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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.
Login To PrismArticle last updated: March 29, 2023.
Most of your clients likely have upcoming deadlines under federal prescription drug benefits reporting requirements. Here’s a summary of the requirements, how carriers can help, and the deadlines.
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.
Enforcement of the requirements was relaxed for reports due in 2021 and 2022. The requirements for reports due in 2023 are being enforced. Failure to report can lead to a penalty of $100 per day per affected individual.
A detailed summary on the requirements can be found in this helpful Mercer article (many carrier communications that you and your clients are receiving refer to technical terms such as “P2,” “D2-D8,” etc. This article explains these terms).
Each carrier is taking action to support your employer clients with the federal reporting requirements. In order to do so, they require information from each employer group. The approach being taken by each carrier is similar, but varies in detail, including important deadlines. Here’s a summary:
Aetna
Plan sponsors should fill out this RxDC Plan Sponsor Data Collection form with the required data by April 1, 2023. The required data includes the:
Anthem
Anthem is sending emails to Small Group and Large Group fully insured clients and Anthem Balanced Funding clients, asking them to submit monthly average premium information required for Prescription Drug Data (RxDC) reporting. Anthem clients should complete this form before March 24, 2023.
Blue Shield of California
Blue Shield is providing fully-insured groups and self-funded ASO group plan clients an option for collecting and reporting all the required information on their behalf. Groups electing this option must complete a Blue Shield Intake Form. Blue Shield has provided an Intake Form FAQ.
Blue Shield will submit the data report on behalf of fully-insured and self-funded ASO group plans only if the group provides a complete response to the questions on the intake form by March 31, 2023 by 6:00 pm PST. By completing the form, the employer consents that Blue Shield will submit the data on their behalf to the CMS.
If the employer group does not complete the intake form by March 17, 2023, then the employer group will be responsible for submitting all required data directly to the CMS by June 1, 2023.
More details can be found in emails sent recently by Blue Shield directly to brokers and employer groups.
CaliforniaChoice
The information above from CaliforniaChoice was provided verbally. Until this information is formally posted on the CaliforniaChoice web site and especially for employers with Kaiser and Sutter enrollment, who are being advised that no action is required, Claremont strongly recommends that brokers contact the carrier and get formal confirmation as to what reporting assistance the carrier will or will not provide. In all cases, it is strongly recommended that the broker or employer request a receipt that the necessary reporting was indeed filed by the carrier. Keep that receipt in the event of a CMS audit.
Cigna+Oscar
Cigna intends to file on behalf of plan sponsors. No action is required of brokers or employers at this time. Look out for future communications from Cigna and Cigna + Oscar.
Covered California for Small Business
Carriers within the Covered California for Small Business (CCSB) exchange will communicate directly with plan sponsors regarding the Pharmacy and Healthcare Data reporting obligation. Plan sponsors should not expect any communication on the matter directly from CCSB.
Kaiser Permanente
Kaiser Permanente (KP) needs to collect certain data in order to submit all applicable reports and required responses on behalf of employers. Employers with KP coverage in 2022 should complete this form no later than April 3, 2023. The broker can also complete the form on behalf of the employer. Once KP has the necessary data, it will submit all applicable reports and required responses to the CMS by the June 1, 2023 deadline.
Note: Kaiser asks for the data in a different way than other carriers. To help simplify the process, Claremont has created a worksheet (Excel, PDF) with instructions. If the broker or employer can assemble three pieces of data for each month in 2022, they can enter those into the worksheet and it will calculate the answers for Questions 8 and 9 which can then be entered into the Kaiser form.
UnitedHealthcare
UnitedHealthcare (UHC) will assist clients by submitting all required information to the CMS if the employer completes UHC’s Pharmacy and Benefits and Costs Survey by March 10, 2023.
UHC sent an email communication on February 3, 2023 to all brokers/groups with fully-insured and Level-Funded plans instructing them of the data collection and action required to complete the Survey. Here is a link to the FAQs from UHC. It also links to the survey. Once the survey is complete, UHC will submit the necessary data to the CMS on behalf of the employer prior to the June 1, 2023 deadline.
The carriers are taking action to support your clients with the federal reporting requirements. In order to do so, they require information from each employer group. Look out for emails directly from the carriers, and follow their instructions. If you or your clients have questions, we can help direct you to the right contacts at the carriers.
Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.
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As the only social platform focused on business and professional networking, LinkedIn (660,000 active users) is one of the top places to reach decision makers, influencers, and practitioners. In fact, B2B blogs and websites receive most of their social media traffic from LinkedIn, according to a 2022 LinkedIn study. 43% attribute their sales to LinkedIn, Facebook followed at 24%, and Twitter at 20%.
If your prospects are active on LinkedIn, chances are they’re talking about the issues you can solve. So, if you can find them, reaching out becomes easier because you know they are more likely to be open to your solutions.
To start building an organic audience that will later convert to clients, follow the tips below.
Now you have a list of potential prospects who follow your competitor(s). Make sure to exclude any employees or founders from the followers list.
LinkedIn member’s networks are searchable (if they haven’t opted to hide them).
Before requesting connections and reaching out to any prospects, use our profile optimization framework to Turn Your Profile Into a Business Growth Machine.
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.
MetLife has teamed up with Snoopy, the iconic Peanuts character, to market its pet insurance through employee benefits programs. Remarkably, MetLife had a 30+ year relationship with Snoopy from 1985 until 2017 – when they separated from their life and annuity business.
Despite the rising number of pet owners in the US, only a small percentage (less than 3%) of pets are currently insured. MetLife aims to change this by educating pet parents about the benefits of pet protection for safeguarding personal finances and improving their pet’s well-being.
MetLife’s research indicates that in 2022, 84% of pet parents experienced higher pet care costs, and 50% of them worry that the escalating costs will make it difficult for them to continue being a pet parent. In addition to rising prices for routine care and pet necessities, pet parents may also have to deal with exorbitant bills they may not be able to afford for emergency vet visits, surgeries, or extended hospital stays.
According to MetLife’s 20th Annual Employee Benefit Trends Study (EBTS), 65% of employees with pets are currently interested in their employer offering pet insurance.
As the leading pet health insurance provider in the workplace, MetLife’s affordable, extensive coverage includes:
With Snoopy’s help, MetLife hopes to raise awareness about pet insurance and its benefits – which means more pets receive the care they need, and pet owners can remain worry-free. Learn more.
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.
With Beam’s new and improved 2023 Brokerage Bonus Program, there are bigger payouts, opportunities to earn, and expanded eligibility.
Earn up to a 6% bonus (increased from 2.5% in 2022) on collected premiums for new group sales. The more groups you sell, the higher your bonus!
How it works:
Earn up to an additional 2% bonus on group renewals.
How it works:
Learn more about the 2023 Brokerage Bonus Program.
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 Covered California for Small Business (CCSB) webinar on Tuesday, March 28th at 9:00 am PDT, to hear from their sales team about the launch of new Blue Shield plans effective July 1, 2023. Learn about the newest plan designs, what they mean for you, your employers, and their employees.
Topics
Space is limited. Register now.
Claremont has been a trusted CCSB partner since its 2014 launch, and we are the 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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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.
Tune in to this NABIP Compliance Corner webinar on Thursday, March 16th at 10:00 am PDT, when NABIP members Barb Gerken and Samantha Malovrh walk you through what you need to know about RxDC Reporting and the end of the COVID public health emergency.
Don’t miss out. Register now!
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.
Earn additional compensation for selling and retaining eligible groups of 2-99 lives by enrolling in Delta Dental’s Small Business Broker Rewards Program.
Retain at least 92% of your book of business through 2023 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.
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 premium received for effective dates in 2023. 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 2023. 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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It’s now even easier to present compelling quotes and proposals to your clients when you log into PRISM, our (no-cost) quote service, with these new enhancements.
1. Easily export multiple reports on the Table Rates & Benefits Report page (available before selecting a group) into Excel.
Once you checkmark the corresponding outputs, you will be able to select “Excel Export (beta).”
This feature can be used with multiple reports at once, and will export all selected reports into a combined Excel spreadsheet with each tab being its own report.
2. Filter Current Plans on the Review Group Data page by Carrier, Plan Type, and Metallic Tier. Previously, you could only filter Current Plans by Carrier. This update allows the user to narrow their filtering significantly while searching for their group’s current plan selections. This feature not only makes plan mapping more efficient and user friendly, but also helps avoid errors in plan selections due to too many options.
3. Sort the Side-by-Side reports so the Current and corresponding Renewal Plans are next to each other. Previously, that report would show all Current plans and then all Renewal plans before including any alternative plans. The image below shows where you select this option in the Medical Plan Reports.
Side-by-Side example of the new Current/Renewal on the left. On the right, there is no sorting by Current/Renewal.
4. Narrow down the plans to include on the Employee Worksheet ACA report in two ways (by Package or now by Plans selected during the quoting process). You can also narrow down the Base Plan for that report in two ways (by Package or now by only the selected/highlighted Plans within the Package).
Selecting the package will ensure mixed packages are not offered.
If you ran a quote previously, you can choose “By Selected Plans from Above” and this will shorten the time instead of having to re-select the plans individually.
5. The cost comparison now includes the Network. This allows you to identify if the Network is full (Broad) or skinny (Narrow).
Whether you need help onboarding new staff or learning how to use PRISM’s advanced features, our short on-demand video tutorials will quickly get you the training you need when you need it.
To take advantage of PRISM, our free online quoting system. Or request a quote by contacting us at 800.696.4543 or quotes@claremontcompanies.com.
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.
On March 1, 2023, Governor Gavin Newsom declared a state of emergency in numerous California counties to assist with disaster response and relief efforts.
In the affected counties, Blue Shield of California is providing assistance to its members to ensure their safety and well-being. Members of Blue Shield of California and Blue Shield of California Promise Health Plan who qualify can receive assistance. Get the details.
For assistance, members can call the Customer Service number on their member identification (ID) card. If they do not have their member ID card, they can contact:
For lost member ID cards, members can view and print their card at www.blueshieldca.com/login or www.blueshieldca.com/promise. Or they can use the Blue Shield of California mobile app to access their ID card.
Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.
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Increase your revenue with the Reliance Matrix 2023 SmartChoice Premier Producer Program and the 2023 Premier Producer Program.
Reminder: Reliances Matrix is the new name for Reliance Standard.
The SmartChoice portfolio of products features plan designs for groups with 2–19 lives.
All licensed producers (appointed with Reliance Matrix) that place new business or retain business are eligible to participate in the SmartChoice Premier Producer Program. The two-part, three-tier program allows you to earn more as you write more. Get the 2023 SmartChoice Premier Producer Program details.
Available for all lines of coverage outside of the SmartChoice portfolio, the Premier Producer Program offers customizable plan options for groups with 10+ enrolled.
All licensed producers (appointed with Reliance Matrix) who achieve both new sales and persistency goals are eligible to participate in the Premier Producer Program. Hit the agreed upon goals, and as a Premier Producer you’ll be rewarded with enhanced compensation on your book of business.
All employer-paid and voluntary group contracts count toward qualification and calculation for the Premier Producer Program. Lines of coverage:
Learn more about the 2023 Premier Producer Program.
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.