Special Annual Open Enrollment

There is an Special Open Enrollment Period from 11.15 to 12.15 every year where a Small Group can enroll without meeting participation or contribution requirements. “Final Rule” (2.27.2013 13416 Federal Register Vol 78 gpo.gov

The  Prohibition of  Management Carve Out Section 2716 Health Care Reform – while not presently enforced, requires that you must treat all employees the same,  and must still offer insurance to all employees…  I don’t think this provision is that big a deal, as at renewal, you MUST meet the participation & contribution rules!

Although carriers must lower their contribution requirements, the Affordable Care Act still mandates that Applicable Large Employers (ALEs) with 50 or more full-time plus full-time equivalent employees must offer affordable coverage that meets minimum value in order to avoid a §4980H(b) employer penalty.

Email us for more information

Insurance Carriers Rules & deadlines 

Email us [email protected] to verify the latest rules

 

Health Plan

Special Open Enrollment Guidelines

Aetna

  • Must be the sole carrier confirmed by an attestation form
  • Groups must be complete at submission with all requirements in by 12/15. No exceptions for missing items
  • Recertification at renewal: Yes, to ensure group meets the definition of a small employer
Blue Cross – Anthem

  • Must be the sole carrier
  • Groups must be complete at submission with all requirements in by 12/15. No exceptions for missing items
  • Recertification at renewal: No; Special Open Enrollment Window groups will not be targeted for a participation audit, however they could be recertified at random
Blue Shield

Blue Shield Info through 3.31.2016

  • Does not require to be the sole carrier
  • Case must be approved within 30 days of submission or it will be withdrawn
  • Recertification at renewal: Yes, groups will need to meet minimum participation requirements upon renewal
California Choice – A Private Exchange

  • Must be the sole carrier
  • Case must be approved by: 12/31
  • Contingent approvals will not be allowed
  • Recertification at renewal: carrier discretion
Health Net

  • Does not require to be the sole carrier
  • Cases must be received by Health Net by 5:00 pm on 12/15
  • Case must be approved by: 1/20
  • Recertification at renewal: carrier discretion
Kaiser Permanente – New Enrollment

Kaiser – Very General Info

 
United Health Plan

  • Does not require to be the sole carrier with staff model carrier. UHC requires at least 5 CA employees to enroll with UHC
  • Groups must be complete at submission with all requirements in by 12/15. No exceptions for missing items
  • Recertification at renewal: Yes, all groups are subject to recertification annually
Sharp Health Pla
  • Must be the sole carrier. Sharp will write alongside a cross border plan. Cross border plans are considered valid waivers.
  • Case must be approved by: 12/15, no exceptions
  • Recertification at renewal: carrier discretion
SHOP – Covered CA for Small Business  
Warner Pacific – Requires Log In  

Steve Shorr
Website Introduction

Introduction to our website by Steve

Get a quote

Appoint us as your broker

 

Our Webpage on Insurance Coverage for 

COVID 19

Our webpage on COVID 19

Graphic from The Sun.UK

Enter your census or securely send us an excel spreadsheet or a list of employees and get instant proposals for California
Enter your census and we will get right back to you with quotes

 

Schedule a Skype, Phone or Face to Face meeting

 

Leave a Reply

Your email address will not be published.