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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.Login To Prism
97% of employers expect their benefits broker to answer compliance questions, provide guidance, and ensure they are well informed about legislative changes, according to a recent Zywave survey. These expectations require that brokers know the Large Employer Mandate (also known as Play or Pay) and how employers will be impacted.
Large employers, those with 100 or more full-time (FT) employees plus full-time equivalent (FTE) employees, may already know they are subject to the Play or Pay Mandate, and have taken action. It’s the smaller employers, those with 50-99 FT plus FTE employees, that could be at risk because it isn’t always obvious if an employer is subject to the mandate.
To properly identify Applicable Large Employers (ALEs), it’s important to avoid conclusions based on a cursory employee count. Under the mandate, all employees of all businesses that are part of a controlled group and/or affiliated service group must be included in the determination of the group size. Hence, businesses with only a few employees can be subject to the mandate if the business is part of a controlled group and/or affiliated service group, and the number of FT and FTE employees combined for all businesses equals 50 or more.
It’s critical you know which employers are subject to the mandate, the compliance requirements and penalties, and how to address their needs. Use Claremont’s comprehensive ‘Play or Pay’ resources to understand the mandate and work closely with your employers to plan ahead and successfully manage the new requirements.
*Download and distribute these guides to your prospects and clients.Download One or All Exclusive Play or Pay Guides
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