Archive for the ‘Broker Updates’ Category

MetLife Extends Dental & Vision Renewal Rate Pass to March 31, 2021

To help small businesses (groups with 99 or fewer employees) who may be facing challenges as a result of the COVID-19 pandemic, MetLife will hold rates (no rate increase) for dental and vision renewals with effective dates commencing on or before March 31, 2021.*

Visit MetLife’s website for updates, resources, benefit coverage, and answers to common questions regarding COVID-19.

Questions?
Contact your Claremont team at 800.696.4543 or info@claremontcompanies.com.

*Excludes cases written through a Trust, Association, or PEO.

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Blue Shield Q3-2020 Updates

Below are the Q3-2020 updates for medical and specialty options, rates, plan changes, renewals, and tips and resources for enrolling both new and renewing business. Additional information can be found on Blue Shield’s Broker Connection.

Use the Plan Comparison Tool to quickly and easily select multiple plans and compare the benefits side by side, or select a single plan and see how benefits have changed from year to year.

Q3-2020 Rates

• There will be a rate action of 0.9% for all PPO medical plans and all HMO medical plans.
• All dental, vision, and life insurance plan rates will remain unchanged.

July – September 2020 Renewals

• July – September group renewals are available to brokers. Employers will be notified that their renewal materials will be available on April 23-28, 2020.
• Group-level changes can be made using Small Group Online Renewal (SGOR) beginning April 21, 2020.
• Reminder — groups will receive an email notification and a one-page mailed letter directing them to their renewal microsite for complete renewal information. Full renewal printed packets will only be mailed to groups if these sites are not visited on or before May 15, 2020.
• Group renewal packets include an options census for quick quotes that display the current and renewing rates, along with several plan options with the new 2020 rates. This options census includes Trio HMO and Tandem PPO plans comparable to a group’s current Access+ HMO® or Full PPO plan selections.
• Visit the Renewal Center for broker resources and more information.

Shield Concierge

• Shield Concierge is available to members who enroll or renew into a Tandem PPO plan on or after July 1, 2020

Healthy Savings

• Available to Trio HMO and Tandem PPO members at no additional cost, Healthy Savings provides up to $50 of savings each week on purchases at retail stores like Walmart, Albertsons, Safeway, Ralphs, and more.

Special Enrollment Period

• Employer groups may enroll new members through a Special Enrollment Period (SEP) through June 30, 2020, with July 1 as the latest effective date. This SEP is for employees who previously declined coverage for themselves or their dependents and applies to medical, dental, and vision plans.
• For May 1, June 1, and July 1 effective dates, enrollment requests must be received on or before the 1st of the month for which enrollment is being requested.

New Business Submission Deadlines

• New business submission deadlines are now up to the last business day of the effective month for April through July effective dates.
• Download the new Master Group Application (MGA).

Reminders

• Relaxed participation requirements for small businesses extended to December 31, 2020.
• Trio HMO plans – enroll as few as one member.

Blue Shield Broker Resources

• COVID-19 Resources
• Product Cycle Updates
• Employer Connection Plus (EC+)
• Broker Communications
• Blue Shield News Center
• Plan Comparison Tool
• Small Business Plan Documents
• Mandates
• Renewal Center
• Forms and Applications

Additional Resources

• 2020 Small Business Plans at a Glance
• Q2-2020 Small Business Sales Brochure
• 2020 Medical Plan Cheat Sheet
• Specialty Plan Quick Facts
• Trio HMO Flyer and Website
• Tandem PPO Flyer
• Teladoc Brochure
• Pharmacy Directory
• Specialty Drug Short Cycle Program Expansion RxNews Flash
• Blue Shield Small Group Underwriting Guidelines
• Relaxed Participation Extended to December 31, 2020.
• New Small Business Multiple Subscriber Change Spreadsheet form for subscriber-level plan changes during renewal.
• Master Group Application Form
• Updated Employee Enrollment Form
• Blue Shield’s Renewal Center will help streamline the renewal process. You can:
  • Complete your renewals, 100% paperless.
  • Compare/add/edit/delete subscribers and dependents to calculate quotes.
  • Submit group renewals and enroll clients’ employees online.

Visit Blue Shield’s Broker Connection to learn more.

Questions?
Contact the small group experts at 800.696.4543 or info@claremontcompanies.com.

Member Options for Accessing Care

As the Coronavirus continues to advance, many employees are left feeling nervous and anxious. To help quell growing fears and cope with uncertainty about the Coronavirus, employers should educate employees on prevention and symptoms, and make them aware of the many options for accessing care through their health plan.

Both Blue Shield and UnitedHealthcare provide helpful resources that outline the options for accessing care.

Blue Shield members can access care through urgent care centers, Heal, Teladoc, virtual visits, NurseHelp, CVS MinuteClinic, and more.

So Many Options for Care
A guide on how to access the many different care options and the cost implications for PPO and HMO members.

Heal On-Demand Physicians
A service that lets you see a doctor at a time and place that’s best for you. Schedule visits from 8 am – 8 pm, 365 days a year. A medical assistant travels with the physician on these visits.

• Primary, preventive, or urgent care services are available.
• Heal physicians are all contracted in the Blue Shield PPO network.
• The Heal co-pay matches a traditional office visit.
• Phone, online, and Heal app access for appointment scheduling.
• Available to Blue Shield PPO members with coverage through Covered California as well as direct.
• Remote house calls for COVID-19 by phone or video.

Teladoc
Embedded in all small group plans, Teledoc provides convenient physician visits via phone or video conference. The changes below are effective January 1, 2020:

• Copay change to $0 on all Tandem PPO and Trio HMO Plans On/Off Exchange.
• The standard copay for all other PPO/HMO, non-PSP plans, On/Off Exchange will remain at $5.
• The copay for all PSP plans will increase from $40 to $45 until the deductible is met; after the deductible is met, the copay is $5.
• How-to Video on how to use the mobile app to talk to a doctor.

Member Coronavirus Resources
The latest COVID-19 updates, help with COVID-19 coverage, telehealth options, emotional health, and more.

Heal
Provides on-demand doctor house calls from 8 am to 8 pm, 7 days a week. Book a house call with a licensed, vetted doctor. In-network with CA PPO Select Plus and Core members. Only available in select cities, visit heal.com for more details.

Telehealth Options

• Telehealth visits through UnitedHealthcare’s preferred telehealth partners including Teledoc®, Doctor On Demand™, and AmWell®.
• Telehealth visits through the member’s local providers.
• UnitedHealthcare is waiving cost-sharing for:
  – COVID-19 telehealth test-related visits and treatment.
  – Until June 18, 2020 – 24/7 Virtual Visits with preferred telehealth providers Teladoc®, Doctor On Demand™, and AmWell®.
  – Until June 18, 2020 – in-network, non-COVID-19 telehealth visits.

Emotional Health Support

UnitedHealthcare’s free 24/7 emotional support line is available to anyone, not just members, to call any time at 866-342-6892. This Optum Help Line is staffed by professionally trained mental health experts. It is free of charge and open to anyone.

Sanvello, a free on-demand emotional support mobile app, is available to help members cope with stress, anxiety, and depression during the COVID-19 pandemic.

Questions?
Contact the small group experts at 800.696.4543 or info@claremontcompanies.com.

Get The Latest News with Text Messaging!

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.

Sign Up for Text Messaging

Heal: Physician Home Visits Through Blue Shield and UnitedHealthcare

The Coronavirus health concern is resulting in more employees and their dependents staying home, either for work or as a health precaution. Now is a good time for employers with a qualifying Blue Shield or UnitedHealthcare plan to remind employees of the availability of physician home visits through Heal.

Heal lets members see a doctor at a time and place that’s suitable for them. Using the Heal app, members can schedule a licensed pediatrician, internal medicine doctor, family practitioner or general practitioner to come to them on their schedule.

Heal is available to members enrolled in qualifying plans in certain geographical areas. To learn more, download the Blue Shield and UnitedHealthcare product brochures.

Questions?
Contact the small group experts at 800.696.4543 or info@claremontcompanies.com.

Zero Cost-Sharing Coronavirus Screening and Testing

Late last week California regulators issued guidance requiring all commercial health plans to provide coverage for medically necessary Covid-19 screening and testing at zero cost-sharing.

All major California carriers have since announced their zero cost-sharing coronavirus policy. Get the details.

Get The Details

Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.

Reliance Standard Voluntary Benefits Insights

Designing benefits plans to help workers manage and maintain their health and finances — and thus remain engaged and productive at work — is a top priority for companies around the globe.

Employers understand that their benefits can be instrumental in shaping the type of organization they are and the way their employees — and their peers — perceive them.

The challenge of providing benefits that satisfy everyone is leading employers to reassess their benefits packages to provide greater benefits choice and flexibility to meet a growing and broader range of needs. The good news – technology advances are reducing some of the roadblocks associated with providing greater choice with the emergence of flexible and streamlined administration platforms that enable a more efficient and customized benefits delivery approach.

Challenges

According to the Willis Towers Watson 2019/2020 Benefit Trends survey, the key challenges facing employers are:

• The rising cost of employee benefits is cited as a key concern by 79% of employers in North America. As health insurance premiums see more price hikes, traditional health coverage no longer provides a financial shield against a health crisis.
• The differing wants and needs of a multi-generational workforce is the second key challenge, with over half of employers citing this as a critical problem.
• Communication with employees around benefit choices is an issue for 52% of employers.
• Lack of employee engagement with benefit programs is a core challenge for 45% of employers.

Opportunities

Employers plan to add more voluntary benefits. 

• 42% of employers offer voluntary income protection benefits, such as accident and critical illness.*
• 69% of employers plan to offer more voluntary benefits over the next three to five years.*

For brokers, this means there’s a great opportunity to win more sales. These benefits can be essential to employee recruitment and retention plans, especially with today’s record-low unemployment numbers.

Employees are seeking better choices.

• 79% of employers are broadening or enhancing their benefits portfolio.*
• Employee choice is driven by voluntary benefits, choice in benefit levels and flexible benefits.
• Tools that support benefit choices and help make informed decisions are being used to drive employee engagement and support benefits decisions for 60% of employers.*

To mitigate the bad news of rising healthcare costs during enrollment and offer the financial protection employees desire, offer them the choice of voluntary benefits.

More interest expected from younger workers.
As millennials and generation Z employees try to protect their assets, there’s an increased interest in voluntary benefits. When explaining the value of voluntary benefits to these savvy consumers, show them how they can offer a financial shield and cite examples that are relevant to their lifestyles.

Solutions for multi-generational workplaces.
Today’s workplaces can include up to five generations. From the silent generation (born in 1945 or earlier) to Generation Z (born in 1995 and after). Addressing the diverse wants and needs of today’s multi-generational workforce is a top challenge worldwide. Voluntary benefits can be the solution that addresses the needs of all generations, protecting wealth at any stage of life.

If benefits packages are to meet the individual needs of today’s multi-generational workforce, employers need to protect core benefits while offering flexibility and choice. Today’s employment deal will need to evolve to encompass a broader range of employee benefits, including voluntary as well as workplace perks. Download the flyer for details.

To learn more about Reliance Standard’s integrated and flexible group voluntary benefits and services, check out their microsite. For articles on topics such as “Growth Opportunities in The Voluntary Insurance Market” and “Why Small Businesses Should Offer Voluntary Benefits,” visit the Reliance Standard Knowledge Center.

To meet your business goals, contact us for a customized Reliance Standard quote today!

Questions?
Contact the small group experts at 800.696.4543 or info@claremontcompanies.com.

*Willis Towers Watson’s 2019/2020 Benefit Trends survey.

Beam – A Unique Approach to Dental Benefits

Valued by both employers and employees, Beam Dental offers:

• All members a complimentary smart toothbrush, toothpaste, dental floss, and the Beam app through Beam Perks.
• Easy dental benefits management for employers through the Beam Lighthouse technology platform.
• Employer savings of up to 15% at renewal, with member dental hygiene, through SmartPremiums.
• A Member Portal to view plan information, print insurance cards, view claims data, and more.
• The Beam App for members to view their insurance card, find a dentist, control brush settings, etc.
• Quality vision coverage through VSP, with frame allowance options up to $250.

Plan Options

Beam offers a range of plan options designed to fit the needs of every employer, including:

• Smart: 100/80/50 plan: Endo-perio-oral is surgery covered under Major.
• Plus: 100/80/50. Endo-perio-oral surgery is covered under Basic. Adult/child ortho options come with a $1,500 lifetime max.
• Select: 100/90/60/50. Up to $2000 annual maximum. Adult/child ortho options are available with a $2,000 lifetime maximum.
• Ultra: 100/100/80/50. Up to a $5,000 annual maximum. Adult/child ortho is available with a $2,000 lifetime maximum. (Available to groups with 10+ enrolled eligible employees.)

Plan Highlights

• 90th UCR Out-of-Network (OON) standard, upgradeable to 95th UCR.
• Dental and vision bundles with VSP.
• Large Max and Unlimited Ultra plans available.
• No downgrades on composites.
• Available for 2+ enrolled eligible employees.
• Rate cap or 2-year guarantee available on request.
• Child Ortho at 5+ with 5 enrolling (standard plans) or 10+ for custom plans.

Standard Provisions

• Annual open enrollment.
• No waiting periods unless requested.
• No missing tooth clause.
• Implants are covered.
• Occlusal (night) guards.
• 90th, 95th, MAC options for OON.
• Composites on posterior teeth covered on all dental plans, porcelain material covered on posterior teeth with no downgrades.
• Standard 12- month rate lock.

Network

• A nationwide industry-leading network with 325,000+ access points, comparable to most major dental carriers.
• Participates in the top nationwide networks such as First Dental Health, DenteMax, Stratose, and Plusnetwork.
• Provider reports are available upon request.
• 90th percentile UCR OON standard. 95th percentile UCR OON available as an option.
• Learn more about the network.

Quality Vision Coverage Available Through VSP Vision Care

• VSP Choice Network and plans.
• $150, $175, $200, $250 frame allowance options.
• Available for 2+ eligible enrolled employees if bundled with dental.
• Beam handles enrollment, billing, and ongoing account management. VSP handles claims and support.
• 24-month rate lock.

Beam Perks

Every Beam member receives complimentary Beam Perks. The member welcome kit contains a sonic-powered, smart, electronic toothbrush, custom formulated toothpaste, dental floss, and access to the Beam App and Member Portal.

• Delivered every 6 months, enrolled members in every plan receive a Beam Perks kit that includes replacement heads and batteries, toothpaste, and dental floss.
• Beam’s smart toothbrushes sync with the Beam Dental App scoring dental hygiene to help lower the group’s pricing at renewal.

SmartPremiums

Beam’s SmartPremiums help groups save up to 15% at renewal. When members use the Beam Brush, the group earns a Beam score. The better the group’s Beam score, the lower the group’s premium at renewal.

Premium reduction occurs at renewal (plan year or calendar year) and is based on the group’s aggregate Beam score, prior year claims data analysis, and changes in dentist reimbursement contracts.

Start quoting Beam today and take advantage of the features, benefits, and savings!

Questions?
Contact our small group experts at 800.696.4543 or info@claremontcompanies.com.

Are You Capitalizing on The Health Care Tax Credit?

Cost concerns continue to be one of the top health care challenges for small businesses.

Address employers’ cost concerns with the Health Care Tax Credit, which provides employer savings of up to 50% on health care premiums for up to two years. Maximize your clients’ savings by moving to them into a Covered California for Small Business plan this year.

Start by estimating the amount of tax credit your clients can realize. Then use our simple turnkey Health Care Tax Credit Solution to ensure your clients get the most for their health care dollars.

Results We’ve Seen So Far:

• 75% qualified for the tax credit.
• Nearly 25% of those purchased coverage after reviewing the tax credit report.
• $5,800 was the average credit received.

Bring the Tax Credit value to your clients.

Partner with Claremont for:

• Help understanding employers’ needs to deliver the right benefits solutions.
• Assistance with small group sales, enrollments, and renewals.
• Actionable solutions and practical tips, such as:
  – Advantages for Agents and Employers
  – Agent Resources
  – Health Care Tax Credit Solution
  – Top 20 Lowest Cost Medical Plans
• Expertise and support behind the scenes — all at no cost to you.

Claremont has been a trusted CCSB partner since its 2014 launch, and we are the top producing general agency in our sales territory. From agent certification and quoting to assessing new group eligibility and resolving post-enrollment issues, our CCSB experts will provide guidance and support every step of the way.

Questions?
Contact the CCSB small group experts at 800.696.4543 or info@claremontcompanies.com.

MetLife Simply Smart Bundles

Easily design and offer multi-product Simply Smart℠ Bundles based on your clients’ needs and local market demands.

Groups with 10-99 employees that offer Dental coverage and add Vision, Life, Disability or MetLaw® can benefit from these exclusive value-adds:

• Dental Rate Certainty. Choose a 2-year rate guarantee or a 6%/6% year one and two rate cap.
• Multi-Year Rate Guarantees. 3-year rate guarantees on Life, Disability and Vision available.
• Guaranteed Issue. Up to $100,000 offered on Supplemental Life insurance.
• Access to MetLaw. Convenient, full-service access to attorneys at a competitive monthly rate. No minimum participation requirements.
• Multi-Product Advantage*. Qualifying bundles of 3+ products earn additional one-time broker compensation.
• Simple Case Set-Up. Web-based implementation featuring pre-populated data, consolidated forms, and e-signatures.
• Employee Participation Drivers. Easy-to-share links to educational videos to help drive employee engagement.

To learn more, visit the MetLife Simply Smart℠ Bundles web page.

Questions?
Contact the small group experts at 800.696.4543 or info@claremontcompanies.com.

^*Excludes business written through PEOs, trust, private or public exchanges or associations where there is one master contract and MetLife does not underwrite at the employer level. MetLife will annualize the premium eligible for payment based upon the generation of the first three bills. Additional broker compensation for customers sold through a General Agent or Third Party Administrator is payable to the Broker only.