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✔ Lowest rates in the market – Affordable options without compromising quality.
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✔ 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.
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Login To PrismHow much is a Covered Employer required to spend on health care for its Covered Employees?
The minimum Health Care Expenditure for each Covered Employee is determined quarterly by multiplying the total number of hours payable to the employee in the quarter by the applicable Health Care Expenditure rate.
Hours payable includes both the hours for which a person is paid wages for work performed within San Francisco and the hours for which a person is entitled to be paid wages, including, but not limited to, paid vacation, paid time off, and paid sick leave, but not exceeding 172 hours in a single month. Hours payable in a quarter refers to when the payment is earned, rather than when it is actually paid out to the employee.
The employer must make minimum Health Care Expenditures to or on behalf of each Covered Employee. Payments to or on behalf of one Covered Employee that exceed the required minimum Health Care Expenditure for that employee will not be considered in determining whether an employer has met its total required minimum Health Care Expenditures for all employees. There is an exception for employers that provide uniform coverage.
Note that “hours payable” is the figure used to calculate the expenditure required for each Covered Employee, but “hours worked” is used to determine whether an employee is covered by the HCSO.
There may be a more recent answer to this question. Contact Claremont for an update.