News
The Latest Carrier Updates, Legal Alerts, Industry News and more.
Anthem Balance Funding Reminders, CCSB Partnership That Pays, Kaiser Permanente Underwriting Update, TriNet Broker Incentive
Thursday, May 14 2026
Carrier Updates
Anthem Balance Funding sales over the past 12-14 months have increased. Anthem is one of the only carriers who offers both ACA and Balance / Level Funding and allow their HMO to be written alongside ABF. Anthem ABF (Level Funded) plans may be sold alongside Anthem fully insured Small Group ACA HMO plan(s) when certain criteria are met. Anthem has provided helpful information when speaking to your clients about this product. Eligibility • The group must qualify as a Small Group (100 or fewer eligible employees). • This applies statewide (CA). Plan Offering • Adding ACA HMO plan(s) does not reduce the number of ABF plans offered. Enrollment / Participation Requirements The group must satisfy both ABF minimum enrollment requirements and ACA participation rules: • Overall participation: At least 75% of net eligible must have comprehensive medical coverage (through ABF enrollment, ACA HMO enrollment, and/or valid waivers, as applicable). • ABF minimum enrollment: At least 50% of net eligible must enroll in Anthem ABF. • Important: Even if ACA HMO enrollment counts as a valid waiver for ABF, it does not reduce the ABF requirement that 50% of net eligible must enroll on ABF. Waiver Treatment (Alongside) • ABF enrollees are considered valid waivers for ACA HMO participation. • ACA HMO enrollees are considered valid waivers for ABF participation; however, they do not offset the 50% ABF enrollment requirement. RFP Requirement (Must Be Requested Up Front) • An alongside sale must be requested at the time of the RFP. • Please include: • The fully insured quote request for the ACA HMO plan(s), and • A census reflecting the anticipated HMO enrollees. Out of State flexibility that is specific to ABF Effective immediately, Anthem will follow the below guidelines for ABF opportunities where CA does not have the majority of eligible employees. • If CA has the majority of the eligible employees, no UW approval is needed (Normal guidelines .. same as ACA) • If CA and Anthem state(s) have the majority of the eligible employees, no UW approval is needed ( New guidelines that apply to ABF ONLY, see example below) • If members are in CA but not majority and also not in Anthem states as majority, UW approval will be required (contact appropriate Anthem SAE based on Boker / Territory) ***** Anthem States (CA,NV,CO,MO,OH,WI,KY,GA,ME,IN,CT,VA,NH, NY) For More Information or Help Quoting Anthem, Please Contact Your Dickerson Sales Representative.
Carrier Updates
Covered California for Small Business (CCSB) has relaunched the Partnership that Pays Bonus Program, running July 1, 2026 through January 1, 2027 . CCSB is excited to introduce more incentives for you and new benefits and features for your clients. Learn more below about how you can help employers maximize their health plan options at no extra cost. Groups sold through Dickerson are eligible for this program. Group Size (Enrolled Employees) Bonus Per Group ($50,000 Maximum Cap) 51-100 $6,000 / $9,000 26-50 $4,000 / $6,000 11-25 $2,000 / $3,000 8-10 $1,000 / $1,500 5-7 $500 / $750 For Full Details Click Here For More Information or Help Quoting Covered Calfornia for Small Business, Please Contact Your Dickerson Sales Representative.
Carrier Updates
Kaiser Permanente has shared an underwriting update for California startup groups, effective June 1, 2026. Payroll Documentation Requirements for California startup groups with 5 or fewer enrolled employees, will now require at least two consecutive weeks of payroll records prior to enrollment. W-4 forms and paystubs will no longer be accepted. • These documents (W-4 forms and paystubs) may not be used to validate the employer–employee relationship This applies to: • Newly established businesses, and • Existing businesses that have not yet established active payroll Acceptable Documentation • Payroll records covering two consecutive weeks (minimum) • Quarterly Wage Reports remain the preferred form of documentation when available Payroll records are required to provide verifiable proof of an active employer–employee relationship. W 4 forms only indicate intent to establish payroll and do not confirm employment. Paystubs alone are no longer sufficient. For More Information or Help Quoting Kaiser Permanente, Please Contact Your Dickerson Sales Representative.
Carrier Updates
TriNet has unveiled a new broker incentive for closed business that you bring in this summer. Any new PEO clients that runs first payroll between June 1 and September 30, 2026 , is eligible for a one-time SPIFF, paid in two installments and based on worksite employee (WSE) size: • $5,000 for new clients with 10–49 WSEs • $10,000 for new clients with 50+ WSEs. Payout timing: • 50% paid in October 2026 • 50% paid in October 2027, assuming the client is still with TriNet PEO For More Information or Help Quoting TriNet, Please Contact Your Dickerson Sales Representative.