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To keep you current on information critical to your business, below are updates and resources to support your sales and service efforts. To access our full library, visit the News and Industry Perspectives site.
A group of states, supported by the Department of Justice, are pursuing legal action to terminate the ACA’s Individual Mandate and with it, two highly popular features, guarantee issue and community rating. A ruling in their favor would impact millions who secure coverage as individuals or through small group plans and could take effect as soon as January 2019. Learn more.
Small group PPO rates will remain unchanged through December 31, 2018. HMO plans will increase an average of 1.5% for October through December effective dates.
Updates — Effective November 1, 2018
No benefit changes to the existing plans.
Two new HMO plans will be available on all four HMO networks. Both will offer a hospital copay.
New "Choice Simplified III" package will be added, giving employers four plan packages to choose from.
Marin County zip code 94924 has been added to the Signature (full HMO) network and all PPO networks.
Underwriting Changes — Effective July 1, 2018
Minimum 60% participation is required for contributory groups, excluding COBRA participants.
Groups offering the UnitedHealthcare Choice Simplified Package and a staff-model must have at least 60% participation between the participating carriers with 5 California employees enrolling with UnitedHealthcare, excluding COBRA participants. Coverage may be written alongside two other staff-model carriers.
Groups offering the UnitedHealthcare Multi-Choice® State Package and a staff-model must have at least 60% participation with UnitedHealthcare, excluding COBRA participants.
Additional participation guidelines for all groups:
When employers contribute 100% of the employee premium, 100% of eligible employees must enroll.
COBRA participants and employees in the waiting period are not eligible and are not included when determining the participation requirement.
With our convenient FAQs, quickly find answers about the ACA, Covered California for Small Business, the San Francisco Ordinance and, in the General section, managing your agency during times of change.
IN THIS ISSUE Healthcare Reform: Key Features of The ACA at Risk -------------------------------- UnitedHealthcare: Q4-2018 Small Group Rates and Updates -------------------------------- Question of The Week
IMPORTANT DATES July 25 • Application Deadline: - Chinese Community Health Care - Covered California for Small Business • Benefit Technology Certification Course -------------------------------- July 31 • Application Deadline: - Reliance Standard -------------------------------- August 3 • Application Deadline: - Delta Dental -------------------------------- August 6 • Application Deadline: - Blue Shield of CA - MetLife -------------------------------- August 7 • Application Deadline: - Beam Dental - Choice Builder - Principal - UnitedHealthcare • CAHU Health Care Summit -------------------------------- August 8 • SDAHU PAC Day at The Races -------------------------------- August 10 • Application Deadline: - Humana
As always, we'll keep you informed about healthcare reform issues and news affecting you and your clients. Our knowledgeable team is here to help you succeed.
