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Covered California for Small Business – New Blue Shield Plans
New Cigna + Oscar (C+O) small group sales and renewals will not be offered in 2025. At C+O’s request, all plans and rates have been removed from the quote engine. However, you can still quote or renew your C+O groups through December 15, 2024 by contacting us at quotes@claremontcompanies.com or 800.696.4543. Please note: the last day of coverage will be December 14, 2025.
A commonly requested dental benefit by employees with children, sealant coverage is crucial to starting young people early on the right path for a lifetime of oral health. Parents naturally seek out the best for their kids, so a simple benefit like sealants that can help protect children’s teeth adds value to an insurance plan. Below is an explanation of sealants and the types of coverage Delta Dental offers groups and individuals.
What are sealants?
Dental sealants are a thin protective coating (clear, white or slightly tinted) made from plastic or other dental materials. The dentist, dental hygienist or other qualified dental professional brushes them in liquid form onto molars and premolars covering the enamel and sealing the small spaces between teeth. Special care is taken to cover the deep grooves and pits on the chewing surfaces that trap food particles that brushing and flossing can’t remove. After the sealant has been applied (painted on), it is then hardened for a few moments with a curing light. It’s a fast, painless procedure that requires no numbing or drilling.
What are the benefits of sealants?
Sealants form a protective barrier or shield against bacterial plaque that causes decay – like a raincoat for your teeth. Once applied, sealants protect against 80% of cavities for two years and continue to protect against 50% of cavities for up to four years, therefore preventing the risk of tooth loss and possible bite issues for other teeth brought on by cavities.
Sealants can help protect teeth from decay for up to 10 years. However, they need to be checked for chipping or wearing at regular dental check-ups and reapplied as needed.
Who can get sealants?
Anyone with healthy teeth can get sealants – including adults without decay or fillings in their molars. But children should receive them as soon as their molars and premolars come in around the age of six, and then again as additional, permanent molars come in around age 12. Protecting them early will keep them healthy between the cavity-prone years of 6-14. Molars and premolars are particularly susceptible to tooth decay. According to the CDC, children without sealants have almost 3 times as many cavities than children with sealants. Sealing these teeth as soon as they come through can keep them cavity-free from the start, which helps save time and money in the long run.
Why sealant coverage is an important benefit.
Sealants aren’t just an effective weapon against bacteria and acids; they’re also cost-effective in the fight against cavities. Sealants can spare families the hassle, discomfort and expense of cavities, and unlike most cavity treatments, sealant application is a simple, one-time, and painless procedure.
First introduced in the 1960s, the prevalence of sealants has increased overall in children ages six to 11, from 31% during 1999–2004 to 42% during 2011–2016. Knowing about and having access to sealants through dental coverage can provide parents and their kids with a health advantage that pays off for a lifetime.
Delta Dental sealant coverage for groups and individuals.
Considered preventive services, most Delta Dental plans cover dental sealants, so members can often get all their kids’ protective sealants at little or no out-of-pocket cost.
Sealants are a standard benefit in group Delta Dental PPO™ plans. An age limitation typically applies.
All standard DeltaCare® USA plans cover sealants.
For individual plans, both Delta Dental PPO and DeltaCare USA include sealant coverage:
The Basic Plan and Premium Plan cover sealants at 100% after members reach their deductible.
DeltaCare USA individual plans cover sealants with a low copayment.
Plans that include sealants generally limit the benefit to permanent first and second molars subject to age limitations by contract. Under some Delta Dental PPO plans, there is a maximum allowance payable per tooth, and the patient is responsible for the remainder of the allowed fee. Benefits for sealants include repair or replacement within 24 months by the same dentist or dental office.
With the growing demand for sealants and the competitive job market, offering affordable, highly rated sealant coverage can give your clients the competitive edge to attract and retain top talent.
Your success is important to us, and we’re actively working on new solutions to support you throughout the year. To get the latest news via text messaging in the future, simply provide your cell phone number here.
Available to groups with 2 to 19 lives, the RSL SmartChoice® Small Group package offers comprehensive, flexible plan designs and standalone products incorporating STD, LTD, Life/AD&D, Dental/Eye Care, Critical Illness, and Accident Insurance.
Key Features
All products can be sold on a standalone basis.
Class carve-outs are allowed on all products. You can have a different eligible class by product on the same group.
No minimum premium requirements.
Husband/wife and 100% family groups are eligible.
100% employer or employee paid at the same rates.
No employee age restrictions or applications required (list enrollment).
Your success is important to us, and we’re actively working on new solutions to support you throughout the year. To get the latest news via text messaging in the future, simply provide your cell phone number here.
Employees needs have changed drastically in just a few short years due to an increasingly diverse workforce, a pandemic, and the lowest job satisfaction rate in 20 years. Today’s workers expect employers to recognize the importance of their lives inside and outside of work.
Benefits are a powerful tool for serving the whole employee and meeting the needs of the entire organization. That’s true not only in the intense competition to win talent, but also in enabling and equipping employees to be their best, both at work and in their personal lives. In this ‘Age of the Employee,’ organizations that offer compelling benefits will be better positioned for success in these uncertain times.
MetLife’s 20th Annual U.S. Employee Benefit Trends Study 2022,The Rise of The Whole Employee: 20 Years of Change in Employer-Employee Dynamics: Reimagining the Healthcare Employee Experience, provides actionable insights to help you recommend a benefits mix for employers that can help them satisfy the complex and divergent needs of their employees.
The MetLife Study Will Help You:
Understand the rebalance of power between employees and employers.
Dive deeper in the nuances of holistic well-being so you can help your clients’ diverse workforce stay invested and productive.
Learn how to design a richer overall benefits experience.
Key Findings
Employers have shifted their benefits priorities but still need to address the widening gap between worker must-haves and current offerings.
Benefits strategies are no longer focused mainly on cost control, productivity, or other financial and commercial outcomes.
80% of employers say that meeting the needs of employees across all life stages and the diversity spectrum is an important benefits objective.
With the decline in mental health, employees are looking to their employers to help support their mental and social well-being through benefits and policies. Holistically healthy employees are:
– 74% more likely to be satisfied with their job.
– 51% more likely to say they intend to be at their organization in 12 months’ time.
– 53% more likely to be productive.
By combining core and supplemental benefits, employers can provide greater choice for employees and more flexibility to meet their needs in the future.
73% of employees say that a wider array of benefits would make them continue working at their employer longer. And 75% think more benefits choices would reduce their stress and improve their financial wellness.
Employee Assistance Programs (EAPs) may be the most powerful and flexible tool employers have to meet the full range of evolving employee needs. Many EAPs offer mental health and counseling. Some organizations enhance their EAPs with additional services, such as legal support, credit counseling, grief counseling, and more. Employees offered an EAP are:
– 34% more likely to say their mental health has improved in the past 12 months.
– 18% more likely to feel holistically well.
Download the MetLife Study for insights, guidance, and expertise to share with your employer groups. Contact us today to develop tailored benefits solutions that address your clients’ needs.
With comprehensively richer benefits at a lower cost compared to many competing plans, Blue Shield’s Trio HMO Bronze 7000/70 plan (new for 2022) offers convenience, quality, and affordability in addition to professional services at set copayments not subject to deductibles, integrated pharmacy deductibles, and chiropractic and acupuncture coverage.
Your success is important to us, and we’re actively working on new solutions to support you throughout the year. To get the latest news via text messaging in the future, simply provide your cell phone number here.
With emotional, behavioral, and mental health benefits increasingly valued by employees, it’s important to make sure your employer clients are aware of the various programs offered by carriers.
Download our Carrier Resources Guide to stay up-to-date and advise your groups about the available carrier services and benefits available to their employees, either through their existing lines of coverage or through additional lines of coverage they may want to consider.
Carrier Services and Benefits Include:
Emotional support hotlines.
Behavioral health services and benefits.
Mental health and wellness phone apps.
EAP programs.
And More!
Carrier Resources Guide
Download our time-saving Guide by clicking on the image or button below.
Employers are increasingly looking for vision benefits to be included in the benefits programs they offer to their employees.
According to the newly released 2021 Transitions Opticals Workplace Wellness survey, employees are reporting more digital eyestrain as a result of increased screen time driven by new work routines and habits developed during the COVID-19 pandemic. As a result, employees have become more concerned about their eye health and are looking more towards eyewear than making adjustments to their electronic devices to help alleviate their eyestrain symptoms.
On average, employees usually take more than three breaks a day to rest their eyes and assuage headaches. And according to the Journal of the American Medical Association, severe headaches can cause a loss in productivity of 3.5 hours of work per week. In fact, every year, employee headaches result in $17 billion in absenteeism, lost productivity and medical costs per the National Headache Foundation.
There’s also increasing awareness by both employers and employees of the wider benefits of regular eye care. A comprehensive eye exam can detect numerous unexpected health conditions, including diabetes, high blood pressure and high cholesterol, cancer, multiple sclerosis, thyroid disease and more, which can lead to early diagnosis and less-expensive treatment for employees.
Vision benefits are an excellent option for employers looking to strengthen their benefits programs and improve employee productivity and wellness. Offer your employer groups exceptional vision benefits through VSP, EyeMed and MES from our high-quality carrier partners.
The US Department of Labor recently announced that it would ramp up FMLA audits on employers. To ensure your employer groups with 50+ employees are compliant with the FMLA and last year’s significant California Family Rights Act (CFRA) leave expansion, now is a good time for them to review their compliance and administration needs.
The newly launched Sterling Family and Medical Leave Act (FMLA) administration service will:
Help employers navigate the complexities of FMLA and state leaves.
Determine employee eligibility for federal and state leave policies.
Create and send required notices.
Collect and review medical certifications and return to work authorizations.
Track available leave time and intermittent leaves.
Communicate with employees to remove the burden from the employer.
Monitor leaves to prevent abuse.
Automatically update employers on the latest federal and state leave legislation.
Provide a dedicated Client Service Specialist for each employer and individualized customer service for employees.
About The FMLA
The FMLA provides eligible employees with up to 12 workweeks of unpaid job-protected leave per year. It also requires covered employers to maintain group health benefits for employees on FMLA leave and offer the same or an equivalent job at the end of their leave.
Employers are eligible and considered a covered employer if they’re a:
Private sector employer with 50 or more employees in 20+ workweeks in the current or preceding calendar year.
Public agency like a state, local, or federal government agency.
Public or private elementary or secondary school, regardless of the number of employees they have.
Employees are eligible for the FMLA leave if they:
Work for a covered employer.
Have worked for that employer for at least 12 months (doesn’t have to be consecutive).
Have at least 1250 hours of service in the past 12 months.
Work at a location where the employer has at least 50 employees within 75 miles.
Eligible leaves under the FMLA are:
The birth and care of a child or employee.
Placement with the employee of a child for adoption or foster care.
Care for an immediate family member (e.g. spouse, child or parent) with a serious health condition.
The employee’s own serious health condition.
Qualifying leave for military families.
Care for a covered service member with a serious injury or illness due to their military service.
Your success is important to us, and we’re actively working on new solutions to support you throughout the year. To get the latest news via text messaging in the future, simply provide your cell phone number here.
Total life insurance new annualized premium grew 20% in 2021, representing the highest annual growth since 1983, according to a recent LIMRA survey.
Driven primarily by the COVID-19 pandemic, Americans are now much more aware of mortality risk and its impact on the financial security of their families.
Your employer clients will want to know how life insurance can be included in the overall benefits program offered to their employees.
Group term life and supplemental life insurance plans are available through several of our high-quality carrier partners. Request a life insurance quote by contacting us at 800.696.4543 or quotes@claremontcompanies.com.
Your success is important to us, and we’re actively working on new solutions to support you throughout the year. To get the latest news via text messaging in the future, simply provide your cell phone number here.
There is a new law going into effect that will impact small employers with more than 5 California-based employees. The law is already in effect for groups with 50+ employees and will go into effect June 30, 2022 for employers with 5-49 employees.
Summary
All employers with 5 or more California-based employees (at least one of whom is age 18) are affected.
The law is meant to help more people save more money for retirement with a convenient payroll deduction.
The new CalSavers law requires employers to join the CalSavers Retirement Savings Program, unless they’re exempt because they have a 401(k), 403(b), SEP IRA, or Simple IRA retirement plan.
If the employer has one of the above retirement accounts in place by June 30th, they may request an exemption from the state and may opt-out of CalSavers. They can do that on the CalSavers website.
If the employer wants to set up an employer-sponsored retirement plan, we can help you facilitate that through our partner Principal.
If the employer does not want to set up their own retirement program, they simply need to register for CalSavers by the deadline. The employer does not need to contribute money toward the account, nor answer any questions about retirement. CalSavers will do that. The employer will be responsible for facilitating the payroll deductions for CalSavers.
Your success is important to us, and we’re actively working on new solutions to support you throughout the year. To get the latest news via text messaging in the future, simply provide your cell phone number here.
Total Choice lets employers offer health plans and benefits available in all four ACA metal tiers: bronze, silver, gold and platinum. This means your clients and their employees have more options when it comes to coverage to fit their individual healthcare needs.
Popular with Employers and Employees, Total Choice:
Provides employees with the most benefit choices and price points to satisfy their needs.
Allows employees to buy up or down, enabling employers to keep costs low without limiting choice for employees.
Encourages increased participation by offering the lowest-cost options for employees who want to enroll dependents, and options providing the highest level of coverage.
Offers more to discuss at renewal! Total Choice is a great way to offer all options to your clients without disrupting current plan availability.
There’s no employer cost to offer Total Choice, and there’s no participation requirement for any tier.
With the state’s largest portfolio of plans and networks, CaliforniaChoice (a private exchange for employee benefits) specializes in helping small businesses control healthcare costs while offering more choices than any single health plan option.
What makes CaliforniaChoice different for your clients:
Employers define what they can afford, and employees use that amount toward the health plan options they like best.
Easy administration – everyone is on one monthly bill.
Outstanding A+ rated customer service.
Free services like HR support, FSA, and COBRA administration.
With CaliforniaChoice, employees get:
The freedom to choose the health plan they want – it’s their choice!
A huge selection of HMO, PPO, EPO, and high deductible plan options.
Access to 80,000+ doctors and 400+ hospitals.
Big discounts on dental, vision, hearing, Rx, wellness products, entertainment, and more.
Your success is important to us, and we’re actively working on new solutions to support you throughout the year. To get the latest news via text messaging in the future, simply provide your cell phone number here.
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.
