CaliforniaChoice has always placed the highest priority on giving its members more choices when it comes to something as important as health care.
Now, as part of our continuing commitment to deliver more, we’re excited to introduce the Member Value Suite. It gives your employees and their loved ones access to outstanding savings on a range of products, services, and activities. Plus, it’s available to your employees at no added cost to you or your business.
Here’s a snapshot of all of the available discounts through the Member Value Suite:
Your employees’ free Cal Perks® program membership offers savings on movies, theme parks, water parks, sporting events, travel, tax prep, retailers, and more.
The ChooseHealthyTM program offers discounts of up to 57% on Garmin®, Vitamix®, and Fitbit® products, fitness memberships for $25/month, and 25% savings on specialty health care practitioners in acupuncture, chiropractic, and therapeutic massage.
Employees enjoy reduced fees on hundreds of procedures at participating Dentegra® dentists across California and nationwide. Dentegra offers instant savings to your employees with no Dental claim forms or waiting periods.
The EyeMed® Vision One Eyecare program offers discounts on frames, lenses, and exams at participating JCPenney, LensCrafters, Pearl Vision, Sears, and Target locations in California and nationwide.
Your employees can save up to 50% on brand-name hearing aids, and take advantage of additional discounts on testing, batteries, and other devices through the EPIC® Hearing Service Plan.
The California Rx Card saves your employees up to 75% on brand name and generic prescription drugs – often reducing their cost to less than their Rx co-pay with insurance.
Talk with an Agent to Learn More
If you are interested in finding out more about the CaliforniaChoice Member Value Suite – and all of the benefits offered to your business and your employees through CaliforniaChoice – talk with your employee benefits agent.
Despite Congressional efforts and numerous lawsuits, the Affordable Care Act (ACA) is still the law of the land. This means your business may be subject to the ACA employer mandate. If so, there are several requirements for your business to stay within the law.
Where Do You Stand?
First, find out if the law requires your business to provide health benefits. Currently, if you own or manage a business with 50 or more full-time employees or full-time equivalent (FTE) employees, you are an Applicable Large Employer (ALE). That makes you subject to the ACA employer mandate. If you are unsure if your business is an ALE, visit the IRS website to help determine your status.
What You Need to Do as an ALE
Under its employer shared responsibility provisions, the ACA requires ALEs to either offer minimum essential coverage that is “affordable” and provides “minimum value” to full-time employees and dependents or pay a penalty to the IRS. ALEs can require employees to share in the cost of their health coverage. However, as of 2019, the employee cost cannot exceed 9.86 percent of an employee’s household income. The ACA further requires ALEs to report annually on coverage offered (or not offered) to employees using forms 1094-C and 1095-C.
Determining the Penalty
If an employer does not provide adequate coverage to at least 95 percent of employees and eligible dependents, and one full-time employee receives a premium tax credit to enroll for health coverage through a state health exchange (like Covered California), the IRS imposes a no-coverage penalty. In 2019, the no-coverage penalty is $2,500 ($208.33 per month) times the total number of full-time employees minus the first 30. There is no penalty for not offering health insurance to part-time employees. A greater penalty, $3,750 for 2019, applies if coverage is not affordable and does not provide minimum value.
The IRS calculates your penalty separately for each month during which you offer no coverage. Therefore, if you offer coverage for some months during the year, but not all, you pay for only those months you offer no coverage.
Businesses with fewer than 50 full-time equivalent employees in 2018 are not subject to the ACA’s employer mandate in 2019. That doesn’t necessarily mean you shouldn’t provide coverage. Many small businesses offer employee benefits, including health insurance coverage, to support recruitment and retention efforts. Keep in mind, your contributions to group health are tax deductible. Moreover, when you set up a Premium Only Plan (POP), your employees can pay their share of the premium with pre-tax dollars. A POP also means reduced payroll taxes for your business.
Controlling Health Care Costs
Cost is a huge factor for employers looking at options for health insurance. CaliforniaChoice allows you to control costs and offer employees more health care choices. With Defined Contribution, you choose the amount you want to contribute toward benefits and your employees apply those dollars toward the health plan they like best.
You can contribute a Fixed Percentage (50% to 100%) of a specific plan type, OR you can choose to contribute a Fixed Dollar Amount. If an employee selects a plan that costs more than your contribution, he or she simply pays the difference.
At renewal, you have the option to adjust your Defined Contribution – up or down – and lock it in for another 12 months.
Proposed California Legislation
In January, the state legislature introduced California Senate Bill (S.B.) 175 imposing a penalty on any California resident without health insurance. This proposed measure is working its way through the State Senate and is before the Committee on Governance and Finance. If it becomes law, we’ll outline the implications for your business.
How to Learn More
For specific details about selecting employee health benefits for your business, consult a health insurance agent. An agent will educate you about the process and provide information to help you choose what’s right for you and your employees.
Winter is finally on its way out and the sun is shining. It’s time celebrate and CaliforniaChoice can help. Check out the special offers and discounts you can take advantage of through Cal Perks, thanks to your CaliforniaChoice membership.
Save on Family Fun
Cal Perks offers savings of up to 40% on admission to some of California’s most-popular destinations for family fun. You can purchase discounted tickets to these attractions:
- Knott’s Berry Farm
- LEGOLAND California Resort
- SeaWorld San Diego
- Six Flags Discovery Kingdom
- Six Flags Hurricane Harbor
- Six Flags Magic Mountain
- Universal Studios Hollywood
Movie Ticket Discounts
With Blockbuster season in full swing, you can save up to 35% on movie tickets for the whole family. Take advantage of discounts at six prominent theatre chains across the state, including:
- AMC Theatres
- Harkin Theatres
- Pacific Theatres
- Reading Cinemas
- Regal Entertainment Group
A Relaxing Getaway for Less
Cal Perks can help you and your employees save on trips with discounts of up to 60% on hotel rates. Whether you want to escape to San Diego, Anaheim, San Francisco, or Las Vegas, you can find rates starting at well under $100 per night. Visit the Cal Perks website and check out the “Hotel Discounts” category.
Cruise the San Diego Harbor
Flagship Cruises & Events offers harbor tours, ferry and water taxi transportation, whale watching excursions, gourmet-prepared dinner and brunch cruises, yacht and boat charters, and fairy tale weddings.
Enjoy 25% off Dinner & Dance Cruises or Sunday Champagne Brunch Cruises on Flagship. You can also get one adult ticket free, when you buy one ticket, on seasonal Whale Watching Cruises or Harbor Tours on San Diego Bay.
Jump Start Your Beach Body
You can join LA Fitness online through until 3/28/2020, and take advantage of a low $25 initiation fee and pay just $34.99 per month per person for membership.
LA Fitness membership includes:
- The finest strength and cardio equipment
- Strength and free weight centers
- Unlimited group fitness classes – any class, any time
- Personal training
- Complete access to pool, sauna, and Aqua Fitness classes
- Basketball and volleyball
- Sports leagues
- Kids Klub (Babysitting)
- Juice bars
Visit www.calperks.com and choose the “Fitness/Wellness” category for details.
Note: Amenities and classes may vary from club to club; an extra charge applies for some amenities.
Enjoy More Activities
Cal Perks partner vendors include theme parks, amusement parks, home services and products, hotels, recreation venues, sporting events, entertainment venues, fitness centers, and much more. There is something for everyone at Cal Perks.
If you are already a CaliforniaChoice customer, login at calchoice.com to access your Entertainment Discounts in the Member Value Suite.
Get Free HR Support Services from CaliforniaChoice
CaliforniaChoice offers small businesses access to an online HR Support Center at absolutely no cost! We’ve partnered with Mammoth HR, a national human resources services leader, to help you stay on top of changing regulations affecting your business and your employees.
When you offer CaliforniaChoice health insurance benefits to your workers, you can take advantage of everything the HR Support Center has to offer, including:
CaliforniaChoice is more than great health benefits. The HR Support Center is one of many valued-added benefits that are part of the Business Solution Suite. Other benefits include discount Dental, Vision, and Hearing services, a Premium Only Plan (POP), prescription drug discounts, HSA Resource Center, and Cal Perks discounts on travel, entertainment, and sporting events.
Talk with an Agent to Learn More
If you are interested in finding out more about the CaliforniaChoice HR Support Center, or any of the other advantages offered in the Business Solutions Suite, contact your employee benefits agent. If you do not already have an agent, we can help you find one.
If you’ve been researching health insurance options for your small business, you’ve likely encountered the term “Exclusive Provider Organization” or EPO. This lesser known plan has its advantages, and it’s important to know all of your options before you make a decision. So, we’re breaking it down for you, including how an EPO differs from other health plan types, like a Health Maintenance Organization (HMO) or Preferred Provider Organization (PPO).
Here are answers to five frequently asked questions about EPOs.
1. What is an EPO?
An EPO is a health plan that combines the traditional features of an HMO with the flexibility of a PPO. Like an HMO, an EPO offers members access to a network of doctors and hospitals from which to choose. Also, like an HMO, it offers a budget-friendly premium. However, an EPO may limit or not pay for services outside of your EPO plan network (except in case of an emergency).
2. Where can I buy EPO coverage?
Roughly half of California is served by one or more EPO plans. CaliforniaChoice offers multiple EPO options among its carriers. Oscar Health offers 11 EPO plan options in Los Angeles County and Orange County, including two Bronze tier plans, three Silver plans, four Gold plans, and two Platinum plans. Anthem Blue Cross offers two Silver tier EPO plans and one Bronze tier EPO plan through CaliforniaChoice.
3. Does an EPO require me to have a Primary Care Physician, who will refer me to other specialists when I need care?
With an EPO, you typically do have a Primary Care Physician (PCP) who will help you manage your health care. However, not all EPOs require your PCP to make referrals. Some plans, like the Anthem Blue Cross EPO and Oscar Health EPO, allow you to self-refer as long as your specialist is part of your plan’s EPO network.
4. What if I need emergency care and have to go to the hospital?
If you have an unexpected emergency need for medical care, an EPO will generally cover your treatment at least for some part of your stay in the hospital. However, you must get a pre-certification for non-emergency hospital care. Special rules typically apply for maternity stays of less than 48 hours. Ask your broker or review your health plan enrollment materials for details.
5. How do I know if my preferred doctor is part of an EPO’s network?
Insurers in the state that offer EPO health plans have provider lists available on their websites. If you offer CaliforniaChoice to your employees, it’s easy to look up doctors and specialists using the Provider Search tool at calchoice.com. You can search for a doctor by name, gender, city or ZIP Code, distance from home or work, affiliated health plan(s), hospital, or medical group, and language(s) spoken.
Get Your Own Custom Quote
If you want to learn more about EPOs, your employee benefits agent can help.