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California Special Open Enrollment Window

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Posted: March 10, 2020 by Staff Writer

Aetna

Guideline:

Must be the sole carrier confirmed by an attestation form

Must be complete at submission with all requirements in by 12/15 midnight – no exceptions

Recertification at renewal: Yes, to ensure group meets the definition of a small employer

Ancillary coverage will follow normal guidelines for participation and contribution

 

Anthem Blue Cross

Guideline:

Must be the sole carrier

Must be complete at submission with all requirements in by 12/16 by 5 PM

Dental/Vision will participate in Special Open Enrollment. Specialty lines must have a minimum of 2 employees enrolled on each specialty line selected

Recertification at renewal: No

 

Blue Shield of California

Guideline:

Can be written alongside another carrier’s HMO only, another carrier’s HMO and MediExcel only, or another carrier’s HMO and SIMNSA only

Regular underwriting guidelines apply

Must be submitted to Blue Shield by 5 PM on 12/31 and approved within 30 days of submission Dental/Vision follow medical. Life does not follow medical

Recertification at renewal: At the carrier’s discretion

CaliforniaChoice

Guideline:

Must be the sole carrier

Cases must be submitted to CaliforniaChoice on 12/16 by midnight and approved by end of business day on 12/31

Contingent approvals will be allowed

Recertification at renewal: At the carrier’s discretion

Ancillary coverage will follow normal guidelines for participation and contribution

Health Net

Guideline:

Does not require to be the sole carrier

Cases must be submitted to Health Net on 12/16 by 5 PM and must be approved by 5 PM on 1/21/20

Recertification at renewal: At the carrier’s discretion

Ancillary coverage will follow normal guidelines for participation and contribution

Kaiser Permanente

Guideline:

Does not require to be the sole carrier

Cases must be submitted to Kaiser on 12/16 by 5PM

Recertification at renewal: Yes, to ensure group meets the definition of a small employer

Ancillary coverage will follow normal guidelines for participation and contribution

UnitedHealthcare

Guideline:

Does not require to be the sole carrier with staff model carrier (can write alongside two staff model carriers)

Requires at least 5 CA employees to enroll with UnitedHealthcare if writing alongside another carrier

Must be complete at submission with all requirements in by 12/15 at 11:59 PM – no exceptions Recertification at renewal: Yes, to ensure group meets the definition of a small employer

Ancillary coverage will follow normal guidelines for participation and contribution

Western Health Advantage

Guideline:

Does not require to be the sole carrier

Case must be submitted to Western Health Advantage on 12/15 by midnight – no exceptions

Recertification at renewal: Yes, to ensure group meets the definition of a small employer




 

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