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Covered California for Small Business –
New Blue Shield Plans

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.

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Why do ancillary carriers need more information than medical carriers in order to provide a proposal in the small group market?

The short answer is that medical carriers, in accordance with the law (AB1083/AB1672), are permitted to set rates for small group members based on only two factors, age and employer location, while ancillary carriers are not constrained by these laws and can rate small group members on many different factors. These factors can include:

  • Member age
  • Member location
  • Employer location
  • Nature of business or SIC
  • Employer contribution
  • Current rates and benefits
  • Claims experience
  • Salary (for certain lines such as disability)

It is possible to limit the amount of information provided to an ancillary carrier by considering an “off the shelf” product such as Reliance Standard’s SmartChoice dental plans, in which case you’ll only need to provide a few data points, however, if your client wants any customization the carrier will likely ask for more information.

Ancillary carriers have good reason for requesting more data. Less data about a group and its members leads to greater uncertainty, which translates into higher cost and at a certain point, a refusal to provide a proposal. However, the more a carrier knows about a group and its members, the tighter their underwriting department can set rates in the proposal and the less likely those rates are to change once the carrier receives all applications and documentation.

The bottom line regarding ancillary proposals: more information means more competitive and better quality proposals and a much lower chance of unpleasant surprises.

 

In our library, you’ll find carrier forms, applications, enrollment kits, broker bonuses, marketing resources, and more (video tutorial). However, not all carrier forms are available online.

If you don’t find what you are looking for, contact our team for help at 800.696.4543 or materials@claremontcompanies.com.