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