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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.
For assistance, please contact our Quotes team at quotes@claremontcompanies.com or 800.696.4543.
Login To PrismArticle last updated: March 19, 2024.
Most of your clients likely have upcoming deadlines under the federal prescription drug benefits reporting (RxDC) requirements. Here’s a summary of the requirements, how carriers are helping, and the deadlines.
Under Section 204 of the 2021 Consolidated Appropriations Act (CAA), insurance companies and employer-based health plans must submit information regarding prescription drug benefits and health care spending. The information must be submitted to the Centers for Medicare and Medicaid Services (CMS) by June 1st of each year for the prior year’s coverage.
According to the CMS, the information that is required to be submitted by insurance companies and employers are:
Blue Shield will collect D1 Premium information from groups between February 5, 2024 and April 19, 2024. Blue Shield will also submit D2 for all groups and D3-D8 for groups with prescription drug benefits under a Blue Shield health benefit plan, and P2 accordingly. If a group does not have prescription drug benefits with Blue Shield, they should coordinate submission of D3-D8 with their pharmacy/prescription drug benefits carrier, and P2 accordingly.
Key Details
Other Details:
Information Requested
Due to technical issues on their end and updated guidance from CMS about the 2024 submission, below are revised dates:
UnitedHealthcare will complete the CAA Prescription Drug (RxDC) reporting for its fully insured and self-funded/level funded groups, including those with OptumRx as the integrated PBM. However, groups with these will need to complete the Request for Information (RFI) tool for RxDC reporting between February 1, 2024, and March 31, 2024. The March 31, 2024, deadline is firm.
To support its customers with this important filing, UnitedHealthcare will be submitting the P2 (Group Health Plan), D1 (Premium and Life Years) and D2 (Spending by Category) files for all employers who had active coverage during the reference year (2023). However, completion of the submission requires gathering some information not currently maintained in their system.
UnitedHealthcare will also submit the D3-D8 data files for customers with OptumRx as an integrated PBM. UnitedHealthcare has access to all data required to complete the submission of the D3-D8 data files. Customers who use any other PBM, including OptumRx Direct, must work with that PBM to submit the D3-D8 files.
Resources
Kaiser Permanente is required to submit information on prescription drugs and healthcare spending to CMS. On February 1, 2024 Kaiser Permanente began to send out a survey form from Kaiser-Permanente-RxDC@kp.org to all contract signers to request this information. The form must be completed by March 15, 2024.
Information Requested
Kaiser Permanente plans to submit all applicable reports and required responses for all employer groups to CMS by the June 1, 2024 deadline.
Employer groups must submit information to Sutter Health Plus regarding the average monthly premiums paid on behalf of enrollees and the amount paid by enrollees each year.
For calendar year 2023 reporting, employers or brokers are to submit the required information through the online Premium Reporting Form.
Submissions are due no later than March 1, 2024.
Cigna is reporting on behalf of Cigna + Oscar groups, so no action is required by employer groups or brokers.
Covered California for Small Business (CCSB) serves as an administrator of their participating Health Plan Issuers and is not an insurance company nor an employer-based health plan. Therefore, CCSB is not subject to RxDC data collection requirements on behalf of their employer groups. Claremont recommends that the employer follow the reporting guidelines for the enrolled carrier(s).
CCSB Resources – CCSB’s Small Business Service Center is available to help with questions at 855.777.6782.
CaliforniaChoice serves as an administrator of their participating Health Plan Issuers and is not an insurance company nor an employer-based health plan. Therefore, CaliforniaChoice is not subject to RxDC data collection requirements on behalf of their employer groups. Claremont recommends that the employer follow the reporting guidelines for the enrolled carrier(s).
The carriers are taking action to support your clients with the federal reporting requirements. In order to do so, they require information from each employer group. Look out for emails directly from the carriers, and follow their instructions. If you or your clients have questions, we can help direct you to the right contacts at the carriers.
Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.
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Earn additional compensation for selling and retaining eligible groups of 2-99 lives by enrolling in Delta Dental’s Small Business Broker Rewards Program at ddsbrewards.com.
Retain at least 92% of your book of business through 2024 and meet a new sales reward level. If you do both, you’ll earn a bonus for each. If you’re new to Delta Dental, your new sales alone will qualify.
Once you’ve met your retention goal, there are three levels of sales rewards. New sales bonuses are based on the number of new groups or total new premium received for effective dates in 2024. As you sell more and retain your existing business with Delta Dental, your rewards grow. And this program is in addition to your existing standard small business commission.
Sign up for the rewards program and access the small business broker rewards dashboard to easily track your reward earnings. Brokers who have joined in previous years just need to log in to be eligible for additional compensation in 2024. To learn more, download the flyer.
Delta Dental Broker Rewards Program
Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.
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We’re proud to sponsor the CAHIP-GG Symposium focusing on “Transforming Organizations and Culture.” This year’s event combines insightful presentations, invaluable continuing education opportunities, and vendor showcases.
Don’t miss this opportunity to meet the Claremont team in-person at our exhibition booth. To learn more, visit cahip-gg.org or contact CAHIP-GG at 800.488.2506, nathan@camgmt.com or info@ggahu.org. Register today.
Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.
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Earn more in 2024 with Humana’s broker bonus programs.
Intended for specialty lines of coverage of all sizes, the Humana 2024 Group Benefits Growth Bonus (formerly known as the Specialty Growth Bonus) is paid once annually, within 60 days after the January 31, 2025 program end date.
Bonus Program Highlights
Eligible Products
The 2024 Group Benefits Growth Bonus qualifications remain the same as the 2023 Specialty Growth Bonus. To learn more, download the Group Benefits Bonus flyer.
Sell a Bundle, Earn a Bundle! To earn a bonus, sell a new Humana dental line of coverage with at least one additional Group Benefits line of coverage with the same employer group with an initial effective date of coverage between April 1 and September 1, 2024.
Group Benefits Lines of Coverage
To learn more, download the Dental Bundling Bonus flyer.
Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.
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Effective January 1, 2024, and announced last year, Blue Shield of California transitioned its vision plan administration from MES to EyeMed following EyeMed’s 2020 acquisition of MES. This change was seamless for members, who were automatically moved to EyeMed’s network regardless of renewal date.
With EyeMed, members have the same vision benefits and access to an extensive network of independent eyecare professionals, popular retail chains like LensCrafters and Target Optical, plus online options. Check out the Blue Shield FAQs and Blue Shield Access Vision Network flyer for details on accessing EyeMed’s exceptional vision care and products.
Questions?
Contact The Answer 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.
With a focus on market expansion and stronger customer relations, Claremont has promoted Nicole Allyn to Director of Sales. Nicole is responsible for leading Claremont’s strategic approach, driving growth, and shaping the company’s sales direction. Nicole joined our team in 2020 as a Regional Sales Manager.
A collaborative and team-focused manager who leads by example, Nicole excels at building strong partnerships with her team, brokers, and carrier partners. She is skilled at developing sales strategies and providing top-notch service and solutions to clients. Nicole derives great satisfaction in helping her team and partners succeed.
Outside of work, Nicole is a devoted mother to her teenage son, Joey. In her free time, she enjoys staying active by lifting weights and pursuing creative outlets like playing guitar and singing. We are thrilled to have Nicole step into this new role and look forward to her continued contributions.
You can reach Nicole at nicole@claremontcompanies.com or 925.296.8818.
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Starting January 1, 2024, MetLife is expanding access to teledentistry by partnering with industry leader Virtual Dental Care. This collaboration gives MetLife PPO members on-demand 24/7 access, including emergency care, to licensed dentists through a video call.
Whether it’s an urgent issue like dental pain or swelling, or just a quick question, Virtual Dental Care’s extensive network of dentists is available anytime, anywhere. Dentists can even prescribe medications and refer to local in-network providers for follow-up care.
Help your groups stay competitive in today’s tight labor market by offering the forward-thinking dental benefits of MetLife and Virtual Dental Care. This powerful combination brings leading-edge teledentistry to your clients’ workforce helping them get ahead of dental problems before they escalate. Learn more.
Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.
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The IRS is increasing enforcement, actively pursuing non-compliant Applicable Large Employers (ALEs) with 50+ full time equivalent employees (FTEs). ALEs are required to furnish Form 1095-C to employees by March 4, 2024, and file Form 1094-C with the IRS by February 28, 2024 (April 1, 2024, if filing electronically).
Attend this webinar for an overview of the ACA requirements and deadlines, and get a demonstration of BASIC’s ACA Elevate filing solution that will handle ACA compliance and help your clients avoid penalties.
This webinar is not eligible for CE credits. Reserve your spot today!
Presenter: Chris Eckert, Vice President of Sales
Chris has been with BASIC for over 18 years, with proven success in helping employers find cost-effective, value-driven solutions for HR Benefits, Compliance, Payroll, and Leave Management. He’s dedicated to providing thorough, professional, and personalized customer service with integrity. Chris consistently goes above and beyond for his clients by finding the BASIC service that satisfies their toughest HR challenges while meeting all their must-haves.
To learn more, check out the BASIC website and contact us at 800.696.4543 or info@claremontcompanies.com for assistance when you’re ready to enroll a group in a BASIC plan.
Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.
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Taking advantage of pre-tax benefit plans through a Flexible Spending Account (FSA), Health Reimbursement Arrangement (HRA), or Health Savings Account (HSA) allows your clients to stretch their benefits budget. With access to tax-free funds for qualified medical expenses, these accounts provide a strategic way to maximize savings and better manage healthcare costs. To ensure your clients make the most of their new accounts, here are tips to keep in mind, and reminders of valuable resources from BRI.
Accessing Funds
Checking Your Balance
View the BRI infographic for details.
Know What Expenses Are Eligible
Please review the Plan Highlights to confirm what expenses or expense types are permitted under the plan.
Understanding Your Accounts
Maximize Savings
To learn more, check out the BRI FAQs. These tips and resources will ensure your clients are well informed and prepared to make the most out of their pre-tax benefit plans.
Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.
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Blue Shield of California remains committed to providing your small group clients with comprehensive benefits that prioritize the well-being of employees. Here’s a summary of the changes for the second quarter of 2024.
Brokers can earn points for every new Tandem and Virtual Blue PPO membership.
The 10% specialty discount is a perpetual program that is applied when a dental and/or vision plan is added to a new or existing small business medical group.
Questions?
Contact The Answer 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.