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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.Login To Prism
If a group decides to cancel group coverage and get employees to sign-up for individual coverage, can a group start a carve-out plan for owners and key executives?
A plan cannot discriminate in favor of highly compensated individuals as to eligibility to participate; and the benefits under the plan cannot discriminate in favor of highly compensated individuals. Highly compensated individual is defined as (1) one of the 5 highest paid officers; (2) a shareholder who owns more than 10 percent in value of the stock of the employer; or (3) among the highest paid 25 percent of all employees.
However, please be aware that on September 13, 2013, the IRS and the DOL issued guidance 2013-54 (“guidance”) on the application of certain ACA provisions on HRAs, reimbursement arrangements or employer payment plans, and health FSAs. Due to the pouring in of questions regarding the guidance, the IRS issued a clarifying FAQ on May 13, 2014. However, the guidance is complex and many questions still abound.
The guidance changes the landscape for certain employer-sponsored arrangements in that arrangements that facilitate the pre-tax payment or reimbursement of premiums for individual medical coverage for active employees are no longer permissible. HRAs and other similar defined contribution arrangements for active employees are also impermissible unless they are “integrated” with an employer’s group health plan or the reimbursement under such arrangements are limited to retirees or certain excepted benefits.
There may be a more recent answer to this question. Contact Claremont for an update.