PRISM Login

To access the carrier product and rate information provided by PRISM, check the box below indicating you have read and agree to the license agreement. A button will then appear to access PRISM.

This site uses cookies to track your agreement option. If the terms of the license agreement change or if you clear the cookies from your browser, this page will appear once again during the PRISM login process.

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.

Login To Prism

Plans

Can a health plan charge more to a member with health problems (Diabetes, Heart Disease)?

Posted by

No. In California, only age, family size, location and plan design can be used to determine rates.

Cadillac Plan Tax penalties?

Posted by

The “Cadillac Tax” is an excise tax on high-cost health plans. Starting in 2020 an excise tax of 40% will be assessed on the cost of coverage for health plans that exceed a certain annual limit ($10,200 for individual coverage and $27,500 for self and spouse or family coverage).

Are provider networks driven by metal levels?

Posted by

No. The metal tiers (Platinum, Gold, Silver, Bronze) are determined by the Actuarial Value of the plan, which is independent of the provider network.

Are carriers also applying the “non spouse W-2s” husband and wife rule outside the exchange? What about 1099s?

Posted by

Yes, carriers are all applying similar small group definition rules regarding both “non spouse W-2s” (sometimes referred to as “common law employee”) and 1099s. Check with the individual carriers for their exact rules.

How can I identify if my client is enrolled in a grandfathered plan?

Posted by

Carriers are required to notify consumers with these policies that they have a grandfathered plan and disclose if they are grandfathered in all materials describing plan benefits.

If in doubt, contact the carrier.

If a carrier drops a plan for a group and offers an alternative can the company still invoke the grandfather clause?

Posted by

No. Grandfathered plans are those that were in existence on March 23, 2010 and haven’t been changed in ways that substantially cut benefits or increased costs.

Do all counties in California have Covered California plans?

Posted by

Covered California (individual exchange and Covered California for Small Business) is available in all counties. Not every plan is available in each county.

Can people still buy direct or will pricing be better with Covered CA?

Posted by

Any plans in Covered California that are also offered by the carrier outside of Covered California have to have the same benefits and premium rates.

Are there any HSA plans for individuals available in Covered California?

Posted by

There are HSA-qualified high deductible health plans (HDHPs) available in Covered California’s individual exchange. For example, the Blue Shield of California Bronze 60 HSA Plan.

Must grandfathered plans provide the full suite of mandated preventive benefits at no cost?

Posted by

Preventive health benefits with no cost-sharing does not apply to grandfathered plans.

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.