Archive for the ‘CaliforniaChoice’ Category

CaliforniaChoice – Offer Your Clients Choices and Cost Control

With CaliforniaChoice, your small groups get more choices and ways to control costs including:

• Nine health plans in one program.
  
• Groups can offer all metal tiers with Total Choice.
• Cost control with defined contributions:
  – Fixed dollar amount, or
  – Fixed percentage of premium.
• Greater access to doctors, specialists, and hospitals.
• Optional benefits including dental, vision, life, chiropractic, and acupuncture.
• Single source administration for enrollment, billing, eligibility, and customer service.
• Smart Decision Technology: online provider and Rx directories, plan comparison tool, and online enrollment.
• Business Solutions Suite: no cost Premium Only Plans (POP), COBRA, HR, and Flexible Spending Accounts (FSAs).
• Member Value Suite: includes employee wellness and Cal Perks discount program.
• Payroll Solutions: payroll/HRIS, 401k integration, general ledger reporting, and workers’ compensation integration.

Download the CaliforniaChoice Program Highlights and Q4-2021 Employer Program Guide for details.

CaliforniaChoice Program Highlights

Q4-2021 Employer Program Guide

Start quoting CaliforniaChoice today!

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

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CaliforniaChoice Q4-2021 Updates

To help you prepare for Q4-2021, below are the CaliforniaChoice updates.

Q4-2021 Rates

• Medical rates for October – December 2021 effective dates are available through PRISM, our free and easy online quoting system.
• Kaiser Permanente, Oscar, UnitedHealthcare, and Western Health Advantage will have rate passes.
• Anthem Blue Cross, Health Net, and Sharp Health Plan rates increased while Sutter Health Plus rates decreased.

Medical Zip Codes

• Sutter Health Plus added seven zip codes.
• Western Health Advantage added 25 zip codes for Humboldt County.

Additional Updates

• Mammoth HR is now Mineral™.
• Landmark added new rates.
• Updated Q4-2021 forms and materials will be available soon.

Start quoting CaliforniaChoice today!

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

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CaliforniaChoice July 2021 Updates

Below are the CaliforniaChoice benefit changes effective July 1, 2021:

Updates

UnitedHealthcare Silver HMO G

• Durable Medical Equipment $50 copay (deductible waived) is updated to 70% (deductible now applies).
• Hospice 100% (deductible waived) is updated to 70% (deductible now applies).
• The above updates have been reflected in the Benefit Summaries and Member Enrollment Guide July 1, 2021 – September 1, 2021, Rev. 6/8/21.

Anthem Blue Cross

• Benefit changes for the Gold PPO E, Silver PPO C, and Bronze PPO A and PPO B plans were inadvertently omitted from the Summary of Changes section of the Exciting News and Summary of Changes document.
• The above changes have been added to pages 13-16 of the Exciting News and Summary of Changes, Groups Renewing July 1 – September 1, 2021, Rev. 5/7/21.

Forms and Documents

• Updated materials are available on calchoice.com.

Note: the above changes do not affect the initial or enrollment quote, renewal quote, or employee renewal enrollment worksheet. This information will also be sent to all July through August 2021 new and renewing groups.

Start quoting CaliforniaChoice today!

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

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CaliforniaChoice & ChoiceBuilder Agent Agreement Amendment

CHOICE Administrators has amended the CaliforniaChoice and ChoiceBuilder Agent Agreement. The revisions are listed below.

Agent Agreement Revisions

• Six Month Commission Consideration Eliminated
  When a group chooses a new broker during the first six months following the original sold effective date, the new broker shall begin receiving commissions the first of the following month, consistent with the new Broker of Record (BOR) effective date.
• 14 Day Rescission Period Eliminated
  Upon being awarded a BOR on an existing CaliforniaChoice group, brokers will now have immediate access to the group’s policy and plan information beginning on the date for which the BOR request is processed, eliminating the 14-day rescission period.
• New Commission Payment Methods
  Brokers will be required to receive commissions via direct deposit or a new pre-paid debit card.

To avoid any commission payment interruptions, please sign and return the Agent Agreement Amendment as soon as possible to commissions@calchoice.com or fax it to 714.908.3519.

Agent Agreement Amendment

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

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CaliforniaChoice & ChoiceBuilder ARPA COBRA Premium Subsidy Updates

CHOICE Administrators has provided updated COBRA (Federal) and Cal-COBRA premium subsidy information regarding The American Rescue Plan Act of 2021 (ARPA).

Updates and Notice of AEI Form:

• CHOICE Administrators ARPA COBRA Subsidy FAQs
• CaliforniaChoice ARPA COBRA and Cal-COBRA Information
• CaliforniaChoice Notice of Assistance Eligible Individuals (AEI) Form
• ChoiceBuilder ARPA COBRA and Cal-COBRA Information
• Department of Labor FAQs and Model Notices

Your groups should review the updates and submit the completed Notice of AEI Form (for those who opted into the COBRA Subsidy) by June 14, 2021 to COBRA-APRA@calchoice.com or fax it to 714.908.3549.

Additional information will be provided when it becomes available.

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

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CaliforniaChoice – Cigna + Oscar Addition, Q3-2021 Updates, & ChoiceBuilder Rate Pass

CaliforniaChoice is adding Cigna + Oscar to their portfolio effective July 1, 2021. See below for more information plus other Q3 updates and the ChoiceBuilder rate pass.

Cigna + Oscar Addition

Cigna + Oscar is included in the portfolio effective July 1, 2021. Eight plans from the LocalPlus network are available. Learn more.

Other Q3-2021 Updates

Medical Plans/Networks – Effective July 1, 2021

• UnitedHealthcare is adding the Harmony network with seven new HMO plans across three metal tiers.

Medical Rates

• New rates for Anthem Blue Cross, Cigna + Oscar, Health Net, Kaiser Permanente, Oscar, and Unitedhealthcare.

Medical Zip Codes

• Cigna + Oscar has added zip codes for the LocalPlus network.
• UnitedHealthcare has added zip codes for the Harmony network.

Administrative

• Two new HSA contribution scenarios:
  • Employer pays a percentage based on the least costly HMO/EPO and specified metal tier.
  • Employer pays a percentage based on the least costly PPO and specified metal tier.

Forms and Materials

• Updated employer and employee forms and materials for July 1, 2021 effective dates have been posted to the CaliforniaChoice website.
• Only updated applications for July 1, 2021 will be accepted due to the CaliforniaChoice portfolio changes.

Download the Summary of Changes to learn more.

CaliforniaChoice Summary of Changes

ChoiceBuilder Q3-2021 Rate Pass

All carriers and plans will have rate passes for July 1, 2021 through September 1, 2021 effective dates.

Start quoting CaliforniaChoice and ChoiceBuilder today!

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

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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.

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CaliforniaChoice Webinar: What’s New for July 2021

Attend the webinar on Wednesday, April 14th at 11:00 am, to learn more about the benefits of CaliforniaChoice, and be among the first to find out about their expanding portfolio and program updates for July 2021.

CaliforniaChoice is a private exchange employee benefits program specializing in saving small businesses on 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.

Register for the CaliforniaChoice webinar on Wednesday, April 14th at 11:00 am PDT.

Register Now!

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

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CaliforniaChoice Launches Redesigned Website

America’s largest multi-carrier private health exchange for small business has launched its redesigned website. This is a key milestone in CaliforniaChoice’s digitization strategy, which seeks to improve processes, including enrollment and renewals.

The new calchoice.com site features a customized experience for brokers, employers, and members, streamlined functionality, and a more modern design. Additionally, the new site simplifies access to key information and resources, and increases the ability for customers to manage their benefits online.

Brokers can:

• Review your book of business.
• Quote and enroll clients.
• Download forms and documents.

Employers can:

• Manage employee benefits.
• Pay invoices.
• Create a new hire quote.

Employees can:

• Review their benefits.
• Search for doctors and hospitals.
• Look up prescriptions.

Check out the new calchoice.com site and view this video to learn more.

Start quoting CaliforniaChoice today!

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

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CaliforniaChoice – Kaiser Permanente COVID-19 Pediatric Dental Premium Credit

To provide some financial relief and help support groups during this challenging time, CaliforniaChoice, on behalf of Delta Dental of California, has elected to credit a portion of a group’s September 2020 Kaiser Permanente premium for their pediatric dental coverage.

This one-time credit for all eligible members enrolled on Kaiser Permanente plans during the month of September 2020 will be applied to an eligible group’s March 2021 invoice. The credit is part of Delta Dental of California’s COVID-19 related premium forgiveness program.

How The Pediatric Dental Credit Works

• The dental premium credit will be applied against the March 2021 billed premiums for September enrollments submitted as of September 30, 2020. The September premium credit will show on the qualified group’s March 2021 invoice with a change code of “CO” indicating a correction in premium for this one-time credit.
• This is a one-time credit. No retroactive credits will be reflected on future invoices. For example: If a new subscriber or member is added after September 30, 2020 for an effective date of September 1, 2020, a credit will not be provided for that subscriber or member for the month of September 2020.
• COBRA enrollees who are eligible for the dental premium credit will be notified by mail.
• If an employee contributes to their Kaiser Permanente plan premiums, the group may have a legal responsibility to notify the eligible member about this credit and to refund part of the employee’s contribution. It is the employer’s responsibility to address employee notification and refund requirements.

Delta Dental of California has also included terminated groups that have paid their Kaiser Permanente September 2020 premium in their COVID-19 premium forgiveness program. A check reflecting the one-time credit will be sent directly to the eligible groups.

CaliforniaChoice will send the following information to affected groups:

• Active Group Notice
• Terminated Group Notice

The premium credit will not affect broker commissions.

Start quoting CaliforniaChoice today!

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

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CaliforniaChoice April 2021 Updates

To help you prepare for Q2-2021, below are the CaliforniaChoice updates.

Medical Rates

Changes for Health Net, Sharp Health Plan, UnitedHealthcare, and Western Health Advantage:

• The updated rate guide will be available soon.
• Q2-2021 new business quoting is scheduled for mid-January 2021.

Medical Zip Codes

The Western Health Advantage full network has added 3 zip codes in Marin and Sacramento Counties.

• 94952 in Marin County, Region 2
• 95678 in Sacramento County, Region 3.
• 95887 in Sacramento County, Region 3.

Ancillary Plans

• MetLife has added two new DHMO plans effective April 1, 2021:
  • MET100 and MET185 can be offered as employer-sponsored or voluntary and include the MetLife Dental HMO/Managed Care Network.
• The SmileSaver logo has changed to the MetLife logo.
• The attached documents; “MetLife DHMO 3-Tier-Final Rates” and “Source Doc (MetLife) Dental Solution Quote Page,” provide a look at the benefits and rates with more details on the new plans once released.

Ancillary Zip Codes

For MetLife, all California counties are covered.

Forms and Materials

Employer and employee applications and change request forms have been revised as a result of the new MetLife plans being added.

• The revised applications and change forms will be accepted beginning with the April 1, 2021 effective date.
• No write-in or alterations to the prior version of the forms will be accepted.
• Once April 1, 2021 quoting is available, updated materials and additional forms will be made available by CaliforniaChoice.
• Currently, only the employer and employee applications and change request forms are available.

Start quoting CaliforniaChoice today!

Questions?
Contact your Claremont team 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.

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