Our Support & Resource Center

Hello!!

 

Highlights/Possible Employer Impact – Key Takeaways

  • Employers could claim religious exemption and discontinue coverage for contraception (although legal challenges are pending. (In response to the Pennsylvania Attorney General’s lawsuit, a U.S. District Judge acted on Dec. 15, 2017, to temporarily block the Executive Order to terminate the ACA birth control. Mandate.)
  • New association health plans (AHPs) – likely with reduced benefits – are expected.
  • It’s possible some employers will move from a health plan (covering only their business) to new association plans (with many participating businesses).
  • State could move to change essential health benefits (EHBs) for plans sold within their borders – replacing current national EHBs for ACA-compliant plans.

President Donald Trump’s October 2017 executive orders on health care could shake things up a bit when it comes to health reform and the Affordable Care Act (ACA), but the full impact may not be felt for a while. And the impact on small business private exchanges, like the CaliforniaChoice multi-carrier, employee-choice exchange, could be minimal – at least in the near term.

Under his October 6 executive order, President Trump expanded the rights of non-governmental employers and plan sponsors to deny insurance coverage for contraception to women on the basis of an employer’s sincerely held religious beliefs. The expanded exemption now includes employers who have a moral objection to providing contraception benefits; it permits employers and insurers to avoid the ACA requirement that birth control pills and other contraceptives be covered as part of the ACA’s preventive care benefits. (California updated its health care coverage provision regarding contraception in 2014, retaining a previously adopted out for religious employers. You can read the California law here.)

A second executive order signed in October (that could affect employee benefits) asks government agencies to implement new rules to enable small businesses to band together and get health insurance through the re-establishment of association health plans, which would be subject to fewer benefit requirements than current ACA-compliant plans.

 

Impact Greater in 2019

Changes proposed under the executive order on association health plans will not occur until federal agencies and Congress write, approve, and adopt new regulations. That process could take months, and include a public comment period. Exempt from federal rules under the ACA, future association health plans could eliminate coverage for mental health, maternity benefits, and pre-existing health conditions. That would certainly give association plans a pricing advantage, but it could also further destabilize the health care marketplace as healthy individuals leave their current employer-sponsored group health plans and individual health plans in favor of less costly coverage.

Another potential change affecting employers is the Trump administration’s proposal to give states increased flexibility when it comes to essential health benefits (EHBs) for plans sold within their borders. The proposed 2019 Notice of Benefit and Payment Parameters, released by the Centers for Medicare & Medicaid Services (CMS) on Friday, October 27, 2017, would allow states to annually set their benchmark plans’ EHBs. It would permit a state to borrow another state’s 2017 benchmark plan – in whole or in part – or create a new plan so long as it follows certain coverage criteria. A state could, for example, keep most of its current EHBs but replace its prescription drug benchmark with one adopted by another state. Stay tuned for updates as insurers and associations work out their planned offerings and pricing in 2018.

Exchange Coverage

The CaliforniaChoice private exchange began more than 20 years as an alternative for small businesses – giving employers and their employees increased coverage and carrier choices, a method for businesses to control their health care costs (through defined contribution), and easy administration (with one bill for all coverage, regardless of how many employees are enrolled in any single plan offered). That will continue, regardless of what may happen with association health plans.

If you want to shop and compare health care options for your employees, contact your broker and ask about the CaliforniaChoice program, which includes coverage from seven different health plans. If you don’t already have a broker, we can help you find one.

 

CaliforniaChoice has been delivering great employee benefits to small businesses in California since 1996, but the portfolio changes coming in 2018 mean you now have even more reasons to consider CaliforniaChoice for your employees.

The CaliforniaChoice multi-carrier employee-choice program offers greater access to doctors, specialists, and hospitals – with both full and limited networks, a range of HMO, PPO, and HSA-compatible plans, and a choice of one or two Affordable Care Act (ACA) metal tiers.

 

A Roster of Outstanding Carriers

CaliforniaChoice is the only place you and your employees can choose from seven leading health plans in one program: Anthem Blue Cross, Health Net, Kaiser Permanente, Sharp Health Plan, Sutter Health Plus, UnitedHealthcare, and Western Health Advantage.

For 2018, Anthem Blue Cross is updating some of its PPO options to provide richer benefits. Across all metal tiers, Anthem is offering three HMO plans, six PPO plans, and two Exclusive Provider Organization (EPO) plans.

Health Net is adding three new plans and access to the Community Care Network. Health Net offers six HMO plans and three Health Care Service Plan (HSP) options.

Kaiser Permanente is offering both rate and benefit parity on all nine of its plans available through CaliforniaChoice. That means you will pay the same and enjoy the same Kaiser Permanente benefits through CaliforniaChoice as you would if you chose a direct plan.

Sharp Health Plan is a favorite in the San Diego area, and you can choose a dozen plan options across all metal tiers with CaliforniaChoice.

Sutter Health Plus continues to expand their Northern California network; coverage is being added in Santa Cruz County for 2018. A total of eight plans is available from CaliforniaChoice across the 15-county Sutter Health service area.

UnitedHealthcare continues to offer coverage in all four ACA metal tiers – with a dozen plans available through CaliforniaChoice.

Western Health Advantage, operating in nine Northern California counties, is adding the Canopy Health alliance of providers and hospitals for 2018, giving CaliforniaChoice members even more health care options.

 

Member Value Program

Beyond a wide variety of health plans, CaliforniaChoice is adding the Member Value Program to its no-cost Business Solutions Suite for 2018.

Through the Member Value Program, CaliforniaChoice members can save up to 40% on a variety of health and fitness products and services:

 

 

And, of course, the CaliforniaChoice Business Solutions Suite includes much more than the Member Value Program. It offers discounted Dental, Vision, and Hearing benefits, a free Premium Only Plan, a free Flexible Spending Account, COBRA billing, human resources support from HRAnswerLink, prescription drug discounts, Cal Perks travel and entertainment discounts, and more.

 

Great Tech Tools, Too

To make it even easier for you and your employees, CaliforniaChoice offers Smart Decision Technology to streamline your health plan selection and enrollment:

 

 

CaliforniaChoice is an easy answer to the question “What plan should I choose for my employees?”

To learn more about all of the advantages available to you, your company, and your employees from the CaliforniaChoice multi-carrier, employee-choice program, contact your broker. Or, if you don’t already have a broker, we can help you find one.