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Starting July 1, Covered California for Small Business (CCSB) is offering new Blue Shield plans, providing more options for enrollees. These plans include the Access+ HMO Network with Platinum, Gold, and Silver metal tier options, as well as the Bronze Trio HMO 7000/70. The two most popular Blue Shield High Deductible Health Plans (HDHP), Silver Full PPO Savings 2300/25% and Bronze Full PPO Savings 7000 plans, are also now available.
All of these plans offer benefits such as Wellvolution, Teladoc Mental Health, Nurse Help 24/7, LifeReferrals 24/7, and the Blue Card program for when members are outside of California.
For assistance, please contact our Quotes team at quotes@claremontcompanies.com or 800.696.4543.
Login To PrismWe are excited to welcome Suzie Wirths as the newest addition to the Service Team. As a Broker Service Representative, Suzie will assist clients in a variety of areas such as eligibility, enrollment support, quoting, carrier knowledge, Ease and more.
Suzie has over six years of employee benefits experience and has worked with Third Party Administrators as well as brokerage firms. “After her first interview, I knew Suzie should be a part of our team,” says Laura Hogsed, Service Manager. “Her experience and knowledge are only part of what Suzie brings to the table. She strives to provide the best possible experience to everyone that she interacts with and she is eager to make an impactful contribution to our customers. Our clients are already saying how much they enjoy working with her.”
Suzie loves the outdoors. In her spare time, you may find her hiking, kayaking, caving and exploring the mountains.
You can reach Suzie at suzie@claremontcompanies.com or 925.348.0856.
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As of January 20th, Debra Scritchfield will be retiring from Claremont.
Debra started with Claremont in December 2013. She joined during a time of change, as ACA requirements were phasing in and Covered California for Small Business (CCSB) was in its infancy. Debra worked hard with the team to initially build the relationship with CCSB and help work through some of the initial growing pains. As time passed, she became one of our internal CCSB experts, helping countless clients navigate their way through the changing world of health insurance. Over the years, Debra has assisted clients with everything from processing new applications, making changes throughout the policy year, quoting, answering benefits questions, and much more.
“Debra will definitely be missed by all of us” says Laura Hogsed, Service Manager. “Not just for her knowledge and contributions as a co-worker, but as a friend. Debra has built strong bonds with all of us both in and outside of the office. While we hate to see her go, we wish her the best in everything that her future has in store for her.”
Please join everyone at Claremont in congratulating Debra on her retirement.
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By law, all carriers are required to offer the small group Special Enrollment Period (SEP) one time per year to allow employers to enroll in coverage with a $0 contribution requirement and no minimum participation requirement. The application period is from November 15 to December 15, 2022, for coverage effective January 1, 2023. Carrier administration of the SEP may vary slightly, including recertification at renewal.
Please note: the Special Enrollment Period is different than the relaxed participation promotions. These carrier promotions are usually offered for a specific time period and may be discontinued at any time.
Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.
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Please join us in celebrating Chris Kersey and Crystal Nelson on their milestone work anniversaries.
Chris Kersey, Applications Developer, is celebrating 15 years. “Chris always has the needs of our clients and team members front of mind when he is designing and coding,” says Ken Ruotolo, Claremont COO. “Inevitably, Chris will point out something that we hadn’t thought of and then will implement it in a thoughtful, easy-to-use and comprehensive way. I know I speak for all his teammates when I say it is a real pleasure to work with Chris. Congratulations on 15 years of service!”
Crystal Nelson, Broker Service Representative, is celebrating five years. Crystal initially came aboard as a temporary employee but quickly demonstrated that she should be a permanent member of the team. “Our broker customers have nothing but good things to say about Crystal,” says Laura Hogsed, Service Manager. “She is thoughtful, thorough, and goes above and beyond in everything that she does. Crystal is a great example of Claremont’s core values of Thoughtfulness, Innovation, Professionalism, Positivity, and Collaboration. She is truly a joy to work with. Please join me in congratulating Crystal on her five years of great service!”
You can reach Chris at ckersey@claremontcompanies.com or 925.296.8849 and Crystal at crystal@claremontcompanies.com or 925.296.8826.
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Starting January 1, 2023, a new California law requires most insurance producers, including life, accident and health agents, to include their individual license number on emails. For details, read the Notice from California Insurance Commissioner Ricardo Lara.
Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.
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The 2023 Small Group Special Enrollment Period (SEP) starts November 15, 2022.
The Small Group SEP is the opportunity for employers to enroll in coverage with a $0 contribution requirement and no minimum participation requirement (at least 1 employee must enroll). The limited application period is from November 15 to December 15, 2022, for coverage effective January 1, 2023. Learn more.
Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.
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On October 11, 2022, the Internal Revenue Service (IRS) announced updated rules designed to fix the Affordable Care Act (ACA) “Family Glitch.” The change impacts family health coverage options for hundreds of thousands of lower-income Californians currently enrolled in group family coverage. The updated rules come into effect for 2023 coverage. As you conduct open enrollment meetings with your clients, you will likely get questions from employees, so you’ll want to familiarize yourself with the updated rules.
The updated rules change how premium tax credit (subsidy) eligibility is calculated for families on the ACA individual marketplaces (Covered California for California residents). Currently, if a family member has employer coverage, subsidy eligibility for the other family members is calculated based on the affordability of the employee coverage, not the affordability of the family coverage. This is often a big difference, because employer premium contribution is often less for family coverage compared to employee coverage. The updated rules change that calculation. Now, for 2023 coverage onwards, if a family member has employer coverage, the Covered California subsidy eligibility calculation for the other family members is based on the affordability of the family coverage. It is expected that many family members currently enrolled in family coverage in group plans will now be eligible for Covered California individual coverage subsidies, which creates an additional factor in their decision on whether to enroll in the group plan.
The updated rules do not affect employer liability under the ACA large employer mandate.
Employers with non-calendar year plans, including health reimbursement arrangements (HRAs), and Section 125 cafeteria plans, will want to review how the updated rules impact family member ability to disenroll mid-plan year.
For more information, check out the resources below.
Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.
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California’s unemployment rate fell to 3.9% in July, its lowest since 1976 and one of the lowest rates on record. This figure, published by California’s Employment Development Department, is a reminder that the labor market remains very tight throughout the state.
In addition to job gains across California, employees today have many options of where to work. Providing comprehensive health benefits are key to helping employers recruit and retain talent. Therefore, at your clients’ next renewal, advise them on how to implement a competitive health benefits program to maintain their workforce.
To learn more about the California labor market, read this KQED article.
Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.
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The Inflation Reduction Act of 2022 (IRA) was signed into law by President Biden on August 16, 2022. While group health benefits are not directly impacted, health insurance professionals will want to be aware of several healthcare and health insurance provisions in the bill.
Increased premium tax credits for low-income individuals, which were implemented in the 2021 American Rescue Plan Act, were set to expire at the end of 2022. IRA extends the increased premium subsidies through 2025.
Prescription Drug Price Negotiation by Medicare
IRA allows for the first time the Centers for Medicare & Medicaid Services (CMS) to negotiate drug prices under Medicare Parts B & D.
$2,000 Annual Cap on Medicare Part D
IRA places a $2,000 annual cap on out-of-pocket costs for prescription drugs under Medicare Part D, starting in 2025.
Penalties if Drug Companies Increase Prices Faster Than Inflation
IRA places inflation caps in Medicare Part D that limit price increases for drugs year over year. Tax penalties will be levied on drugmakers that increase the prices of their products more than the rate of inflation.
$35 Out-of-Pocket Cost Limit on Insulin
IRA places a $35 out-of-pocket cost limit on insulin for individuals under Medicare.
Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.
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Educate your clients about the advantages of vision benefits for eye health and safety, and controlling healthcare costs with the early detection of chronic or life-threatening conditions like heart disease, stroke, diabetes, high blood pressure, or even cancer.
A popular option for small businesses, VSP Choice provides quality vision benefits including an annual WellVision Exam® and annual prescription lenses.
The VSP Choice provider network includes thousands of professionally certified optometrists and ophthalmologists who offer comprehensive vision exams and ways to purchase glasses or contacts in office. Best of all, members have the freedom to choose from both in- and out-of-network vision providers (out-of-network costs are usually higher).
Value-Add Benefits
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.