California health insurance - Group Health - Benefits
Anthem Blue Cross is one of the dominant carriers on the California market for Group health benefits and that has been the case for decades now.
They have consistently led the market with progressive changes that other carriers followed.
In fact, it's been a game of catch up for a while now. Let's look at the core options that Anthem offers small groups.
This was a game changer. Employee Elect was (and is) Anthem's option that allows a company to offer almost all of Anthem's Small Group plans to each employee (HMO, PPO, or HSA).
They combined this with a funding ability to fix a company's contribution to either a fixed dollar amount per employee or a percentage of a particular plan or the plan of choice. This was a tremendous level of flexibility for the Small Group market that no one offered until then. It's the best of both worlds.
The employees can choose according to their needs and employers can lock in a budget. Employees would pay the difference above what the employer pays if they choose a richer plan. We can create a proposal which will show each employee's contribution by plan.
Anthem has one of the largest PPO networks in the State.
They have over 40,000 providers in the PPO network network and 400 hospitals. Their HMO network is roughly half that size and more concentrated in more populous areas. You
can research their providers networks here.
If you're on an Anthem Group PPO plan, you can
use the Blue Card network which extends your
benefits to BCBS providers in other States. This is
great for companies that have employees who live
outside of California or travel often.
Quote Blue Cross Anthem Group Benefits for California
Participation
EmployeeElect Portfolio: The standard group
participation requirement in the employer's Blue
Cross Small Group Health Plan is a minimum of 75% of
the eligible employees. BeneFits Portfolio: A
minimum of 60% of the eligible employees are
required to enroll in the employer's Blue Cross
Small Group plan.
Required Group Size
1-100
Employer Contribution
Employers must contribute either: Traditional Option
- A minimum of 50% of the employee's monthly health
premium or Fixed Dollar Option - Any fixed dollar
amount $100 or greater (in $5 increments) per
employee per month for employee's health premium or
Percentage & Plan Option - A minimum of 50% toward a
specific plan, chosen by the employer. It is NOT
available for the Basic PPO Plan.
Kaiser Split Carrier Participation
75% of eligibles must enroll with Blue Cross.
Waivers required for Kaiser enrollees but will count
as eligibles towards participation requirements. As
long as 75% participation is met, group may choose
any or all EmployeeElect plans. If selecting
"EmployeeChoice", waivers for Kaiser enrollees are
considered valid waivers & don't count towards
participation requirements. Minimum of 5 must
enroll. (Applies only to EmployeeChoice program.)
For BeneFits program, 60% participation required.
Participation with Carriers Other Than Kaiser
Only allowed with EmployeeChoice product. Requires
75% participation with minimum of 5 enrolled.
Cal-COBRA/COBRA Maximum
No maximum. 10% premium load for CAL-COBRA
employees. Groups may charge a 2% administration fee
for Federal COBRA.
Out of Area/State Maximum
49% Maximum
Composite Rates
Not Available for medical. Composite Life program is
available.
NCQA
Excellent
Domestic Partners
Affidavit or equivalent document required for
opposite sex domestic partners under 62 years of
age.
Administrative Fees
No
Product Combinations
EmployeeElect Portfolio: Employers have the option
of selecting "all plans" for their employees, or
designating specific plan options. (Note: Power
SelectHMO Plan cannot be offered along with any
other HMO plan.)
1099 Contractors
No
Again, there is absolutely no cost to you for our services. Call 800-320-6269 Today!