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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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ACA/Healthcare Reform

What’s the best way to conduct “virtual meetings”?

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Let’s say you have the following scenarios with your clients or prospects:

  1. You want to review documents or proposals with a prospect who is not located nearby.
  2. You want to host a meeting for your client’s employees, but they work in different locations and it’s not practical to bring them to the same location.
  3. You want to show your client how to use a carrier’s online portal but can’t make it to their office.

What’s the most effective solution for these scenarios where you can’t arrange an in-person meeting? The ideal solution is a virtual meeting; a combination of screen-sharing and either a direct call or conference call.

Everyone knows how conference calling works, but you may be less familiar with screen-sharing. If you’ve ever attended a webinar, then you have seen screen-sharing at work. It is the ability to view, in real-time, what is on someone else’s computer screen and it is a powerful tool that can boost efficiency for you and your prospects and clients. Let’s see how this solution can work in each of the above scenarios:

  1. Instead of driving long distances, set up a call and email your client a link that allows your prospect to connect to the screen-sharing web site. At the appointed time, you call them, they log in (at no cost) and you start sharing your screen. This allows you to talk to your prospect while you are both seeing the same documents at the same time and most importantly allows you to use your cursor to “point to” each section of the document on which you want to focus the conversation. You can even edit documents together in real-time.
  2. Similar to #1, but instead of a direct call, you set up a conference call. Employees dial-in and then log in. You can show them a presentation or review documents with them (plan brochures, descriptions of services that carriers offer, etc.)
  3. Similar to #1, you arrange a virtual meeting with your client, log into the carrier portal, share your screen and take them through a demo of how to use the portal.

There are numerous companies that offer conference calling and screen-sharing capabilities: GoToMeeting, Join.Me and Zoom are just a few. With most services, you can experiment with a free trial and with some, you can even use a basic version at no cost, indefinitely. The basic versions typically limit the number of participants and exclude more advanced capabilities.

One really useful feature, available with the advanced version of these services, is the ability to pass control of the presentation to someone and allow them to share their screen. For example, in scenario three above, if the client wants to show you a problem they are having in the carrier portal, you can set up a quick call and screen-share, pass the control to them and now you can look at what is on their screen to determine where they are having problems and help solve them.

There are many more capabilities offered by these services, but even using the most basic features can help you collaborate with clients and colleagues in real-time. Once you start using virtual meetings enabled by screen-sharing services, you will find them irreplaceable and well worth the cost. Here at Claremont, if we want to quickly review documents with a colleague, we’ll sometimes set up a virtual meeting even if they are just down the hall!

Should clients contribute to their HSA before contributing to their 401K or IRA?

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There are compelling reasons to do exactly that:

There is one situation where the decision becomes a bit more difficult. That is if the employer offers a matching contribution to a traditional retirement account. It’s tough to turn down that “free money.”

As with all matters related to tax and finance, it is strongly recommended that you do not provide advice unless you are certified to do so. That said, if you are not a tax or finance professional, you could certainly encourage your clients to solicit the professional opinion of their tax or financial advisor on this matter.

Please note that this FAQ is meant to be informational only. It is not tax advice and Claremont Insurance Services is not a tax advisor.

Resources
Employee Benefit News recently published two helpful articles: “The Case for an HSA-First Investment Strategy” and “How HSA Savings Can Be Used for Long-Term Care in Retirement.”

Why are some of my Covered California for Small Business clients receiving delinquency and termination notices?

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CCSB’s processes on late payment notices and contract terminations are similar to that of other carriers in the small group market. When an employer does not make payment by the last day of the month for the following month’s coverage they will receive a Notice of Delinquency. The payment must be for the full amount of the invoice. It’s recommended that employers not “self-adjust” based on additions or deletions of plan participants. Employers should pay the invoiced amount.

Once an employer loses coverage with CCSB or any carrier and fails to have a replacement plan in place resulting in an unplanned gap in coverage, there are potentially serious consequences, including but not limited to:

If your client’s coverage is cancelled they may request that the coverage be reinstated. The decision to rescind the termination is made solely at the discretion of the carrier.

To help you and your clients, we have developed Advice to Agents About CCSB’s Payment Policies. However, the most important piece of advice we can provide: advise your clients to pay on-time and for the invoiced amount.

Finally, when you and your client are simply terminating coverage in order to move to another carrier, you should always notify the current carrier via a formal letter of intent to terminate prior to the termination date. CCSB and any other carrier will issue delinquency and termination notices if they have not been notified and will expect to be paid for any unpaid coverage months if they have not been notified in advance of a termination.

Is the Small Business Healthcare Tax Credit still available?

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With all the talk about repeal, replace and changing regulations, you might have thought the Small Business Healthcare Tax Credit provision in the ACA would have been terminated, but it is alive and well and there is still money available for your clients if they are eligible. This is an excellent and sometimes overlooked financial reward for small employers in low wage industries to encourage them to offer coverage and may be a source of new clients.

To qualify for the tax credit, the business must:

If the employer meets these requirements, they could be eligible for up to a 50% tax credit (35% for non-profits). The dollar value of the credit is based on how much the employer contributes towards the employees’ (and dependents’) premiums. The credit works on a sliding scale; companies with 10 or fewer employees and average wages of $25,000 or less qualify for the maximum, while companies with employee counts and average wages near 25 and $50,000, respectively, will qualify for the least.

Claremont has been working with CCSB since its inception in 2014 to help assist agents and their clients in understanding the tax credit. We will even provide an estimate of the potential tax credit for which your client may qualify. And don’t forget a tax credit is far more valuable than a tax deduction or a deductible expense. A credit allows the for-profit employer to reduce their tax bill by the amount of the credit earned.

We have a crafted this Health Care Tax Credit Solution and posted it on our web site. It provides all the information you need in order to discuss this great program with your clients.

Did the IRS just reverse its recent reduction in Health Savings Account contributions?

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Yes it did. In our March 8, 2018 Question and Answer of the Week we alerted you to a $50 reduction in the maximum allowable contribution to an HSA account with family coverage; from $6,900 to $6,850.

In response to stakeholder concerns about unanticipated financial and administrative burdens, the IRS has reversed itself and has just published this announcement restoring the maximum allowable contribution to an HSA account with family coverage to $6,900.

The maximum contribution for accounts with self-only coverage remains unchanged at $3,450.

Does my California resident life/health license allow me to write business in other states?

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Yes, provided you obtain a non-resident license from that state. From time to time, you may have a client whose business is based outside California. Or perhaps you would like to start pursuing business in other states. In order to write business in another state you will need to obtain a non-resident license for that state for yourself, and if desired, for your agency.

Fortunately, California has reciprocity with many states. This means that, provided your California life/health license is current and in good standing, you do not need to take the license education class and pass the license test for each state. You just need to apply (and pay) for a non-resident license for yourself and your agency. You’ll need to secure a non-resident license for your agency if you intend to market your agency in that state or be paid through your agency for business written in that state.

To make this convenient, most states have signed on with the National Producer Insurance Registry (NIPR) which is an organization that facilitates cross-state licensing. NIPR’s web site allows you to apply for and renew non-resident licenses. We have developed this step-by-step guide to apply for your non-resident license. We hope you find it helpful.

Can the allowable maximum contribution to a Health Savings Account decrease?

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Yes. And it just did. On March 5, 2018, the IRS announced that for 2018, the maximum allowable contribution to an HSA account with family coverage decreased $50. Previously the IRS had set the maximum contribution at $6,900, it is now $6,850. The maximum contribution for accounts with self-only coverage remains unchanged at $3,450.

This article from the Society for Human Resource Management explains that the IRS took this unusual step after calculating how the tax reform legislation recently enacted impacts inflation adjustments to HSA contribution maximums. Benefits brokers and agents should consider passing this information on to their clients who have high-deductible HSA-compatible plans in place.

Is there a dental plan that provides coverage after the annual maximum has been met?

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Most of us would answer that question with a “no.” There is good news, however, Humana’s small group dental plans include an “extended annual maximum” feature which pays 30% of the negotiated rate even if the member hits their annual maximum; and there is no cap. Extended annual maximum is superior to the “rollover” features offered by other carriers because it does not require the member to accrue unused amounts before it can be used. Even if a member incurs substantial costs early in the plan year (well before they’ve accrued unused benefit amounts), the extended annual maximum feature kicks in immediately, so members are never without coverage. To learn more, contact your Claremont sales representative at info@claremontcompanies.com or 800.696.4543.

How should I advise my clients regarding their benefits compliance obligations?

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Brokers and agents take different approaches to helping clients with their benefits compliance obligations. Some become a virtual extension of the client’s team, working closely with them to handle most of the notification and reporting requirements. Others provide clients with an outside source for compliance consulting; paying for none, some or all this expense.

Regardless of which approach you take, realize that clients, particularly smaller firms, often look to their benefits professional as an advisor in this area and will place their first call to you. As you consider how you will handle benefits compliance questions, we thought it would be helpful to provide this benefits compliance reference document created by HR Service, Inc., a firm that specializes in providing outsourced benefits compliance and human resource management. Feel free to follow the link and take an online risk assessment (for your firm or for one of your clients).

Should you wish to subscribe to HR Service, Inc.’s Compliance Basics or Compliance Basics Plus services, the cost ranges from $10 to $15 per month per employer group. Be sure to mention that you were referred by Claremont Insurance Services.

Can I electronically submit new groups to Covered California for Small Business?

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Yes. Covered California for Small Business (CCSB) has just launched the ability to submit new groups directly from EaseCentral. This efficient, new service allows brokers and agents to save time and money.

As the only general agent to help test this new electronic capability, Claremont Insurance Services is an expert in how it works and how it can benefit brokers, agents, and their clients. To help benefits professionals take advantage of this new integration, Claremont has launched eQuote-to-Enrollment, a no-cost service that allows brokers and agents to offer an online quoting, plan selection, and application process that saves time, increases accuracy, and leads to faster approvals.

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.