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The Latest Carrier Updates, Legal Alerts, Industry News and more.
RxDC Reporting Guidelines, Anthem Promotion Extended, Health Net SB 729 Updates, Kaiser Permanente Medical Center Spotlight, Molina March Madness, HCSO, Legal Alerts, News & More
Thursday, March 27 2025

Carrier Updates
* Extended For All 2025 Effective Dates* Anthem has a great solution for your CA Small Group Cigna + Oscar business. All they need are the following items for groups who are moving off Cigna + Oscar. • Small Group Employer Application • Cigna + Oscar bill / statement (80% enrollment required from on the C+O bill / statement … no reconciliation required) • Employee Enrollment • 1st months premium *Groups must be headquartered in CA *We will review groups with high out of state participation on a case-by-case basis. Please contact your sales representative or GA Concierge for specific case review For More Information or Help Quoting Anthem, Please Contact Your Dickerson Sales Rep.

Carrier Updates
SB 729 Healthcare Coverage: Treatment for Infertility and Fertility Services SB 729 requires large group healthcare service plans and insurance policies issued, amended, or renewed on or after July 1, 2025, to cover fertility treatments, including in vitro fertilization (IVF), while small group plans are only required to offer coverage of fertility treatments, including IVF. Key Implementation Details Effective Date: Coverage updates mandated by SB 729 will be effective for new and renewing groups starting July 1, 2025. Large Group (Fully Insured, 101+ Participants) Coverage is required for the diagnosis and treatment of infertility. Benefits include artificial insemination, GIFT, IVF, and ZIFT, with up to three (3) oocyte retrieval cycles per lifetime and unlimited embryo transfers. Includes all necessary covered services that prepare members for these procedures, including prescription drugs, professional services, inpatient and outpatient care and treatment by injections. No lifetime maximum limitation on covered infertility services. Cost-sharing for infertility services aligns with the applicable service type listed in the Schedule of Benefits. For example, if an infertility service requires an office visit, the office visit copayment will apply. Infertility prescription drugs are subject to the applicable Tier 1, 2, or 3 drug copayments as listed in the Schedule of Benefits. Coverage applies only to Health Net Members. Large Group Renewal Letters have been updated to reflect SB 729 coverage changes. California Large Custom Groups Coverage includes artificial insemination, GIFT, IVF, and ZIFT, with three (3) or more oocyte retrieval cycles per lifetime and unlimited embryo transfers. Includes all necessary covered services that prepare members for these procedures, including prescription drugs, professional services, inpatient and outpatient care and treatment by injections. No lifetime maximum limitation on covered infertility services. Cost-sharing for infertility services aligns with the applicable service type listed in the Schedule of Benefits. For example, if an infertility service requires an office visit, the office visit copayment will apply. Infertility prescription drugs are subject to the applicable Tier 1, 2, or 3 drug copayments as listed in the Schedule of Benefits. Coverage applies only to Health Net Members. CalPERS plan implementation is delayed until July 1, 2027. Small Business Group (SBG) Plans are available with or without infertility benefits, with the latter offered at a lower cost. The following outlines the options available to small groups. Benefits include artificial insemination, GIFT, IVF, and ZIFT, with up to three (3) oocyte retrieval cycles per lifetime and unlimited embryo transfers. Includes all necessary covered services that prepare members for these procedures, including prescription drugs, professional services, inpatient and outpatient care and treatment by injections. No lifetime maximum limitation on covered infertility services. Cost-sharing for infertility services aligns with the applicable service type listed in the Schedule of Benefits. For example, if an infertility service requires an office visit, the office visit copayment will apply. Infertility prescription drugs are subject to the applicable Tier 1, 2, or 3 drug copayments as listed in the Schedule of Benefits. Coverage applies only to Health Net Members. For More Information or Help Quoting Health Net, Please Contact Your Dickerson Sales Rep.

Carrier Updates
Kaiser Permanente is here for you in the Riverside area. From primary care to urgent care to speciality care, Kaiser Permanente locations offer a variety of services to help you get the care you need. To see facilities near you, visit kp.org/morenovalley San Bernadino Medical Center Fact Sheet All over California, people turn to Kaiser Permanente for quality care that's simple, personalized and hassle-free. Whether you're visiting one of our locations for a simple checkup or more serious medical treatment, we've got you covered. Most of our locations include pharmacy, lab, x-ray services, and many other innovative features that help Kaiser Permanente the care you need when you need it. Kaiser Permanente Summary of California Locations Click Here For More Information or Help Quoting Kaiser Permanente, Please Contact Your Dickerson Sales Rep.

Dickerson News
Dickerson Insurance Services is bringing the excitement of March Madness to you with our NEW Molina March Madness Bonus Program. The broker with the highest number of new lives enrolled through the month of March will take home a $500 bonus. If you're not already selling Molina, now is the perfect time to start! Important: You must be appointed with Molina at the time you write the policy to receive commissions. Don’t miss out—get appointed today! About the program: Program Term: Policies with effective dates from March 1, 2025 through April 1, 2025 will count towards the program. *Bonus is hosted by Dickerson and will be paid out in August through the Dickerson commission system. Eligible Participants: Brokers must be licensed, appointed and sell Molina Healthcare under Dickerson Insurance Services and enroll a minimum of 10 new lives during the program term to be eligible. Eligible Business: Must be new business to Molina. Exclusions: PEO plans and Medicare plans are excluded from this program. ** Members must remain active with premiums paid for 3 months. Final Determinations: This program is offered at our sole discretion, and we can terminate or modify it at any time and without notice. Any subsequent program is at our discretion. We may modify programs and compensation to comply with state law, regulations or approvals. Our records determine producer’s final results and will be the only basis for determination of qualification, calculation and payment of credits. Our decisions are final. To see the Molina Healthcare Bonus Program for 2025 Click Here For More Information or Help Quoting Molina Healthcare, Please Contact Your Dickerson Sales Rep.

Carrier Updates
The Consolidated Appropriations Act of 2021 (CAA) added pharmacy reporting requirements under the Internal Revenue Code, ERISA, and the PHSA. To help brokers and groups navigate these requirements, we've created a RxDC guide. RxDC reporting deadlines are different for each carrier. Check out our RxDC Guide that organizes carrier deadlines, links to the employer survey, and additional information about this requirement from our carriers. These requirement deadlines are coming up, review the RxDC guide below. Please note this is guide is for fully insured plans. For more information about Pharmacy Data Collection Under the CAA read our Whitepaper here . Carrier Who's Reporting Employer Survey Link Survey Due Date Resources Aetna Carrier will report View survey here 3/31/25 Anthem Carrier will report Surveys were sent 2/17/25 View survey here 3/28/25 Anthem CAA Transparency Client FAQ Blue Shield Carrier will report Survey is on Employer Connection or View survey here 4/19/25 Blue Shield RxDC Survey FAQ California Choice Please refer to enrolled carrier Refer to specific carrier's guideline N/A Covered California Small Business Please refer to enrolled carrier Refer to specific carrier's guideline N/A Health Net Carrier will report No survey required N/A Health Net will meet all regulatory obligations for 2024 reporting due June 1, 2025. The Plan will not require any data from employer groups. Humana Carrier will report Not released yet Kaiser Permanente Carrier will report Survey is on KP employer portal or View survey here 3/31/25 Kaiser RxDC FAQ MediExcel Carrier will report MediExcel has reached out to groups 5/5/25 Employers and brokers can reach out to rxdc@mediexcel.com for more information. Sharp Health Plan Carrier will report Not released yet United Healthcare Carrier will report UHC will send reminders via Connect. This worksheet to help with the request. UHC RxDC worksheet 3/31/25 United Heathcare RxDC FAQ