NEWSROOM

Quarterly Wage Report/DE 9C not required for:

Aetna

Guideline:

Groups of 6+ enrolled with prior coverage

Anthem Blue Cross

Promotion:

Groups of 6+ enrolled through 12/15/2020 effective dates

Copy of last month’s prior carrier bill is required for all products selected

Excludes virgin groups

New groups without prior coverage will need to submit DE9C or payroll records

Payroll records are required for employees not listed on the prior carrier bill

Blue Shield of California

Promotion:

Groups of 5-95 FT/FTE that have 5-95 eligible employees do not require a DE9C. Owners do not qualify
towards the employee count

Underwriting reserves the right to request the wage and tax information (DE9C, payroll) whenever necessary to determine eligibility

DE9C may be requested for groups with employees 65+ years old enrolling 

If a group is enrolling with Out Of State employees, companywide payroll may be requested to confirm 51% eligible are in California 

CaliforniaChoice

Guideline:

Groups of 6+ medically enrolling employees

The most recent prior carrier bill is required

Employees that are enrolling and are not listed on the prior carrier bill will require one full run of payroll showing eligible hours and wages

Groups with a lapse of coverage of more than 3 months are not eligible

Health Net

HMO Package through the end of 2020

Quarterly Wage Report/DE9C not required for groups of 6+ enrolled through the end of 2020

6+ enrolled required. No further participation requirement

Participation Attestation Form, Prior Carrier Bill and Waivers are not required

Virgin Groups are eligible

The HMO package is separate from the Enhanced Choice A and B packages

Mix and Match any plans from the HMO networks

HSP and PPO plans do not qualify for this promotion

Kaiser Permanente

Promotion:

Quarterly Wage Report/DE9C not required for 6 or more enrolled with no end date

Business Documentation required (example: business license/SOI)

Start Up groups and groups leaving a PEO do not qualify for this promotion

UnitedHealthcare

Guideline:

Groups of 10+ eligible employees

Completed and Signed Participation Certification Form is required

This guide has been created as a quick reference and does not replace the full underwriting guidelines published by each carrier
Please refer to the carrier guidelines for additional information