of the group. Deadline: April 18, 2025.
UnitedHealthcare will complete the CAA Prescription Drug (RxDC) reporting for its fully insured and self-funded/level funded groups, including those with OptumRx as the integrated PBM. However, groups with these will need to complete the Request for Information (RFI) tool for RxDC reporting between February 1, 2025, and March 31, 2025.
To support its customers with this important filing, UnitedHealthcare will be submitting the P2 (Group Health Plan), D1 (Premium and Life Years) and D2 (Spending by Category) files for all employers who had active coverage during the reference year (2024). However, completion of the submission requires gathering some information not currently maintained in their system.
UnitedHealthcare will also submit the D3-D8 data files for customers with OptumRx as an integrated PBM. UnitedHealthcare has access to all data required to complete the submission of the D3-D8 data files. Customers who use any other PBM, including OptumRx Direct, must work with that PBM to submit the D3-D8 files.
Resources
Western Health Advantage will request employer contribution data via a Request for Information (RFI) survey and will file on behalf of the group. Deadline: April 15, 2025.
Covered California for Small Business (CCSB) serves as an administrator of their participating Health Plan Issuers and is not an insurance company nor an employer-based health plan. Therefore, CCSB is not subject to RxDC data collection requirements on behalf of their employer groups. Claremont recommends that the employer follow the reporting guidelines for the enrolled carrier(s).
CCSB’s Small Business Service Center is available to help with questions at 855.777.6782.
CaliforniaChoice serves as an administrator of their participating Health Plan Issuers and is not an insurance company nor an employer-based health plan. Therefore, CaliforniaChoice is not subject to RxDC data collection requirements on behalf of their employer groups.
Like last year, CaliforniaChoice is facilitating the RxDC for its employers and their plans for the 2024 reference year (reporting due June 1, 2025). CaliforniaChoice will coordinate directly with their carriers to facilitate all reporting obligations. There is no action required from the employer.
The carriers are actively assisting your clients with federal reporting compliance and will require specific information from each employer group. Watch for direct communication from the carriers and follow their instructions. If you or your clients need assistance we can connect you with appropriate carrier representatives.
Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.
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Disability Guard for Doctors™ delivers unparalleled group long-term disability (LTD) coverage, designed exclusively for physicians. Unlike standard LTD policies that use broad disability definitions, this specialized solution provides higher income protection by defining disability based on actual medical procedures (CPT, CDT/ADA codes) performed in the 12 months before disability. If a doctor is unable to perform one or more of these procedures, they are considered disabled—a level of precision absent in typical group LTD plans.
Physicians with traditional LTD coverage often face significant income protection gaps. Many individual disability insurance (IDI) policies cap benefits at $10,000 per month, covering just 33-40% of earnings. Financial advisors recommend covering at least 60% of income, making this specialized group LTD solution an essential addition to physician benefits.
Disability Guard for Doctors™ provides the tailored coverage doctors need and expect from IDI, with the added benefits of group insurance:
Through an exclusive partnership, MGIS and Reliance Matrix provide industry-leading group disability and specialty coverage for doctors in all medical specialties and practice settings, with:
Available to groups with 3+ eligible employees, Disability Guard for Doctors™ makes it easy for practices of all sizes to secure specialized income protection that traditional group LTD policies fail to provide.
To learn more, view these resources:
Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.
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Blue Shield of California will soon distribute its annual Medical Loss Ratio (MLR) Employer Survey to small business groups with fewer than 150 employees. This important survey, mandated by the Affordable Care Act (ACA), must be completed by March 31, 2025. The survey helps Blue Shield calculate whether premium rebates are due to members based on the percentage of premium dollars spent on medical care rather than administrative costs.
Employers Must Provide:
The information collected helps determine if Blue Shield of California met its MLR requirements for 2024. If the carrier didn’t meet the minimum threshold for spending premium dollars on medical care, rebates would be issued to affected customers by September 30, 2025.
It’s important to understand that while the survey collects 2023 information, it’s used for statistical sampling purposes to calculate potential 2024 MLR rebates.
To learn more about the MLR survey process and requirements, please review the Blue Shield of CA Broker Alert and MLR FAQs.
Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.
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We are excited to welcome Elisha Youngman to our Service Team as our newest Broker Service Representative. With a background in medical office administration, Elisha managed patient appointments and insurance verifications before advancing to the billing department of an infertility clinic, where she gained in-depth expertise in insurance processes. Now transitioning into employee benefits, Elisha is eager to expand her knowledge of the market, our carrier partnerships, and strategies to support brokers in growing their business.
Outside of work, she enjoys strength training, cooking, caring for plants, and spending time with friends.
You can reach Elisha at elisha@claremontcompanies.com or 925.296.8819.
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Earn additional compensation for selling and retaining eligible groups of 2-99 lives by enrolling in Delta Dental’s Small Business Broker Rewards Program. You must register for this program first to qualify for the rewards, so visit ddsbrewards.com today to get started.
Retain at least 85% of your book of business through 2025 (compared to last year’s 92%) and meet a new sales reward level. If you do both, you’ll earn a bonus for each. If you’re new to Delta Dental, your new sales alone will qualify. To improve your chance to earn incentives, Delta Dental has cut the premium thresholds. The lowest threshold is now $50,000, down from $150,000.
Your retention bonus will be tied to your sales tiers. For example, if you sell 15 new groups and retain 90% of your existing book of business, you’ll qualify for a 1.5% retention bonus. But if you sell 15 new groups and retain 95% or more, you’ll qualify for a 2% bonus.
Once you’ve met your retention goal, there are three levels of sales rewards. New sales bonuses are based on the number of new groups or total new annualized premium received for effective dates in 2025. As you sell more and retain your existing business with Delta Dental, your rewards grow. And this program is in addition to your existing standard small business commission.
Sign up for the rewards program and access the small business broker rewards dashboard to easily track your reward earnings. Brokers who have joined in previous years just need to log in to be eligible for additional compensation in 2025. To learn more, download the flyer.
Delta Dental Broker Rewards Program
Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.
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With tax deadlines approaching, eligible small businesses can qualify for federal tax credits of up to 50% on health insurance premiums–available exclusively through Covered California for Small Business (CCSB).
To be eligible, businesses must:
The tax credit is calculated on a sliding scale—smaller businesses with lower average wages qualify for higher credits. Employers can apply the credit directly to their Federal Tax Return. Use the CCSB Tax Credit Calculator to estimate potential savings.
To learn more, download the Small Business Tax Credit flyer and the How to Apply For The Tax Credit flyer.
Since 2014, thousands of small businesses have trusted CCSB for quality, flexible health coverage. With consistent double-digit membership growth, here’s why CCSB stands out:
Employee-Only Coverage
CCSB provides flexibility for employers to apply their full budget to employee coverage while dependents can access separate coverage and subsidies on the individual marketplace.
No Admin or Late Fees
Every dollar goes directly toward employer premiums.
Streamlined Onboarding
Quick quoting, simplified applications, and easy invoicing. Start-up groups need just two weeks of payroll, with monthly ACH payments accepted.
Fast Certification
No testing or annual re-certification—just a one-hour course to get started.
Multi-Carrier Portfolio
Employers and employees can choose from the top-tier PPOs and HMOs with affordable access to the broadest network of physicians and hospitals in California. Multi-state coverage is available for groups with employees out of state.
Exclusive Tax Credit
Eligible small businesses can qualify for federal tax credits up to 50% on premiums to help pay for the cost of providing quality health coverage for employees. (Contact us for help in determining employer eligibility.)
MyCCSB Portal
Employers and brokers can enroll employees, update plans, manage renewals, and more—all within 24 hours.
With California’s most comprehensive access to doctors and hospitals, CCSB offers flexibility, control, and convenience, including:
Claremont has been a trusted CCSB partner since its 2014 launch, and we are a top producing general agency in our sales territory. From agent certification and quoting to assessing new group eligibility and resolving post-enrollment issues, our CCSB experts will provide guidance and support every step of the way.
Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.
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Selecting the right benefits is essential for ensuring financial security and peace of mind. Humana offers comprehensive life and disability coverage options to help employees protect their loved ones, as well as tools like the Dental Cost Estimator to assist members in planning for dental expenses. Below are coverage options and resources.
Quickly identify the advantages of Humana’s life and disability coverage for employers and employees with these three plan guides:
Humana members can now estimate their dental expenses using the Dental Cost Estimator, accessible through the Resources section of the Plan Benefits page in MyHumana. By entering their zip code and a dental procedure keyword, code, or category, members can view a cost range, helping them better plan for out-of-pocket expenses.
Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.
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After nearly six and a half years of dedicated service as a Broker Service Representative, Beverly Daniel-Patton is retiring. She has been a valued member of our team, making a positive impact on colleagues, broker customers, and business partners alike. Her contributions will be greatly missed. Please join us in wishing Beverly all the best as she begins her next chapter!
Please email your congratulations and best wishes to Beverly at beverly@claremontcompanies.com.
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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.