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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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Is there a Dental & Vision Special Enrollment Opportunity?

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Yes.

UnitedHealthcare has announced a Dental & Vision Special Enrollment Opportunity to enroll employees who previously did not enroll in Dental and/or Vision coverage. The one-time opportunity will be limited to those employees who previously waived coverage or did not elect coverage for themselves or their dependents (e.g., spouses or children).

Get the details.

Where can I find information on the recent COVID-19 Special Enrollment Period for medical plans?

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UnitedHealthcare’s FAQs on the Special Enrollment Period has answers to many questions.

How will UnitedHealthcare cover COVID-19 treatment?

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Get the answer in UnitedHealthcare’s COVID-19 Treatment and Coverage FAQs.

Does UnitedHealthcare have some information related to employer groups returning to their worksites?

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Get the answer in UnitedHealthcare’s COVID-19 Back to Worksite FAQs.

What is the “Premium Deferral Program”?

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Covered California for Small Business has introduced a flexible premium payment plan to employers who have not yet paid their premiums for April or May.

Learn more.

Is MetLife waiving the usual waiting period requirement for re-hires?

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For Group Life, AD&D, Accident and Health, Dental and Vision, if the employee’s employment is terminated and coverage lapses due to non-payment, and they return to work or are re-hired within 6 months, MetLife will reinstate their prior coverage amount without needing to provide evidence of insurability, where applicable, or satisfying benefit eligibility waiting periods. For accident and health coverage, any limitations for pre-ex conditions will be applied from the reinstatement date.

For disability coverage, if the employee’s employment is terminated and coverage lapses due to non-payment, and they return to work or are re-hired within 3 months, MetLife will reinstate their prior coverage amount without needing to provide evidence of insurability, where applicable, or satisfying benefit eligibility waiting periods. In addition, the pre-ex provision will be applied as if there was no interruption in coverage.

MetLife will continue to review the needs of their clients during this time and if additional flexibility is needed based on the duration of this pandemic, they may modify our reinstatement position.

Learn more.

Will MetLife be making any changes or having leniency for premium payments?

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MetLife understands these are challenging times for many businesses. As an accommodation to their clients, In the event premiums cannot be paid during the contract grace period, MetLife will be extending grace periods for the lesser of 90 days from premium due date or July 31, 2020, unless a different grace period is required by law.   This policy will be applied for all premiums due 3/1/2020 and forward, as well as apply to any premium within the current 30-day grace period. MetLife will continue to monitor the situation and will provide additional guidance as it becomes available.  MetLife is also monitoring state specific mandates and will comply with those mandates. As the coronavirus situation continues to evolve, MetLife will review this guidance for necessary actions and provide updates where the guidance or process has changed.

Learn more.

Is MetLife issuing premium credits to employer groups?

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Yes. Employers with fully insured dental PPO plans will receive a premium credit on a future bill in the amount of 25% for the months of April and May, 2020.

Learn more.

Is Humana extending grace periods for premium payment?

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Yes. Humana is extending its usual 30 day premium payment grace period to 60 days for California employers.

Contact Claremont for more information.

Will ChoiceBuilder allow employees who are currently furloughed, not working, or whose hours have been reduced below 30 hours per week to keep their insurance?

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As long as the group and employees are current on their monthly payments, ChoiceBuilder will allow employees that would otherwise have lost eligibility to remain on the plan. COBRA is available to employees where there is an active employer policy.

Learn more.

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.