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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 PrismCaliforniaChoice has announced rates are now live for April 1 – June 1 effectives dates.
Medical plan rates are changing for Anthem Blue Cross, Sharp Health Plan, and UnitedHealthcare. Rates are not changing for Kaiser Permanente, Sutter Health Plan, and Western Health Advantage.
The annual rate trends from Q2 2025 to Q2 2026 (trends may vary by plan and region):
Q2 plans are now available for quoting through PRISM, our free and easy online quoting system. Or reach out to your Claremont team for help with your Q2 renewals.
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.
CaliforniaChoice is the only small group (1-100 employees) private exchange for employee benefits in California. Partnering with seven top health plans and 18 provider networks, CaliforniaChoice offers a variety of full and limited network HMOs, PPOs, and other benefit options to choose from – all at different price points so you can help your clients control costs and offer their employees choices. Learn more.
With CaliforniaChoice, you can offer multiple health plans side-by-side in a single employee benefits package. That means you only have to learn one product and run one quote, while still giving your clients the value of choice.
Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.
CaliforniaChoice offers something clients will love—pet insurance from MetLife and Spot, available exclusively to members. This new Member Value Suite benefit helps employees manage the rising cost of veterinary care while giving their pets the protection they deserve.
Pet insurance is a popular employee benefit that enhances your clients’ overall benefits package and supports employee well-being—both for themselves and their furry family members. CalChoice Pet Insurance flyer
Encourage your California Choice clients to log in to calchoice.com and explore this new addition to their Member Value Suite today.
CaliforniaChoice is the only small group (1-100 employees) private exchange for employee benefits in California. Partnering with seven top health plans and 18 provider networks, CaliforniaChoice offers a variety of full and limited network HMOs, PPOs, and other benefit options to choose from – all at different price points so you can help your clients control costs and offer their employees choices. Learn more.
With CaliforniaChoice, you can offer multiple health plans side-by-side in a single employee benefits package. That means you only have to learn one product and run one quote, while still giving your clients the value of choice.
Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.
CaliforniaChoice has announced the following Q3-2025 updates:
Q3 plans are now available through PRISM, our free and easy online quoting system.
For essential CaliforniaChoice and ChoiceBuilder Q3 updates and valuable insights that will position you for success, view the webinar “Q3 Scoop: What You Need to Know.”
CaliforniaChoice has introduced the Anthem Blue Cross Platinum PPO B plan with a $5,000 out-of-pocket maximum, expanding their PPO offerings to 14. This is an additional option and does not replace existing plans. Contact us for a benefit summary.
CaliforniaChoice is the only small group (1-100 employees) private exchange for employee benefits in California. Partnering with seven top health plans and 18 provider networks, CaliforniaChoice offers a variety of full and limited network HMOs, PPOs, and other benefit options to choose from – all at different price points so you can help your clients control costs and offer their employees choices. Learn more.
With CaliforniaChoice, you can offer multiple health plans side-by-side in a single employee benefits package. That means you only have to learn one product and run one quote, while still giving your clients the value of choice.
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.
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.
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.
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.
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.
CaliforniaChoice has announced the following Q2-2025 update:
CaliforniaChoice is the only small group (1-100 employees) private exchange for employee benefits in California. Partnering with seven top health plans, CaliforniaChoice offers a variety of full and limited network HMOs, PPOs, and other benefit options to choose from – all at different price points so you can help your clients control costs and offer their employees choices. Learn more.
With CaliforniaChoice, you can offer multiple health plans side-by-side in a single employee benefits package. That means you only have to learn one product and run one quote, while still giving your clients the value of choice.
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.
CaliforniaChoice has announced the following Q1-2025 updates:
CaliforniaChoice is the only small group (1-100 employees) private exchange for employee benefits in California. Partnering with seven top health plans, CaliforniaChoice offers a variety of full and limited network HMOs, PPOs, and other benefit options to choose from – all at different price points so you can help your clients control costs and offer their employees choices. Learn more.
With CaliforniaChoice, you can offer multiple health plans side-by-side in a single employee benefits package. That means you only have to learn one product and run one quote, while still giving your clients the value of choice.
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.
CaliforniaChoice is offering a streamlined underwriting process for groups with Cigna + Oscar (C+O) direct coverage. This special promotion applies to new business effective dates from July 1, 2024 to December 1, 2024.
Groups with 1+ medically enrolled subscriber may submit their most recent Cigna + Oscar invoice instead of a DE9C.
Eligibility Criteria
Please note: all standard CaliforniaChoice eligibility criteria apply. This is a limited-time offer.
CaliforniaChoice is the only small group (1-100 employees) private exchange for employee benefits in California. Partnering with eight top health plans, CaliforniaChoice offers a variety of full and limited network HMOs, PPOs, and other benefit options to choose from – all at different price points so you can help your clients control costs and offer their employees choices. Learn more.
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.
CaliforniaChoice has announced the following Q4-2024 updates:
CaliforniaChoice is offering a streamlined underwriting process for groups with Cigna + Oscar (C+O) direct coverage. This special promotion applies to new business effective dates from July 1, 2024 to December 1, 2024. Get the details and contact us for assistance with your Cigna + Oscar groups.
Eight health plans, 136 different plan designs (HMO, PPO, EPO and HSAs) and 20 different provider networks. Learn more.
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.
Now available in CaliforniaChoice through the new Platinum tier HMO Plan B, Vivity’s unique and popular network is an excellent choice for your employer groups, especially in the highly competitive markets of Los Angeles and Orange Counties.
Vivity is a first-of-its-kind joint venture in Southern California, bringing together top-ranked health systems and Anthem Blue Cross to create a value-based care model. This popular model emphasizes high-quality, coordinated, and affordable care, ensuring a seamless member experience. It includes renowned providers such as:
For your Southern California clients, Vivity offers a compelling combination of quality, accessibility, and affordability backed by some of the best medical providers in the region. With its inclusion in the CaliforniaChoice Platinum tier HMO Plan B, you can offer a solution that not only meets high standards of care but also provides significant flexibility and support for members. Visit VivityHealth.com for more detailed information.
Rates are now available for quoting through PRISM, our free and easy online quoting system.
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.