News

Oscar and Cigna Healthcare will not renew Cigna + Oscar Small Group plans nationally. Coverage for Cigna + Oscar Small Group services will continue through the end of each member’s policy, and specific timing is dependent on each groups’ enrollment date. Key dates to know: Cigna + Oscar will no longer enroll new small groups beginning January 1, 2025. The last date for an employer to start a new policy with Cigna + Oscar will be December 15, 2024. Cigna + Oscar will not renew Small Group plans beginning January 1, 2025. The last Cigna + Oscar Small Group plans renewed will be those with effective dates of December 15, 2024. The last date of member coverage in the market will be December 14, 2025 . Contact You Dickerson Sales Representative to Learn About Available Options.

Providence has rescinded its termination, and a new contract agreement has been tentatively reached with Blue Shield of California. This new agreement would ensure members have continued in-network access to their Providence doctors, clinics, and hospitals. Members will be able to continue receiving care from their Primary Care Providers (PCPs) with no action required. If members updated their Providence PCP online or via Customer Service, they would need to either call Customer Service again or update their selection through their Blue Shield member portal. For Help Quoting Blue Shield Contact Your Dickerson Sales Rep Today.

CCSB has received reports of a new phishing scam targeting Covered California enrollment partners. The recent reports are phishing attempts that appear to come from admin@hbex.ca.gov and request the recipient click on a secure link to verify or update personal information. Please disregard these emails as they are not real; do not click on any links within the email. Emails from Covered California will always have @covered.ca.gov email addresses. Please confirm the sender’s actual email address is correct before opening messages. Many phishing scams will feature familiar contact names with fake email addresses. If you have any questions or need to report future phishing emails that appear to be from Covered California, please call the Agent Service Center or email outreachandsales@covered.ca.gov. For More Information, Please Contact Your Dickerson Sales Rep.

Humana is now offering short-term and long-term disability plans for California-based groups. These plans are currently available for quoting and provide comprehensive financial protection for employees who may be unable to work due to illness, injury, or disability. Key Advantages Include: Flexible Plan Design: Options for both employee- and employer-paid premiums allow tailoring to meet workforce needs and provide a competitive benefits package. Streamlined Administration: The plans integrate easily with other benefits, and dedicated support simplifies management for employers. Extensive Coverage: Whether short-term or long-term, Humana’s plans cover a wide range of conditions like pregnancy, cancer, heart attack, accidents, and more. Bundled EAP: Employers bundling one Humana disability plan with two other Humana lines of coverage receive an Employee Assistance Program at no extra cost. Humana’s disability plans prioritize employee well-being, are easy to use, and provide comprehensive income protection, making them a valuable addition for employers looking to enhance their employee benefits. For More Information, Click Here For Help Quoting Humana, Contact Your Dickerson Sales Rep Today!

(April 23, 2024) Early in the year is the time for employers who are approaching or over 50 employees to document and update the “key components” of being a larger employer, to ensure that no compliance obligation is missed. The world of human resources is fast-paced, and it’s easy to overlook compliance requirements, especially if they are new to you or you are new to your organization. Following are three key considerations for larger employers. First, determine if you will have any 5500 obligations for your health and welfare plans (this is a separate obligation from the 401(k) 5500s). You do this by determining how many employees are enrolled on the first day of the plan year for your plans subject to ERISA (including Medical, Dental, Vision, Group Term Life and Disability Insurance). If any one of those plans have more than 100 employees enrolled on the first day, you will be obligated to file a 5500 for that year. Your local Alera Group office can assist you with finding a partner for your 5500s and determining how many 5500s you are responsible for (your ERISA plan documents will play a part in that determination). Second, if you are an applicable large employer (ALE), which means you have 50 or more full-time or full-time-equivalent employees, you are obligated to offer affordable, minimum value, minimum essential coverage to every full-time employee. There are three ways to calculate affordability. Alera Group can assist you with these calculations and provide you with a PPACA Affordability Calculator. Third, if you are an ALE, you must track hours of all of your employees — even if you are confident everyone works 30 hours a week or more — and you must use either the monthly measurement method or the look-back measurement method. Your tracking results dictate which employees need to receive a 1095-C and how to handle leaves of absence. To Read More, Click Here

(By Kristen Hwang) You won’t notice it right away, but a new California state agency took a major step this week toward reining in the seemingly uncontrollable costs of health care. The Office of Health Care Affordability approved the state’s first cap on health industry spending increases, limiting growth to 3% by 2029. This means that hospitals, doctors and health insurers will need to find ways to cut costs to prevent annual per capita spending from exceeding the target. Between 2015 and 2020, per capita health spending in California grew more than 5% each year, according to federal data. A board appointed by Gov. Gavin Newsom and the Legislature on Wednesday approved the new regulations in a 6-1 vote. Health and Human Secretary Dr. Mark Ghaly, who chairs the board, said the regulations recognize that Californians are struggling every day to pay for health care and the state has a role in helping them. “We have a place in making sure it becomes more affordable,” Ghaly said. Hospitals, doctors and insurers battled over the regulations for months, arguing that rising inflation and labor costs would make the target impossible to achieve. An earlier proposal would have moved more aggressively to cap costs. The final version gives the industry time to rein in spending. Ghaly said he is confident health care industry leaders will be able to find solutions to meet the new target. “When that happens, it’s going to be great for Californians.” How does it work? Increased health spending most often translates to higher out-of-pocket costs for consumers in the form of premiums, deductibles and copays. The annual spending benchmark would require health care providers to limit spending growth to 3.5% next year, decreasing to 3% by 2029. Providers — including hospitals, doctors groups and health insurers — will have to submit spending data to the state to demonstrate that they are complying with the cap. The affordability office also has authority to enforce penalties, including performance improvement plans and fines, for organizations that exceed the benchmark. It will not enforce penalties until 2029. Assemblymember Jim Wood, a Democrat from Ukiah, at the meeting urged the board to send a clear message to Californians that the state is taking affordability seriously. Wood spearheaded the legislation that created the office in 2022. “It is not an exaggeration to say that people are deciding whether to get food on the table or get their medicines,” Wood said. “This is not an exercise. This is an effort to impact the real life experiences of people in California.” To Read More, Click Here