see all offices

Search by keyword:      Show posts by:     
Carrier & Compliance Updates 11.20.17
by Rosa Tessandori » Monday, November 20, 2017 3:07 PM

BLUE SHIELD OF CA Producer Alert
  • Updated Enrollment Spreadsheet: Updated versions of the 2017 and 2018 spreadsheets were posted on November 15 and are available under Employee Forms and Applications on Broker Connection. The updated forms automatically duplicate some information from section 3 to section 4 to help reduce potential pends.
  • 2018 New Case Submission Rules for Groups of 1-100: View the list of documents that are required at the time of new case submission, click here.
  • Bundling Bonus: Earn a bonus when placing new specialty lines of coverage with the same employer and initial effective dates of coverage between October 1, 2017 and January 31, 2018. For more information, click here.
  • Bonus for cases 51-999: Sell 51-999 eligible Humana dental cases with effective dates December 1, 2017 through January 31, 2018 and earn $40 per subscriber, for more information click here.
  • HR Complete: Offer your clients the premiere, full-service HR compliance and strategy solution, the industry’s most comprehensive HR protection and support service by partnering them with a certified HR professional. To learn more, click here.
  • IRS 2018 Plan Year Tax-Free Limits: The maximum annual limit for a Medical FSA will increase to $2,650. The maximum tax-free monthly mass transit and parking amounts will increase to $260 and the HSA contribution limits are $3,450, for single coverage, and $6,900, for family coverage. For full details, click here.
  • New Group Submission Deadlines: Groups with 12/1/2017 start date can be submitted no later than 12/14/2017 and groups with 1/1/2018 start date can be submitted no later than 1/14/2018. View the HealthiestYou flier.
  • ACA Reporting Training – Changes & Requirements: Join HR Service Inc, for training on Tuesday, Nov, 21st at 1:00 PM MT (12 PM PST). Click here to register
    and feel free in invite your employers.
  • ACA Penalty Enforcement: The IRS has started, “for the first time, to enforce one of the law’s most polarizing provisions: the employer mandate.” For more information, click here.

View Document
Carrier & Compliance Updates 11.6.17
by Rosa Tessandori » Tuesday, November 14, 2017 10:12 AM



  •    Changes to the New Group Initial Payment Process:  CCSB now has approval to accept checks before invoicing of new business. This new process will result in faster processing of member's carrier eligibility and ID cards.  Contact your local RBG sales rep for additional details.


      Small Group Broker Pulse

  •   COI and EOC Updates:  Plan Certificate of Insurance (COI) and Evidence of Coverage (EOC) booklets will contain the updates as shown in the "Notice of Changes to Coverage Terms" document(s),  for more information, click here.

       Large Group Broker Pulse

  •     Enhanced Choice Portfolio Updates:  Learn more about the new PPO-Only package, New PPO Lean Plan and more, for more information, click here.


  •  2018 Updated Materials:  View the updated HMO Network Comparison  and the UHC Overview.  Various other updated marketing pieces are available on
  • Real Appeal Webinars:  Real Appeal® is offering half-hour Employer and Broker Informational Sessions throughout November and December 2017.  Participants will learn more about the weight loss program and the benefits it offersregister for a session today.

 HR 360

  •  2018 updates for HSAs, FSAs, and HRAs:  View HR360's 2018 HSA/FSA/HRA Comparison Chartit features all the latest updates for next year. PLUS, you can easily compare key features of each tax-favored account in one convenient chart.


View Document
Carrier Updates 10.30.17
by Rosa Tessandori » Tuesday, November 14, 2017 9:39 AM



       Partner Alert

  • Commissions:  Beginning January 1, 2018, a 5% commission will apply to any new enrollment for groups with 1-50 enrolled employees. All 1-50 groups written from January 1, 2014 through December 1, 2017 will remain on the current 6 ½% down-graded commission schedule and will not be affected. For groups 51-100, no changes are being made.  For further details on the commission schedule changes going into effect January 1, 2018, please review the Agent Commission Structure found here >>


        Large Group 101+

  • Bonus Program:  Broker Cash Rewards for plans with effective dates 1/1/18-12/1/18.  Brokers earn a $50 bonus on each member enrolled in a newly sold plan.
  • Online Resources:  Visit for details on Health Net's Enhanced Choice and Starting Line-Up packages that offer flexible and cost savings choices.

View Document
Carrier Updates 10.23.17
by Rosa Tessandori » Monday, October 23, 2017 2:38 PM


 2018 Q1 Update

  • Rate Action:   The average difference for CA for the first quarter of 2018 is:  HMO increase of 2.5% and a decrease for MC/PPO  - 0%.  Child Age Rating Changes include a new single age band age 0 through age 14,  individual age band ages 15 through 63 and a single age band age 64+.
  • Portfolio Updates:  View the updated plan additions and changes.
  • Pharmacy Updates:   New single ACA formulary for SG plans.  Renewing plan members will transition to the new SG ACA formulary and will have a one-time Rx refill for up to a 30-day supply for medications requiring precertification, step therapy, or other utilization management review.
  • Network Name Changes:  Same networks,  just different names.
  • New Hire Effective Dates:   1st or 15th of the month option after meeting the required waiting period. 
  • Indemnity Plan Restrictions: The indemnity plan is no longer available for employees that don’t reside in an MC or PPO network area
  • Participation:  Stand alone is 60% and alongside Another Carrier's HMO is 40% with a minimum of 5 enrolling in Aetna.  
  • Special Open Enrollment for 1/1/18:  Aetna must be the sole carrier for groups enrolling under the special open enrollment period from 11/15/17 through 12/15/17, for a 1/1/18 effective date.  An attestation form will need to be submitted with the group confirming Aetna is the sole carrier.
  • New Business Submission Deadlines: A complete submission must be received by Aetna on 1st of the month for 1st of the month effective date and 15th of the month for the 15th of the month effective date. Groups submitted after the deadline are moved to the next effective date.
  • Renewals: Groups should submit their renewal confirmation in writing prior to the renewal date or make the renewal premium payment prior to the renewal date.  The plan change submission deadline is 10 days prior to the renewal or 5 days if using the eList tool.


Q1 2018 Resources



  • Paperless Update:  Reminder, BSC no longer accepts paper for many submissions.  January renewals are available online for downloading.  also, post enrollment materials are available online from the same renewal site.  Use Employer Connection Plus for open enrollment and ongoing member-level changes.  View the update.

Broker Update - Large Group


  • Trio Network Expansion: Effective January 1, 2018, 8 additional counties will be added making Trio available in 24 counties.
  • Vaccine at Retail Locations for HMO Membership: Effective October 1, 2017, members in select
  • non-grandfathered plans will be able to receive select vaccines at participating retail pharmacies.
  • SB17:  Is a new state law that provides transparency to prescription drug pricing in California and now applies to drug companies.
  • Assistance for Members Affected by CA Wildfires:  Services include immediate refill of prescriptions, even if they are not yet due for refills and more. 



CA 2018 SG Benefit and Rate Updates


  • Q1 Rate Action:  PPO & Enhanced Care PPO increase +3.3% and HMO & HSP decrease -0.2%.
  • Plan Updates:  New plans and plan change information
  • Medical Plan and Rate Resources:  Download rate tables, side by side comparisons and more.
  • Ancillary Rates:  Download the rate tables.
  • ACA Mandated Child Rate Age Factor Changes:  Learn more about the new age slop factor.

       Broker Pulse 

  • Assistance for CA Fire Victims:  RX Refill assistance and more.


  • Q4 Group Incentives:  For groups larger than 50 employer paid enrollments (HealthiestYou product), HealthiestYou is offering a 2-year rate guarantees and other incentives like 1 or 2 months free premiums.  For more information, contact your RBG Sales Representative.  Also, qualify to win an Apple Watch, a $400 Amazon Gift Card or the Grand Prizeclick here for more information.
  • Top Reasons Why Employers Want To Offer HealthiestYou:   $0 Copays, Prescription Savings Tool, Procedure Pricing Tool, Enhanced Provider Search Tool and the Claim Status tool. View their flier. 

View Document
Carrier Updates 10.16.17
by Rosa Tessandori » Monday, October 23, 2017 1:42 PM



  • 2018 Q1 Rate Action:  PPO Average decrease -0.4% and the HMO average increase +2.4%.  For more information on added or discontinued plans and other renewal resources, click here.
  • Age Band Rate Changes:  New age-band ruling impacts premiums for children ages 15 through 20 years of age effective January 1, 2018.  For more informationclick here.
  • Disabled Social Security Registration Option:  As of September 15, members can no longer use their social security number to complete their online member registration or to reset their username or password.  For more information, click here.
  • New Website Resource:  The Stronger Together website combines many resources in a single location for people touched by cancer.  For more information, click here.




  • Tips to Streamline New Group Installations:   To streamline group installation, all components must be submitted together to begin processing. Incomplete submissions will be returned to the writing producer or general agent rather than pending for later completion or rolled into the next effective date.   For more information, click here.



       Broker News

  •  2018-Q1 Rate Action:  PPO & Enhanced Care PPO increase of +3.3% and HMO & HSP decrease of -0.2%.  This update also includes details regarding new and canceled plans, plan enhancements like Teladoc for CommunityCare HMO members and EnhancedCare PPO plans, ancillary rate information, medical and ancillary rate tables and the Federal Standard Age Curve changes.





       Nor Cal SG Webcast Resources


  • Presentation Copy:  View a copy of the presentation, click here.  
  • 2018-Q1 Rate Action:  PPO rates increased by +2.5 % for all networks and HMO rates decreased by -0.6% for all networks.
  • Canopy Health Fliers:  View the flier launching Canopy Health and the overview flier on Canopy HealthCanopy Health is now available to members enrolled on HMO Advantage plans.  The 2017 HMO network comparison brochure is being revised to include this change and will be posted shortly on once finalized.
  • Real Appeal Flier:  Weight loss planning and support is available in 2018 to members enrolled on PPO plans.  To learn more, click here.
  • Heal Flier:  Services include on-demand doctor house calls and is now available to new groups and existing groups at renewal to members enrolled on a PPO Select Plus or Core plan designs (in applicable areas) . To learn moreclick here.

     Broker Connection

  • Digital On-boarding:  When conducting an open enrollment, be sure to use the Digital On-boarding tool to not only simplify the member enrollment process but better inform and engage the employees about their benefit plans.
  • Wellness Webinars:  Build and Retain Clients with UnitedHealthcare Motion.  Pick from three dates October 23rd, 24th and 30th.
  • Opioid Crisis:  UHC can help your clients with strategies to prevent and treat Opioid Use Disorders
  • Prescription Drug List (PDL):  View the latest updates.
  • 2018, Jan 1st Prescription Drug List (PDL):  View the latest updates.
  • Vision Network:  Beginning in 2018, UHC has added Warby Parker to it's vision network.
  • ®Employer eServices Upgrade:  The Customer Reporting Tool, will have a technology upgrade in November to enhance data security on Employer eServices.
  • Real Appeal:  Join one of UHC's broker information sessions throughout October, November, and December 2017.  

View Document
UHC Support for Those Affected by NorCal Fires
by Rosa Tessandori » Wednesday, October 18, 2017 4:46 PM


Broker Connection - Special Edition*

United Healthcare is taking action to help people affected by the wildfires in Northern California.

  • Contact customer service for assistance finding a network care provider
  • Prior-authorizations waived
  • Deadlines for claims and appeals filings extended
  • Durable medical equipment replacement
  • Early refills available
  • Replace lost medical ID cards, call 866-633-2446 8 a.m. - 8 p.m. Mon-Fri or download the app
  • Free Behavioral Health Help Line - this service is free of charge and open to anyone

*These measures apply to individuals insured through UnitedHealthcare and living in Napa, Sonoma or Yuba counties and are effective through Oct. 23, 2017. Other measures apply to all counties included in the Governor's disaster proclamation. 

View Document
Carrier Updates & Compliance 10.9.17
by Rosa Tessandori » Wednesday, October 18, 2017 4:23 PM


       Producer Alert
  • Expanding Trio Network: Coverage available in 24 counties. For more info visit
  • New Tandem PPO Network: Beginning in 2018, these plans are offered at a lower rate than the Full PPO Network plans with the same plan benefits.
  • 2018 Q1 Rate Action: Find full rate information and sheets on Broker Connection. Rate increases for Q1 2018 are 1.1% for PPO plans and 2.4% for HMO plans.
  • Enrollment Spreadsheet: Reduce errors and turnaround time on new group submissions by using the Enrollment Spreadsheet available on Broker Connection under
    Forms and Applications
  • 2018 PPO Savings Plans: Chiropractic services are embedded in all 2018 PPO Savings plans.
  • Healthy Equity H.S.A. Services: The Silver 2000/20% can now be paired with Health Equity H.S.A. Services.
  • HMO Infertility Rider: 2018 HMO plans can be offered with or without supplemental infertility (INF) coverage.
  • HMO Members: No Cost Vaccines are covered under the pharmacy benefit and provided at no extra charge through retailers.
  • Summary of Benefits (SOBs): Beginning in 2018, SOBs replace Benefit Summaries.


       Partner News – September
  • 2018 Rate Action: The weighted average rate change for 2018 is 5.6%. Rates are now available for quoting.
  • 2018 Carriers: Blue Shield, Health Net, Kaiser, Sharp Health Plan and Chinese Community Health Plan in San Francisco will continue to be participating carriers.
  • Discontinued Carrier effective 1/1/2018: CCSB will not be offering Western Health Advantage in 2018, a move that will affect approximately 350 consumers.
  • Agency Contract: Register your agency to allow office staff and account managers to help service CCSB groups. Contact for more information.
  • Group Submission Deadlines: October cases are due 9/25, November are due 10/25 and December are due on 11/27. Due dates can be extended for those groups signing the late submission form. Click here to view the form and contact our office for specific deadlines.
  • Dental Only Enrollment: With a valid waiver (through another employer, union, the military, or Medicaid or Medicare), CCSB allows your clients’ eligible employees to enroll in a dental-only plan without electing a health plan.
  • Reference Plan Educational Video: View the educational video which clarifies the importance of a reference plan and ways to best leverage the exchange to benefit both small business owners and their employees. Click here to view the video.
  • Promotional Video: This video outlines the benefits of prospective clients partnering with CCSB.
  • CCSB Website Updates: View the alert to see a list of updated web pages.


       RBG Tip Sheet Reminder

       Medicare Part D Creditable Coverage: Annual notices are due by October 15, 2017.

View Document
Carrier & Compliance Updates 10.2.17
by Rosa Tessandori » Monday, October 02, 2017 6:06 PM


Small Business Broker Update
  • New PPO Network Tandem PPO: Blue Shield has collaborated with select providers to create the Tandem PPO Network available for effective dates starting January 1, 2018. Members will be matched with a primary care physician (PCP) in the Tandem PPO Network. Like all PPO plans, members have the flexibility to see any health care professional, including specialists or access any facility in the Tandem PPO Network, without a referral.
  • Top Ten Underwriting Issues: View the Blue Shield lists of the top 10 most commonly missed fields which result in pending applications.
  • 2018 Q1 Rate Action: PPO average rate increase is +1.1%, HMO +2.4% and Trio +2.4%. The cumulative rate impact for the last four quarters is an average of PPO +2.4, HMO +5.8% and for Trio +0.9%.
  • Trio Rates: On average, Trio rates are 12% below the full Access+ HMO rates.
  • Tandem PPO: Blue Shield introduces a statewide network of choice providers, with plan benefits matching their Full PPO plans, but at a lower cost. Tandem PPO rates are on average 4% below the full network plan rates, and as much as 8% lower in some regions.
  • Ancillary Rates: On average, rates for dental, vision and life insurance remain flat.
  • Bundling Discount: For groups with a Blue Shield Medical Plan, a 5% discount is applied directly to the total dental or vision premium.
  • Changes to the Child Rate Tables: Due to ACA mandated new age slope requirements, for 2017 to 2018, members turning age 15 to 21 will have additional rate impacts from +20.5% to +57.5%.
      Producer Alert
  • New Hire Rate at Enrollment Clarification: For groups renewing on 10/1/17 or thereafter, the rate charged for new hires will based on the age at the time of enrollment rather than the age as of the group’s last renewal.
  • 2018 Q1 Rate Action: Rates are valid January-March 2018 effective dates. PPO rates are increasing +2.5% across all networks and HMO rates are decreasing -0.6% across all networks. Note, the optional infertility coverage is not factored in the above rates.
  • New Value-Add program: Real Appeal is a no-cost value add program including tools and support to help employees lose weight, feel good and prevent weight-related health conditions. Real Appeal is included in the CA small group PPO plans, click here to view the flier.
  • Vision Network Update: Earlier this year UHC announced the addition of Target and Sears Optical to their network. Starting in 2018, UHC is also adding online retailer Warby Parker as an in-network provider.
  • October Webcast: Join UHC on 10/11/17 @ 2:00 p.m., which will include their 2018 rollout. Click here to view the PDF & the outlook calendar invite.
      Broker Connection
  • SAM Enhancements: The census and enrollment templates are now combined. In addition, you are now able to change an effective date and drop a plan while you are in enrollment.
  • SAM Trainings: Several dates are available, register early.
  • New Medicare ID Cards: The new cards will no longer include the members social security number.
  • Prescription Drug List: View the latest updates.
  • Specialty Medications: Prior pre-authorization is required starting Oct. 1st for Radicava, Brineura and Soliris.

E is for ERISA

      Compliance Update
  • ACA Cheat Sheet: View the cheat sheet with affordability safe harbor thresholds, applicable large employer penalty tax amounts, and out-of-pocket maximums for 2017 and for fast-approaching 2018. Click here to view.

Carrier & Compliance Updates 9.27.17
by Rosa Tessandori » Wednesday, September 27, 2017 11:12 AM


Small Group
  • New Hire Age at Enrollment: Blue Shield has corrected the age attainment calculation for new and existing groups. All existing small business groups will see the fix applied starting October 1, 2017. View the alert, click here.
  • Relaxed Participation: This program has been extended through the end of 2017. View the update, click here.
Large Group
  • DPPO Network: Additional providers have been added increasing the network to nearly 45,000 providers.
  • Prenatal Support: At no additional cost to members, this program offers support before, during and after childbirth.
  • Trio Momentum: Membership is growing steadily and the network continues to expand, which means you can offer high-value health care to more people, in more places.
  • Product Mandates: Changes have been made based on current California and federal laws affecting the Alpha-Fetoprotein (AFP) Genetic Testing Program, contraceptives and the Diabetes Prevention Program.
  • SoFi: Is a new financial wellness benefit. An example of the services provided include student loan refinancing and employer student loan contribution administration.
  • Hurricane Victim Services: Blue Shield has implemented services to help ensure continuity of care for affected members.
  • Palliative Care Program: This program was introduced in Sacramento earlier this year and it has recently been made available in the San Francisco area. With time, the goal is to expand services through California.

  • Bundling Bonus: A Humana Agent Bonus is available for groups sold October 1, 2017 - January 31, 2018. View the flier, click here.


Broker Connection - September
  • MLR Rebates: Groups eligible for a rebate should receive them by September 30, 2017 deadline.
  • Child Age Band Rating Change: Effective January 1, 2018, a new age band structure will apply due to ACA requirements.
  • Preventive Care: Learn more about which preventive care services have been updated.
  • Pregnancy App: This new phone application is designed to improve pregnancy outcomes and to lower costs.
  • Pharmacy Updates: View the updated Prescription Drug List.
  • Specialty Product Promotion: UHC will send direct mail advertisements to groups 2-50 from September 2017 – August 2018. View samples of the Specialty product materials that will be sent to clients:

  • Winning with an HSA: Learn how to financially leverage your H.S.A., to download a copy, click here.
  • The Complete H.S.A. Guidebook - 10th edition: Includes health care reform and tax change updates, to download a copy, click here.


Federal Law Alert
  • New I-9 Form: As of Monday, September 18, 2017 employers should be using the I-9 with revision date of 7/17/17.

View Document
Carrier & Compliance Updates 9.11.17
by Rosa Tessandori » Tuesday, September 12, 2017 11:06 AM


       Partner Alert

  • Membership Growth: 25% growth over prior year.
  • 2018 Rate Action: The weighted average rate change for 2018 is 5.6%. 
  • 2018 Carriers: Blue Shield, Health Net, Kaiser, Sharp Health Plan and Chinese Community Health Plan in San Francisco will continue to be participating carriers.
  • Discontinued Carrier effective 1/1/2018: CCSB will not be offering Western Health Advantage in 2018, a move that will affect approximately 350 consumers.


       Broker Briefing
  • Mobile Bill Pay: Now available for paying bills and viewing payment history.
  • Optical Plans: Four new plans are being added for large group in 2018.
  • Q4 Service Tips: Avoid common mistakes, click here.
  • Current Email Addresses: Update client email addresses, click here for instructions.


      1-Minute Sales Tip
  • Job Descriptions: Help your clients and prospects by taking a large project off of their plates – job descriptions.

      Federal Law Alerts
  • EEO-1 Pay Data Reporting: The Office of Management and Budget put an indefinite hold on the pay data collection portion of the EEO-1 form. 
  • Overtime Rule for White Collar Workers: A federal judge ruled that the DOL overstepped its authority. 
  • Predictive Scheduling Laws: The states of Oregon and New York City have joined San Francisco, Emeryville, and Seattle in passing predictive scheduling laws, which require certain employers to give employees a minimum amount of advance notice of their work schedule.



View Document
Carrier & Compliance Updates 9.5.17
by Rosa Tessandori » Tuesday, September 12, 2017 10:46 AM

  • Express Enrollment: View the simplified underwriting guidelines, click here.

  • Multi-Product Advantage: Sell a dental plan and at least two new coverages from two or more of the different product groups, verify the group meets the qualifying criteria and earn an additional one-time payment of 1.5% of the annualized premium for each product sold. For more information, click here.


COBRA Compliance
  • Webinar: "Pitfalls to Avoid with COBRA" on Sept. 14, 2017 at 1:00 EDT. This event will help you: (1) understand COBRA rules and regulations, (2) recognize the pitfalls and consequences of improper COBRA management and (3) identify key questions you should be asking regarding COBRA services. Register now.
  • eBook: What makes a great COBRA partner?" The eBook outlines several items to consider when evaluating COBRA services and what really differentiates partners that truly excel at COBRA services. Download a copy.

View Document
Carrier & Compliance Updates 8.21.17
by Rosa Tessandori » Thursday, August 24, 2017 8:31 AM


Producer Alert

  • New - Enrollment Spreadsheet: For groups effective September 1, 2017, and later, the new Enrollment Spreadsheet is available to all brokers enrolling new groups in medical and/or specialty benefits.  Download the spreadsheet on Broker Connection and it will also soon be available through EaseCentral.

Partner News - August

  • IFP Open Enrollment:  Join Covered CA at one of their scheduled “In It, To Win It” kickoff tour meetings, which start on Wednesday, September 6th and run throughout the state, ending on Tuesday, October 3rd in Sacramento.
  • Revised Agency Agreement:  When completing your new agreement, keep in mind that the designated Agency Manager will act in an administrative and operational role for your Agency within the CalHEERS Agency Portal.
  • Agency Portal Update:  Learn More about the two phase process of the portal rollout. CCSB anticipates launching the 1st phase of the rollout for use with fourth quarter renewals.
  • Q4 Update:  New plans and rates are available for quoting.  The Blue Shield HMO Trio plans are experiencing a rate reduction.  Health Net has added their Value PPO plans on the Silver and Gold levels and a Health Net HSA PPO plan at the Bronze level.
  • Website:  Visit their updated pages.
  • Educational Video:   View the, “CCSB Health Plan Budget Control | Reference Plan Strategy.”  This video clarifies the importance of a reference plan and ways to best leverage the exchange.



Broker Briefing

  • Website Resources:  Visit for information that helps make deductible plans easier for your clients to understand.
  • Facility Updates:  The Santa Cruz facility is now open, click here to view a list of future sites.
  • Large Group Deductibles: Effective January 1, 2018, the IRS is raising minimum deductible levels and allowable out-of-pocket maximums for large group health savings account (HSA)–qualified plans.
  • Webcast Invite:  1-100 Northern CA August Webcast 8/23/17 2PM PST.  Updates from UHC on how they are serving you and your clients in 2017 – and far beyond.  For more information, click here.


  • Opt-Out Payments:  In the 2016 opinion in Flores v. City of San Gabriel, the Ninth Circuit court held that opt-out payments had to be included in the regular rate of pay used to calculate overtime payments under the federal Fair Labor Standards Act (FLSA). For more information, click here.


HR Snapshot -  Provide your clients with a real time look at trending HR Topics through HR AndswerLink.


  • How Do We Calculate Whether We’re Covered Under FMLA?  For more information, click here,


Compliance Alert

  • Who is a Dependent?  The IRS issued proposed regulations 26 CFR Parts 1 and 301 in January 2017 regarding the definition of a dependent. These proposed regulations provide guidance and clarification for the current definitions under Internal Revenue Code (IRC) IRC Section 152 plus other conditions introduced by the Working Families Tax Relief Act of 2004 (WFTERA) and by the Fostering Connections to Success and Increasing Adoptions Act of 2008 (FCSIAA). To learn more, click here.

View Document
Carrier Updates 8.14.17
by Rosa Tessandori » Thursday, August 24, 2017 8:20 AM


Producer News Online

  • Q4 Underwriting Promotions:  Relaxed Participation - 30% for 5 or more enrolled, DE9C - not required for groups with existing coverage with 6 or more enrolling, individual coverage counts as a valid waiver, dual HMO network option, same day approval is available for groups submitted by 8.a.m. Mon-Fri that are complete and have utilized the census enrollment tool, 9/1 anniversary date changes are available once in a 12-month period and must be submitted by 8/24 for a 9/1 effective date.
  • 2018 Plan Offerings:  Anthem CA Small Group Plans will continue in all 19 rating regions for 2018. The recent CA Individual announcement does not impact CA Small Group business or regional footprint.


Producer Alert

  • Underwriting Updates:   BSC is increasing access to affordable health care by streamlining the underwriting process for small groups and for brokers with reduced participation requirements, waived DE9C requirements,  flexibility in document requirements, earlier start dates for start-ups and waived participation requirements for Trio.

Large Group Broker Update

  • Earned Rewards:  Double your rewards for Trio.
  • Trio Network:  Effective July 1, 2017, Allied Pacific IPA joins the Trio ACO HMO Network in Los Angeles County
  • Narcotics Safety Initiative:  View the 2nd-year report results.



  • Bundling Bonuses:  To earn a bonus, place new specialty lines of coverage with the same employer and initial effective dates of coverage between August 1, 2017 and January 31, 2018.  Click here to learn more.


  • Simply Smart Bundles and Bonuses:  MetLife has expanded the flexibility of its small business bundles. Any Dental-plus bundle combination comes with exclusive value-adds to help you close the sale. Bundles with 3+ products can qualify for MetLife's Small Business Multi-Product Advantage, earning you additional one-time broker compensation. Click here to learn more.


Broker Connection

  • Methadone Coverage:  Beginning Jan. 1, 2018, UHC will introduce the Methadone maintenance program for the treatment of opioid use disorder to self-funded plans.
  • Flu Shot Program:  Preventive services, including immunizations, are provided under the standard, fully insured UnitedHealthcare Certificate of Coverage (COC).  Access to flu shots are available through a variety of providers including retailers like CVS, Safeway, Rite-Aid and more; offering a range of convenient options.  
  • Prescription Drug List (PDL) Updates:  View the latest PDL Tracker.


  • Webinar - Solving the Unsolvable in Health Care:  Thursday August 17, 2017 @ 10:00 AM PST.  In July, HealthiestYou joined forces with Best Doctors. Best Doctors solves the unsolvable in healthcare, by identifying and providing solutions to the most complex health conditions.  Click here to learn more.


  • HR On-Demand - Document Customization Feature:   Save your clients and prospects time and money by introducing them to the Document Customization feature included with HR On-Demand, the live consulting feature that provides access to certified HR Pros.  Click here to learn more. 

View Document
Carrier Updates 8.7.17
by Rosa Tessandori » Tuesday, August 08, 2017 6:45 PM


4th Quarter Updates

  • Rate Action:  Rate Pass for HMO, MC, and PPO medical plans for all rating areas
  • Network Updates: Who's new and who's going away.   Access Heal providers for on-demand house calls. Take advantage of Teladoc providers that available for phone or video consultations 24/7/365 days a year.  View the updated CA HMO comparison.  Click here for more information.
  • Springboard:  Aetna's online enrollment platform is available free of charge.
  • Renewal and Plan Changes:  Allow enough time for processing, submit renewal and plan changes no later than the last day of the month prior to the renewal.
  • Sold Case Submissions:  Aetna's underwriting team must receive sold case submissions by the requested effective date: the 1st or the 15th of the month.


Producer News Online - Small Group

  • 8/23/17 Webinar:  Reduce tobacco use in the workplace.
  • Employer Access:  The portal has been updated and is now available.
  • Form and Flyers:  The updated 2017 Anniversary Month and Plan Change request forms, and the New "Top 10 Reasons to Sell Anthem" flyer, are now available for Small Groups.

      Producer News Online - Large Group

  • Specialty Account Management:   Michele Bodie has been promoted to Director of Specialty Sales Account Management for California, Colorado, and Nevada.
  • 8/23/17 Webinar:  Reduce tobacco use in the workplace.
  • Online Billing and Payment Effective 9/1:  Anthem is moving Large Groups in California to electronic billing and online payment, starting September 1, 2017.


  • Trio ACO HMO:  BSC is waiving their participation requirements for groups of 1 to 100 eligible employees with Trio-only membership!  Click here for additional details.


  • Q4 Rate Action:  HMO/HSP Rate pass through December 15, 2017.  PPO/EPO insurance medical plan rates were given a 0.0% quarterly increase . While this is not a rate pass per se, you will find that most of the PPO/EPO Q4 rates are identical to Q3 rates.  Click here for additional details.


  • Covered CA:  Rates are available for quoting.

View Document
Carrier Updates 7.31.17
by Rosa Tessandori » Tuesday, August 08, 2017 6:26 PM

  • CA AB7:  Benefit updates have been implemented to meet new guidelines, click here to learn more for individual and small group contracts, click here.  For large group contracts, click here.  

  • Nivano Physician IPA:  Blue Shield of California has issued a termination notice to Nivano Physicians IPA (formerly Sierra Nevada Medical Associates IPA) effective August 10, 2017. Blue Shield is notifying affected HMO/POS members that they are being reassigned to alternate network IPAs in the area to help ensure uninterrupted access to care, effective August 10, 2017.  Members can call the Member Services number on their ID card to self-select a PCP or IPA.  Click here for more details.  
  • Digital Roadshow:  The invitation is coming soon, save the date - Wednesday, August 30th. or Thursday, August 31st., click here for more details.

  • Q4 Revised Health Net Rates:   Rates effective 7/1/17 will hold through 12/1/17 effective dates.  Please replace the previously published Rate Guide with the revised Rate Guide, click hereto download a copy.  Quotes processed prior to 7/20/17 will need to be requoted.

  • Choice Pharmacy Network:  Health Net is introducing their new, tailored pharmacy network designed for cost control.  Learn more, click here.

  • Northern CA SG 1-100 Webcast:  If you missed the webcast, click here for a copy of the presentation 7.21.17.  Get up to speed on UHC4Me, click here.  Check out the ancillary plan recommendations, in particular the dental $5K Max DPPO plan, click here.
  • CAHU SB 562  Tool Kit:  SB 562 would establish a state-run single-payer health care system.  Please review the CAHU Tool Kit for resources to use in your discussions with clients, colleagues and friendsClick here for more information.

  • Earn a Reward and Win A Trip:  Any broker that brings in 6 or more new clients (or 2 or more clients with >2500 lives) between 8/1 and 12/1, will get either an Apple Watch or $400 Amazon gift certificate,  plus a plaque as HY Top Performer and you could also win the Grand Prize! Click here for more details.   

View Document
Carrier & Compliance Updates 7.24.17 - part 1
by Rosa Tessandori » Monday, August 07, 2017 11:29 AM


      Producer Online News  - Small Group

  •  Q4 Rate Action:  The average quarterly rate increase for medical plans are PPO 3.2% and HMO 2.2%.  Dental, vision and life products, no rate increase. 

        Producer Online News  - Large Group

  •  Whole Health Savings Guarantee:  Some ASO large group clients that choose to combine Anthem medical, pharmacy, dental, vision, and behavioral health products,  may be eligible up to $30 PMPM savings guarantee.  
  • Vivity Broker Bonus Program:  Anthem brokers are eligible to receive a $100 bonus per subscriber for each new Vivity case sold!
  • Employer Access Enhancements: With the introduction of the new enhanced Employer Access benefit management resource tool will result in changes to Plansource arrangements for Large Groups effective 10/1/2017.


  •  Q4 Master Application:  Download a copy of the revised Master Group Application effective 10/1/17.   
  • Q4 Employee Enrollment Form:  Download a copy of the revised Employee Enrollment Form effective 10/1/17.


  •  Q4 Revised Health Net Rates:   Rates effective 7/1/17 will hold through 12/1/17 effective dates.  Please replace the previously published Rate Guide with the revised Rate Guide, click here to download a copy.  Quotes processed prior to 7/20/17 will need to be requoted.


       Partner News - July

  •  Agent Portal Access:  Via DocuSign, CCSB will reach out to all agencies to obtain a new signed Agency Agreement and/or Non-Monetary Agreement, this will be required to be able to sign in to the new Agency Portal.       
  • LinkedIn:  Use LinkedIn to gain immediate access to informational articles and education posting to share with your clients and followers.
  • First Month's Payment:  Please inform new groups to only submit the first month's payment after receipt of their first invoice.
  • Redesigned Invoice:   For details on the changes, see the CCSB Employer Invoice Redesign Tutorial.
  • 2017 Employer Guide:  The CCSB Employer Guide has been updated and is now available on the Resources for Participating Employers page on the CCSB website.
  •  Late Submissions:  If a new group is submitted after the 25th of the month prior to the effective date, a late submission form must be completed. Late submissions are accepted up to the 5th day of the requested effective month and are subject to management approval.

View Document
Carrier & Compliance Updates 7.24.17 - part 2
by Rosa Tessandori » Monday, August 07, 2017 11:19 AM


  • 7/26 Webcast - Q4 updates and more:   Registration is not required but space is limited so join early!  July webcast on 7/26/17 at 2:00 p.m.  Click here to learn more.  Add it to your calendar, click here.

     Broker Connection - July
  • Digital Onboarding Webinars: For new and renewing groups with 101+ employees, Join a UHC webinar on July 26, 28 and August 1. For more details about Digital Onboarding and to register for a webinar, go to
  • Wellness Program:  Employers Honored by UnitedHealthcare for Creating a Culture of Wellness.
  • Prescription Drug List Changes:  View the latesPDL Tracker for a recap of changes outside the Jan. 1 and July 1 pharmacy benefit updates.
  • Prior Authorization Required for Renflexis and Brineura: For dates of service on or after Aug. 1, 2017, UHC require notification/prior authorization for Renflexis and Oct. 1, 2017 for Brineura.
  • Premium (Physician) Program:  This program evaluates physicians in 16 specialties for quality and cost efficiency.  UHC is changing the timing of the UnitedHealth Premium designation release from the end of the year to September. The ability to identify Physicians with Tier 1 status designation will be available during the standard fourth quarter Open Enrollment period. 
  • PCORI Fee Reminder: All Savers Alternate Funding plan sponsors must file a Form 720 and pay the PCORI fee directly to the IRS by July 31, 2017 of the calendar year following the last day of the plan year.

  • Expansion into Bay Area:    Effective 1, 2018, WHA is partnering with Canopy Health as part of their expansion into four additional Bay Area counties: San Francisco, San Mateo, Alameda and Contra Costa.  Click here for more details.


     HR Support Center Update
  • Use the HR Fitness Test to Grow Your Business:  Connect with your prospects and generate new leads, use this tool to identify their organization’s HR  strengths and weaknesses.  
  • Offer Branded "Insight" HR Webinars:  Presentations are 30 and 60 minute webinars on popular HR topics presented by one of their certified HR professionals. Take advantage of their Summer Insight Savings offer. 
  • Enhance your website: Use eAlert to bring cutting edge HR content directly onto your website to keep clients informed of federal and state employment law changes.
  • HR Support Center Enhancements:  Filter HR Topics by employee count.
  • Interested in HR AnswerLink?  Email us at to request additional information.

  • Does a Domestic Partner have COBRA Rights?  Read more about the complexities of when a domestic partner can or cannot be covered under COBRA,click here for more details. 

View Document
Carrier Rate Update 7.20.17
by Rosa Tessandori » Friday, July 21, 2017 9:25 AM


Q4 Released Rates as of 7/20/17:

Carrier & Compliance Updates 7/17/17
by Rosa Tessandori » Thursday, July 20, 2017 10:50 AM


       Producer News Online

  • Medical Specialty Precertification:  Anthem is expanding their precertification program to include medical specialty edits.
  • MyAnthem News:  The July issue is available for your California Small Group clients.
  • Updated 2017 Small Group HMO Network Guide:  The updated HMO Guide includes 6 new Sutter Providers added in Northern California effective July 1, 2017,  view the updated 2017 Small Group HMO Network Guide*. 


       Producer Alert 

  • Trio ACO HMO: Trio leads the way in Q4 with an average 4.8% rate decrease across the state.  
  • Q4 Rate Action:  HMO OffEx plans are experiencing on average a -0.9% rate change and PPO plans +0.5%.  The average overall rate action for renewals is 1.1%.  Click here to view the Alert.
  • Specialty:  No change to dental, vision or age banded life insurance rates from Q1 2017
  • Relaxed Participation OffEx Medical and Specialty:  BSC has extended their Relaxed Participation Guidelines through the end of 2017, requiring only 25% employee participation (minimum of five enrolled employees for medical plans).
  • Streamlined Life Underwriting - BSC has extended their promotion through the end of the year.  The  Small Business Quick MatchSM  matches renewal rates from the group's current life insurance company
  • Trio - Participation Requirement Waived:  Effective 7/1, Trio-only groups may enroll in a Blue Shield small business plan with just one eligible member.  Click here to learn more.
  • October & November Renewal Kits:  Visit the Shield Renewals site to download kits starting Monday, July 17.  Group-level changes will be available on SGOR starting July 20.
  • Health Equity:  Offer HSA administration through Health Equity for all of the BSC HSA qualified plans, now including the Silver Full PPO Savings 2000/20% OffEx plan.
  • Teladoc:  Renewing existing members,  they can begin using this program at renewal.  For new groups, no wait required.  View the flier.
  • Trio Bonus:  Earn an additional $250 per group and $25 per member for adding Trio to your fourth quarter groups with the Trio Incentive Program (TIP).
  • Bundled Savings:  As of May 1, 2017, anytime you add dental and/or vision to a new or existing small business client's medical coverage – a 5% discount applies, view the Small Business Bundled Savings.
  • Value Add Services:  Clients have access to Wellvolution, ID protection, HealthEquity, and Blue Shield's updated mobile app. Learn more by by


  • Q4 Rates:  Quoting is now available on the California Choice Website.  Quoting through EBIX/HealthConnect is expected to be available 7/17.  Click here for the 4th Quarter Rate Guide.
  • Q4 Summary of Changes:   For groups renewing 10/1/17 and 1/1/17, distribute a copy of the Summary of Changes to employers and employees, click here to download a copy.
  • Q4 Benefit Summary Guides:  The guides are not yet available.
  • Employer Administrative Guide:  Keep your clients informed on how to best administer their Cal Choice group health plans, click here
    to download a copy.


  • Get Certified:  Not certified to sell Covered Ca small group insurance policies?  Create an account today, click here to get started.


      Broker Briefing

  • Q4 Renewals:  Broker will be able to access renewal packet through the broker portal 105 days prior to the renewal date, 
  • Preventive Care Guidelines:  View the 2017 preventive care guidelines.
  • Updated New Group Application:  Download the  New 7/1/17 group application (PDF).
  • COBRA:  Learn more about small business service tip for COBRA reporting.  
  • Sales Tools:  Support your client discussions with fliers that highlight key benefits included in SG plans like DME, Chiro & Acupuncture and Pediatric Vision.


  • 7/26 Webcast - Q4 updates and more:   Registration is not required but space is limited so join early!  July webcast on 7/26/17 at 2:00 p.m.  Click here to learn more.  Add it to your calendarclick here.


  • Rebranding:  The CONEXIS® name and logo is being retired and will be rebranded to WageWorks® over the remainder of 2017.  Click here to learn more.
  • PCORI Fees Due by 7/31/17:  Self-insured groups, groups offering a health Reimbursement Arrangement (HRA) or Flexible Spending Account (FSA) should consult with their Third Party Administrator to determine any applicable PCORI fees.  Click here to learn more. 

View Document
Carrier Updates 7.10.17
by Rosa Tessandori » Tuesday, July 11, 2017 2:41 PM

  • Webinar July 19th:  Invite your groups to join the employer webinar to learn  how Anthem is fighting the opioid epidemic.  Webinar is open to small and large group clients.  For more information, click here.

BLUE SHIELD OF CA - Small Group (1-100)
  • 2018 NEW Summary of Benefits (SOB): The new SOB will replace the current medical Benefit Summary for HMO, PPO, PPO Savings and POS plans.  Get the details, click here.

BLUE SHIELD OF CA - Large Group (101 to 249)
  • Bundling Discount:  With the NEW Benefit Solutions package, your clients can save up to 2.75% off their medical premiums when they bundle dental, vision and life insurance* with their benefits package.  View the Flier.


Q4 Released Rates as of 7/10/17:

View Document
Carrier & HR Update 7.5.17 Part 1
by Rosa Tessandori » Tuesday, July 11, 2017 2:02 PM


June Newsletter

  • Heal & PayForward - Just Launched:  Heal provides on demand doctor house calls.  PayForward lets members earn redeemable rewards.
  • Medical Network Updates:  The Small Group HMO Network now matches the Large Group HMO Network in Northern California with the addition of 6 new Sutter providers effective July 1, 2017.    
  • Health and Wellness:  View a health and wellness on the run webinar, view the calendar.
  • Resources for Brokers:  Access quick links to forms, benefits, underwriting guidelines and more.

Producer News Online - Large Group

  • Manifest MedEx: This organization helps doctors and health plans securely share critical health information, making sure that members get the safest and highest quality health care possible. 
  • Vivity Broker Bonus:  Vivity is one of the most innovative delivery systems to hit the Southern California health care market. 


  • Q4 Rate Action:  Trio ACO rates reduced on average 4.8%; HMO plans -0.9%; PPO plans +0.5% and the average overall rate action for renewals is 1.1%.  Click here to view the Alert.
  • HMO Renewal Packet Error:  August and September renewal packets included a benefits error in the "Changes To" document. This incorrect version of "Changes To" was sent only to customers with HMO plans.  Click here to view the Alert.
  • CA Assembly Bill (AB) 72 - Balance Billing Protection:  Members will receive an EOC endorsement letter informing them of the changes and how it affects them. Click here to view the IFP Alert.


  • Reduced Participation:  Through 11.15.17, take advantage of Health Net's reduced participation promotions, view the flier.


  • Master Application Updated:  The Master Group Application now includes a section for designating the Agency FEIN#, see page 2 step 3 #4 under Agent Information.  Click here to download the new application.  The form is available for immediate use.

View Document
Carrier and HR Updates 7.5.17 part 2
by Rosa Tessandori » Tuesday, July 11, 2017 2:01 PM

Broker Connection- June

  • New, Required Broker  Questionnaires and Attestations: As part of ongoing efforts to ensure protection of customer data, UHC will be asking agents to confirm that their computer equipment and practices are compliant with certain security standards, where applicable.
  • Specialty Medications:  AxelaCare® Health Solutions has a new name, BriovaRx Infusion Services.
  • Travel Protection Program:  Grow your business while helping to address your clients’ safety and well-being needs throughout their travels.
  • Specialty Broker Bonus Program:  View the requirements for earning a bonus.
  • Broker and Client Training:  Lean more about UHC's quoting tools, broker resources or how clients can better administer their benefit programs by attending an informational webinar.


HR Support Center - eAlert

  • Minimum Wage Increases:  Seven municipalities in California have passed minimum wages that are higher than the state rate and will go into effect or increase on July 1, 2017.  
  • Domestic Violence Victim Leave Notice:  Employers with 25 or more employees must provide this notice to all new hires (as part of a new hire packet is acceptable) and to any employee upon request.
  • Expanded Protections for Transgender Employees: New regulations going into effect July 1 extend existing protections by requiring that employers take affirmative steps to acknowledge and respect an employee’s gender identity.
  • Further Restrictions on Use of Criminal Histories: The Fair Employment and Housing Council released new rules related to the use of criminal histories in employment decisions, which take effect July 1. 


View Document
RBG Now Contracted with CA Health Net Small Group Eff 7/1/17
by Rosa Tessandori » Wednesday, June 28, 2017 1:52 PM

We are pleased to announce that CA Health Net Small Group plans are now available through Rogers Benefit Group!

We have enjoyed a successful large group partnership with Health Net for many years and the timing is perfect to expand the partnership to include small group products.

Health Net companies help more than five million people get the health coverage they need.

Whether you're looking for PPO, HMO or EPO coverage; Health Net offers a wide range of plan benefit designs at the right price point for maximum value and accessibility.

We look forward to partnering with YOU on your Health Net small group needs!

Please contact your RBG representative or our office for additional information, or if we can be of service in any way.

View Document
Carrier Updates 6.26.17
by Rosa Tessandori » Monday, June 26, 2017 3:59 PM


     Producer News Online
  • Optional PCP:  To engage members in the Anthem value-based model, members are encouraged to pick a PCP even if doing so is not required by their health care plan, click here to learn more.


     Broker Update
  • Trio Plans:  5 good reasons to sell Trio... Reasons #1 & #2, no participation requirements for medical and ancillary, click here to learn more.
  • HSA Administration:  Effective October 2017, HealthEquity can now also administer accounts the Silver Full PPO Savings 2000/20% plan in addition to the bronze level plans.
     Broker Update
  • California Assembly Bill (AB) 72:  Effective July 1, 2017, this new state law protects individuals from receiving unexpected "surprise or balance" medical bills from an out-of-network (OON) doctor when receiving inpatient and outpatient non-emergency care and services at an in-network healthcare facility such as a hospital, clinic, lab, imaging center or other healthcare facility.  
    Marketing Bulletin
  • Quick Match:  The program making it easier to sell life insurance has been extended through the end of the year and is available to groups with Groups 51 to 100 eligible employees.
  • Reduced Life Rates:  Effective 7/1/2017, BSC has lowered their composite life rates for groups with 10+ eligible employees.

View Document
Carrier & Compliance Updates 6.19.17
by Rosa Tessandori » Wednesday, June 21, 2017 10:43 AM


      Broker Announcement
  • New Venture with Sutter Health: This joint venture will deliver a differentiated, personalized experience for members and is designed to help lower the cost of care, resulting in competitively priced products. Sutter Health and Aetna anticipate offering self-insured commercial products starting mid-2018 in the greater Sacramento, Central Valley and Bay Area communities, as well as fully insured PPO products to follow in early 2019, pending regulatory approval. 


     Producer News Online -Small Group
     Producer News Online - Large Group

     Small and Large Group:
  • Cash Back Rewards: Members can earn up to 15% cash back from participating retailers
  • Voluntary and Optional Life:  Sell more life, Anthem offers Guarantee Issue up to $100,000.
  • Employer Portal:  Technical upgrade delayed to July 28, 2017.

     Small Group
  • Disability 2-9 Market View the underwriting guidelines 
    for Short Term and Long Term disability for groups with 2-9 eligible employees. Coverage is also available on a voluntary basis for groups with 10+ eligible and 10 enrolled.  A bundling discount with dental does not apply to 2-9 STD or LTD coverage (or voluntary).

     Large Group
  • Integrated Health Care Report - Edition 2:  This new whitepaper contains industry research on Integrated Health Care (IHC), an employee benefits strategy that connects medical, dental, vision, pharmacy and disability data to engage employees in wellness programs and improve health outcomes.
  • Plansource Contract Changes:  Effective 10/1/2017, Anthem will no longer offer Plansource to new customers for free or at a subsidized cost. 


     Small Group
  • 4th Quarter Rates:  A formal rate release has not been announced, however rates have been posted 120 days in advance due to recent guideline requirements and the t is expected soon.
  • Q4 Rates are currently available online.  A formal announcemen
     Large Group


     Partner News
  • Broker Bonus Q3 Program: View the flyer to learn more.
  • Broker Bonus Q4 Program: View the flyer to learn more.
  • HMO 2017 Comparison Brochure:  The brochure has been corrected, please discard prior versionsclick here for the latest version.
  • 2017 Strong Presence CA Brochure:  View the flyer to learn more.

       UHC Broker Connection - June
  • MLR Rebate Timetable:  Rebates will be mailed to customers in the final two weeks of September.
  • eServices:  Browser updates will be effective July 21st.
  • Preventive Screenings:  Expanded screenings for colon cancer available beginning July 1st.
  • Vision:  New lense formulary goes into effective July 1st.
  • Rx Drug List Changes:  View the latest PDL Tracker.

E is for ERISA
  • ACA Reporting Penalty Process:  Until ACA is repealed, employers must continue to comply with the requirements of the law. The IRS is currently issuing notices to employers that require them to disclose whether they complied with ACA large employer reporting duties, or their excuse for not doing so, where applicable. This post describes the notices and how to respond to them.  View the article.

  • No More Pre-Tax Commuter Transit Benefit Plans?  Act now to preserve tax savings for you and your employees, click here to learn more.

View Document
Carrier, HR & Legal Updates 6.12.17
by Rosa Tessandori » Friday, June 16, 2017 8:31 AM


Producer News Online

Small and Large Group
  • Employer Portal Update:  On June 16, EmployerAccess, is moving to a new and improved platform as part of a technical upgrade.  Learn more.
  • Required Annual Notices:  Members will receive several required notices such as the Notice of Privacy Practices, Women's Health and Cancer Rights and other important notices.  Learn more.
  • ACA Reminder:  Collection of corrected names and Social Security numbers is currently under way.  Learn more.

Small Group
  • Dental Complete Online Member Guide:  View the Online Dental Guide Demoit includes information on benefit details, how to search for a dentist, a dental cost estimator and more.  Learn more.
  • Real-Time Online Enrollment:  Beginning July 1, 2017, the Anthem standard will be to submit new enrollments, changes and terminations online through EmployerAccessLearn more.

Large Group
  • Mandatory Online Payment:  Effective 9/1/17, the new Anthem standard will be to issue bills (invoices) online and accept premium payments online throughEmployerAccessLearn more.
  • Act Wise CHDP Webinar: Register today for the June 22 webinar. Find out why Act Wise CDHP is the solution for your large group clients. Learn more.
  • Dental Prime and Dental Complete Online Member Guide:  View the Online Dental Guide Demoit includes information on benefit details, how to search for a dentist, a dental cost estimator and more.  Learn more.
  • Disability Claims:  View the Overview Brochure for an explanation of what to do to file a claim, what information is needed and more.

  • UCLA PCP Transitions:  Effective July 1, 2017, UCLA Medical Group will be transitioning 24 primary care physicians (PCPs) to Providence Saint John's Health Center, dba Saint John's Health Clinic, a participating IPA/medical group in the Blue Shield HMO network.  Learn more.


Support Center HR Advisor Newletter - June
  • Five Tips for Effective Meetings 
  • Unpaid Internships - DOL's six specific criteria
  • State Defined Protected Classes
  • OSHA Delays Electronic Record-Keeping Rule Compliance Date
  • Working Families Flexibility Act 
  • American Health Care Act (AHCA) - Employer Penalties Reduced to Zero
  • Working with Summer Scheduling Challenges
Want to learn more about HR AnswerLink's Support Center?  Click here or email us at  

  • Special FSA Discount:  Take advantage of this limited time offer available from July 1st -  September 30th,  to learn more, click here!

View Document
Carrier & Compliance Updates 6.5.17
by Rosa Tessandori » Thursday, June 08, 2017 12:31 PM


  • MLR Survey:  Surveys were mailed beginning May 25th and will be staggered over several weeks. When groups receive the survey notice, they will be prompted to visit a link and complete the survey. As a reminder, responses are not due until July 31. NOTE: Although most fully-insured small and large group customers will receive the survey, a small subset of customers will not if it does not apply to them. If a customer has not received the survey by the end of June, it is most likely the survey does not apply to them. 



       Producer Alert

  • New VP: Blue Shield is pleased to announce Steve Shearer as the Vice President and General Manager for our Small Business market. He joined the company on May 1, 2017.


     Broker Connection

  • 2018 HSA Limits:  Guidelines recently releases by IRS.
  • Pharmacy Update: Updated PPACA/HCR Preventive Care Medication Lists available


  • Earn a trip to Las Vegas:  Sell five (5) EaseCentral subscriptions before August 31, 2017 and you'll qualify for the EaseCentral Partner President's Club celebration in Last Vegas, Nevada this September.  View the flier.


  • HSA Webinar:  Join Benefit Resource, Inc, Thursday, June 8, 2017 at 1:00 ET for a webinar presentation; Be an HR Superhero: Drive HSA Adoption - Case Studies and Best Practices RevealedRegister now!


  • Wearable Technology:  What are the potential HIPAA compliance requirements that may apply when an employer receives health information that doesn't fall into the definition of Protected Health Information (PHI)? View the Alert.

View Document
Carrier & Compliance Updates 5.30.17
by Rosa Tessandori » Wednesday, June 07, 2017 4:53 PM


Producer Online News

  • ·         Cuidado Medico:  LiveHealth Online expanding.  Now members and consumers in 48 states will have access to Spanish-speaking doctors in their plans from the comfort of their home. 
  • ·         2017 Employer Application and Underwriting Guidelines:  Anthem has updated the language in the 2017 Employer Application in the Company Information, General Agreement, and Agent/Producer/Broker attestation sections.



     Small Business Broker Update

  • Relaxed Participation:  The employee participation requirement is just 25%, with a minimum of five enrolled employees. This promotion applies to dental, vision, and life* plans as well, as long as Blue Shield is offered as the sole carrier for specialty plans. View the flier.
  • Start-up Underwriting: Effective immediately, BSC has expanded their underwriting guidelines and will view new small business groups as a start-up based on the hire date of their first eligible common law employee.
  • Age Calculation Correction:  The new hire age calculation error for groups with effective dates prior to 9/1/16 has been fixed. Groups will be corrected as they renew.  Corrections will not be retroactive. Look for additional updates in July.

      Employer Connection Plus Update

  • EC+ Upgrade Rollout:  BSC has simplified and streamlined the renewal and benefit administration processes on EC+.  The new services will be available to select groups which renewed in the first quarter of 2017, and their respective brokers. Additional groups will be added through 2018. Eventually, all small business groups and brokers will have full access to the new services and tools.


E is for ERISA
  • Single-Payer: California is leading the discussion.
  • “Play or Pay”:  It is still in play.
  • Funding: If there are no penalties, revenue has to come from another source.
  • Renewals: 2018 Health insurance renewals will be business as usual.
  • Cost-containment:  Strategies that are gaining in popularity.



  • Teladoc Webinar:  Learn more about the telemedicine industry from a doctors' perspective, Teladoc's Senior Medical Director Dr. Kyon Hood.  Click here to view the recording.
  • Free HealthiestYou Membership:  As a thank you to brokers for viewing the Teladoc national webinar, HealthiestYou will provide you with a FREE Healthiest You VIP membership.  Contact to request assistance in setting up your free membership.


View Document
Carrier Updates 5.22.17
by Rosa Tessandori » Tuesday, May 23, 2017 8:46 AM

  • Member Portal:  View the update regarding the features and benefits of the Member tool, called Aetna Navigator. 
  • MC/PPO "HEAL" Benefit:  Aetna has partnered with HEAL to offer on-demand doctor house calls in two hours or less.  Click here for more info.
  • 8/1/17  Renewals:  As of Friday, May 19th, renewals will be available on the broker website and will be mailed out to groups on Thursday, May 25th.  Employers will be able to access a copy of their renewal through Employer Access (EA) as of Tuesday, May 30th.
     Producer Alert
  • Trio Only Groups - Participation Waiver Program:  Effective 9/1/17, BSC is waiving their participation requirements for groups of 1 to 100 eligible employees with Trio-only membership.  Frequently asked questions (FAQ’S)  will be sent out as soon as they are available.  Groups selecting Trio only for their medical health plans can also add specialty coverage – dental or vision – with the same minimum participation requirements waived! 
  • Updated Materials:  View the Q3 updated product guides, underwriting and marketing pieces.   Special underwriting note:  The additional Proof of Ownership requirements (listed based on business type), are ONLY Required for groups with less than 10 eligible employees –or- groups that don’t submit the Participation Certification Form (regardless of length in time in business).  Click here.
  • Quick Reference Sheet:  View a recap of product options, underwriting notes, commissions, Q3 rate action and network updatesClick here.

View Document
Carrier Updates 5.16.17
by Rosa Tessandori » Tuesday, May 23, 2017 8:36 AM

  • Athena WISDOM Study:  Members who choose to participate in the Athena Mammogram Study, may qualify for advanced testing options.  Blue Shield will send email invitations to potentially eligible members beginning May 8, 2017. Click Here to learn more.

     Broker Connection
  • Form 1095-B:  A new process will be used for collecting IRS 6055 Aggregate Information for 2-50 Small Group New Business.
  • Self-Funded Plan Sponsors:  A PCORI notice is scheduled for All Savers® Clients.  The employer groups will determine which counting method they wish to use, complete and file the IRS Form 720. The Federal Excise Tax return Form 720 can be found on the IRS website.
  • Vision:  The new vision network includes Target and Sears.
  • Sales Automation Management (SAM): The broker sales tool is now available in new markets.
  • Opiod Abuse:  Learn how UHC invests in a multi-dimensional programs to address opioid abuse.
  • PDL Tracker:  View the latest prescription drug list changes.

  • IRS Announces 2018 HSA Limits: To view the announcement, Click Here. The new annual maximum contributions are $3,450 for Individuals and $6,900 for families.

View Document
Blue Shield of CA 9/1 Renewals - Revised Release Date
by Rosa Tessandori » Tuesday, May 09, 2017 9:23 AM

  •  September Renewals: The previously published expected release date for September renewals has been revised from May 12, 2017 to June 16, 2017. Printed copies will be mailed to employers on June 23, 2017. These dates may be subject to further changes. Visit the Renewal Center for future updates.

Carrier Updates 5.8.17
by Rosa Tessandori » Tuesday, May 09, 2017 9:15 AM

  • Producer e-newsletter: View the May 4th, 2017 issue. It includes topics on the Rx 90-day retail network, real-time online enrollment, disability insurance awareness month and encourage employers to learn about wellness incentives.
  • My Anthem (Employer) News: View the May 9th Issue, it includes topics on the wellness webinar updates, tips on choosing a broker, Telahealth insights, unlocking online wellness, Provider Care Management Solutions (PCMS) and the latest in pharmacy news.
  • Wellness Webinar: Invite your employer groups to register for the May 17, 2017, 11:00 a.m. wellness webinar. Small and large group employers are welcome.

  • September Renewals: Renewals will be available for downloading via the broker website May 12, 2017. Printed copies will be mailed to employers on May 19th.  For more information, visit the Renewal Center

  • Trio Rewards: You can start generating your Earned Rewards bonus with a minimum of two new business cases or 500 new medical members or 200 net new Trio members. Click here to learn more.

  • September Renewals: Renewals will be available for downloading via the broker website the last week of June. Printed copies will be mailed to the employer for arrival during the 1st week of July.

  • Broker Webcast: Join UHC May 24, 2017 2:00 p.m. for an overview of UHC4me Sales Tools (focusing on renewals), 7/1 Underwriting Updates, How to Obtain Deductible Credit and more. Registration is not required but space is limited. Click here for details and click here to add to your calendar.


View Document
Carrier & Compliance Updates 5.1.17
by Rosa Tessandori » Monday, May 01, 2017 6:32 PM


      Producer Online News
  • Provider Care Management Solutions (PCMS): New Video educates members on this web-based program.
  • LiveHealth Online: Starting the week of May 1, Anthem individual and group members will get a series of campaign communications from Anthem about LiveHealth Online. Learn how members who sign up for LiveHealth Online during the campaign get a chance to win the grand prize.
  • Life & Disability Quotes: Producer Toolbox life and disability quotes now include a Group Plan Summary page at the end of their quote.
  • Small Group Ace Broker Program: This brochure highlights the benefits of the Anthem Circle of Excellence (ACE) Broker program.

  •  Trio Incentive Program (TIP): Earn an additional $250 for groups and $25 for members enrolling in one of our Trio plans between May 2017 and January 2018. TIP applies to new sales and renewals. View the details and more.
  • AuthAccel Online Tool: There is a new online system for providers to obtain accurate medical and pharmacy authorizations. View the alert.
  • Athena WISDOM Study: This study aims to improve how women are screened for breast cancer. Blue Shield of California is collaborating with UC Medical Centers, and some members may be eligible for benefits to participate in the WISDOM study. To learn more, click here.


     Compliance Update
  • Nondiscrimination Tests: What are they?
  • Form 5500:  is the employer subject to Form 5500 filings?  What is a Welfare Benefit Plan? Who must file a form 5500?

View Document
Carrier Updates 4.24.17
by Rosa Tessandori » Monday, May 01, 2017 6:14 PM

  • 7/1 Rate Action: Average quarterly increase - PPO 3.2% and HMO 7.1%.
  • 7/1 Product Grid: View the updated product grid, which includes the new Silver HSA 2000 (Indv) / 2600 (Fam) Aggregate (Non Embedded) deductible plan.
  • 7/1 Product and Benefit Selection Form: View the updated form.
  • ACEC Program: The American Council of Engineering Companies (association) offers health plans utilizing UHC's National Choice Plus Network. To learn more about this program and benefits for engineering and land surveying based companies, contact your RBG sales representative.

View Document
Carrier Updates 4.17.17
by Rosa Tessandori » Friday, April 21, 2017 6:03 PM


 Producer News Online

  • Q3 Rate Action:  Average quarterly rate increase PPO +3.1%, HMO +2.8% and 0% on specialty benefits.  View the rate guide.
  • Emergency Room Member Outreach Campaign: Take a peek at a few of the campaign examples on how to reduce unnecessary ER expenses.
  • Real-Time Enrollment:  Communications begin in April 2017.  Beginning July 1, 2017, the Anthem standard will be to submit new enrollments, changes and terminations online through EmployerAccess, also known as the Employer Portal.
  • Special Benefits Broker Guide:  Your guide to everything about dental, vision, life and disability.
  • Webinar- Health & Wellness:  Invite your clients to a 30-45 minute webinar Wednesday April 19, 2017, 11 a.m. Pacific Time.


  • Q3 Rate Pass:  No rate increase for medical and specialty plans.
  • "No DE9C":  Program is continued through August 2017.  
  • Relaxed Participation:  Program is continued through August 2017, view the flier.
  • July Renewals:  Kits are available online to download, mailed copies go out to the employer on April 21st.
  • Trio ACO HMO Updates: Incentive program begins in May, dual HMO option alongside Access+ HMO reminder and don't forget to use the Trio Zip Code finder tool.
  • Specialty Benefits:  Additional details coming soon on the Small Business Bundled Savings program.
  • Teladoc: Clients have access to Teladoc upon renewal.  Other value added features include Wellvolution, ID protection, Healthquity and Blue Shields Updated mobile app.