California health insurance  -  California Group Health  -  Blue Cross California Group Underwriting

Blue Cross of California Group Health Underwriting Guidelines
Participation

 

Requirements are always changing so make sure to check with for up to date company rules and options.

 

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.

 

You can always run your quote here:

quote California employer health plan rates

 

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

 

1099 Contractors

No

 

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