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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 PrismJoin the Health Net leadership team for a quick and informative webinar on April 23, 2025, at 3:00 pm PT, as they share what’s ahead for Small Group business in 2025. From stable rates to product and network updates, they have exciting news to help keep you and your clients one step ahead.
You’ll also get the chance to meet Stan Kim, their new leader, and hear important product and network insights from Sean Lemon, their Commercial Operating Officer.
Don’t miss out. Register now!
Learn more about Health Net’s versatile health plans, ancillary coverage, wellness programs, and value-added services.
Questions?
Contact The Answer Team at 800.696.4543 or info@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.
Health Net continues its 38-year partnership with Scripps Health, providing in-network access to reliable, high-quality care across San Diego for all participating products.
With this renewal, your clients can offer their employees the opportunity to receive care from one of the region’s most respected health systems, featuring top-rated hospitals and leading specialists.
Top-Rated Scripps Health & Medical Groups in San Diego
Offer your clients a trusted, local care solution with Health Net and Scripps Health. Learn more about Health Net’s versatile health plans, ancillary coverage, wellness programs, and value-added services.
Questions?
Contact The Answer Team at 800.696.4543 or info@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.
Join the webinar on April 9 at 10:00 am for essential Q3 updates for CaliforniaChoice and ChoiceBuilder. This informative session will be packed with insights you won’t want to miss.
What You’ll Learn:
Interactive Q&A
Their experts will be available live to provide answers and practical takeaways and tools.
Win a Prize
Three attendees will receive a special prize. Winners will be randomly selected from participants who remain until the conclusion of the webinar.
Register now to secure valuable insights that will position you for success in Q3 and the rest of the year.
What makes CaliforniaChoice different for your clients:
With CaliforniaChoice, employees get:
Questions?
Contact The Answer Team at 800.696.4543 or info@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.
This week we celebrate Kim Dinh’s 25-year work anniversary. “Kim is an invaluable member of our team and we are incredibly grateful for her hard work, dedication, and positive contributions,” says Michael Traynor, President of Claremont Insurance. “She has consistently gone above and beyond, and we appreciate her commitment to Claremont.”
Kim is responsible for company IT, connectivity, and computer security. She can take great pride in her accomplishments and the respect that she has earned from her peers over the past 25 years.
Please join us in congratulating Kim on her 25 years of service at Claremont!
You can reach Kim at kim@claremontcompanies.com or 925.296.8833.
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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.
Claremont Insurance is excited to welcome Health Net of California to our portfolio of carrier partners. With over 3 million members across California and more than 45 years of experience, Health Net offers comprehensive affordable medical, dental, vision, and life coverage for brokers and their small group clients.
Learn more about Health Net’s versatile health plans, ancillary coverage, wellness programs, and value-added services.
Questions?
Contact The Answer Team at 800.696.4543 or info@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.
The Humana 2025 Producer Partnership Plan offers significant earning potential through the Group Benefits Growth Bonus. This comprehensive bonus program rewards you with enhanced earnings for both acquiring new business and maintaining existing clients.
Intended for all case sizes, the Group Benefits Growth Bonus is calculated based on three primary components:
To learn more, download the Humana 2025 Producer Partnership Plan brochure.
Questions?
Contact The Answer Team at 800.696.4543 or info@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.
Small 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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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.
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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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.
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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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.
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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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.