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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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Reliance Standard

What emotional, behavioral and mental health services and benefits does Reliance Standard provide for employees and their families?

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Contact Claremont for more information.

Disability: are there any exclusions for pandemics?

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No, there’s no exclusion for pandemics. COVID-19 is evaluated like any other medical condition.

Contact Claremont for more information.

Is Reliance Standard providing any relief to employer groups?

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Yes. Reliance Standard is providing relief in a number of ways, including temporarily:

More information of these new actions can be found on Reliance Standard’s Coronavirus Response page, with links to general FAQs and Dental and Vision FAQs.

What Coronavirus resources is Reliance Standard making available for brokers, groups, employees and members?

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You can find Reliance Standard’s Coronavirus resources in the Coronavirus Carrier Resources section of our website. You can also stay up-to-date here with carrier actions in response to the Coronavirus.

If an employer group remains open and temporarily reduces the hours for certain employees because of coronavirus, are its employees still considered actively at work?

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Reliance Standard will allow the employee to maintain insurance coverage during the time period that the temporary reduction in hours occurs. The employer must maintain the employee’s same employment status as prior to the work hour reduction [e.g. active, full time etc.]. Additionally, at this time, Reliance Standard has determined that a temporary hour reduction is one that occurs for up to 30 calendar days. This means that if the employee continues to work a reduced scheduled on the 31st calendar day from the date the reduced schedule began, the employee will need to meet the eligibility requirements in the applicable policy to maintain coverage. As the pandemic situation develops Reliance Standard will evaluate the 30-day time frame to determine if modification is warranted.

Please note that all other policy provisions still apply, including the standard policy requirement that all income related changes are effective on the date that change occurs. For example, this means that if an employee’s income is reduced and the employee files a disability claim, the employee’s income immediately prior to the employee’s date of disability will be used to determine the employee’s benefit amount.

Employer groups should check their policy: certain policies may not allow this extension of coverage or certain policies may allow changes in income to be effective on dates other than the date the change occurred; if so, that information will be specifically listed.

 

Helpful Resources

Reliance Standard Coronavirus Response page, with links to general FAQs and Dental and Vision FAQs.

If an employer group has to temporarily lay off employees because of coronavirus, are its employees still insured?

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Certain policies (e.g. the standard life contract) have specific continuation of coverage provisions, which will be followed. Without such a provision, standard policies (for example, disability policies) do not allow an employee to maintain insurance coverage once the insured is no longer in an eligible class. Groups should check their policy; certain policies may allow extension of coverage in compliance with applicable laws, and if so, that will be specifically listed. 

Helpful Resources

Reliance Standard Coronavirus Response page, with links to general FAQs and Dental and Vision FAQs.

How are Coronavirus claims considered across the Reliance Standard Product line?

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Short Term Disability

If a person is diagnosed with COVID-19, a claim for fully-insured STD benefits would likely be
payable after the elimination period if the definition of disability has been met. Individuals who
are quarantined without a diagnosis would not have a payable claim.

Long Term Disability

If a person is diagnosed with coronavirus, a claim for fully insured LTD would likely be payable after the elimination period if the definition of disability has been met. As with STD, individuals who are quarantined but not sick generally would not have a payable claim.

Group Term Life Insurance

A life claim following a COVID-19 diagnosis would likely be payable assuming all other provisions of the policy are met.

Accidental Death & Dismemberment

A COVID-19 diagnosis is not a covered condition under Reliance Standard’s Accidental Death & Dismemberment product.

Accident Insurance

Accident insurance does not provide benefits for the diagnosis or treatment of COVID-19.

Critical Illness Insurance

COVID-19 is not a covered condition under Reliance Standard’s Critical Illness product.

Hospital Insurance

Admission/confinement due to a positive diagnosis of COVID-19 may be considered for eligible benefits provided all other provisions of the policy are met.

Wellness Benefits

COVID-19 testing is not a covered test under our Wellness Benefit; however, most major medical plans and many government programs provide free COVID-19 testing.

EAP Services

For any individuals experiencing panic, anxiety or fear, or are in need of community resource referrals for child care or life management needs, an EAP provides work-life referrals that can help. This value-added service is optional on Reliance Standard’s LTD and Group Life contracts. Contact Claremont to confirm coverage.

 

Helpful Resources

Reliance Standard Coronavirus Response page, with links to general FAQs and Dental and Vision FAQs.

Can an employer group get an extension of time to pay its premium?

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Reliance Standard understands the coronavirus outbreak has impacted everyone. They will work in good faith with all their clients impacted to extend reasonable accommodation with regard to timely payment of premium. In addition, the group may be covered by a local, regional, state or federal relief program or proclamation; Reliance Standard will cooperate fully with these requirements. 

Helpful Resources

Reliance Standard Coronavirus Response page, with links to general FAQs and Dental and Vision FAQs.

How long can an employee remain covered by STD, LTD or Group Life in the event they are subjected to temporary reduction in hours, or sent home as a result of a temporary layoff, furlough or facility closure?

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For policies without a continuation of coverage provision, including standard disability policies, Reliance Standard will allow an employee to maintain insurance coverage for 60 consecutive calendar days if an employer temporarily

For policies with a continuation of coverage provision, including standard life policies, Reliance Standard will follow the applicable contract provision. In instances where the provision allows coverage to continue for less than 60 consecutive calendar days, they will administratively extend the timeframe to 60 consecutive calendar days.

In all instances:

As the pandemic situation develops, Reliance Standard will evaluate the 60 calendar day time frame to determine if modification is warranted.

Helpful Resources

Reliance Standard Coronavirus Response page, with links to general FAQs and Dental and Vision FAQs.

Is Reliance Standard offering premium grace period extensions to avoid unintentional lapse/cancelation of coverage?

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Reliance Standard follows all applicable regulations related to billing grace periods in all states that have released specific guidelines tied to the COVID-19 pandemic.

Additionally, each policy contains a grace period which allows for continued insurance coverage for a defined period of time. We are adhering to grace periods outlined in each client-specific policy at this time and will continue to monitor market changes as appropriate. After a grace period ends, Reliance Standard will communicate and work with clients before coverage might lapse to better understand ability to remit premium prior to termination.

Helpful Resources

Reliance Standard Coronavirus Response page, with links to general FAQs and Dental and Vision FAQs.

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.