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At CaliforniaChoice we offer flexible health care solutions. Our program includes eight top California health plans in a single package, giving your employees the freedom to select the option that fits their unique needs.

Our health plan comparison series explores the benefits of each of our offerings. This comparison spotlights Oscar Health, which offers group coverage in Los Angeles and Orange counties, and UnitedHealthcare, available statewide.

Oscar Health

Oscar is the country’s first technology-driven health insurer focused on improving the member experience through easy, personalized service.

Oscar for Business was launched to bring the same Oscar experience that individuals already love to the employer market.

 Oscar Benefits Overview

UnitedHealthcare

UnitedHealthcare of California provides access to quality care and helps you manage your family’s health care costs. The insurer’s large California HMO network includes physicians and health care professionals in your community. Offering a combination of benefits, quality care, wellness programs to help keep you and your family healthier, and award-winning customer service, makes UnitedHealthcare the smart choice for your family’s health care coverage needs.

UnitedHealthcare Benefits Overview

The CaliforniaChoice Advantage

With CaliforniaChoice, you and your employees can find a health plan that best meets your individual needs. One of your employees might choose UnitedHealthcare because of its statewide provider network. Another employee might prefer the technology focus of a regional plan like Oscar. With CaliforniaChoice, they both get what they want – plus the option to choose from six other plans, too.

The advantages of CaliforniaChoice are not just for your employees. There are benefits for you, too — like the ability to manage all of your employees’ health insurance benefits in a single program and pay just one monthly bill. CaliforniaChoice also offers single source administration for enrollment, eligibility, and customer service.

Check back to see additional CaliforniaChoice comparisons for these health plans:

An employee benefits agent can help you learn more about all of the advantages and coverage options from CaliforniaChoice. If you do not have an agent, we can help you can find one here.

CaliforniaChoice recognizes the importance of having choices when it comes to something as important as health care. That’s why we’ve created the most diverse portfolio of health benefits on the market. We give you and your employees the freedom to choose from eight different health plans in a single program.

We’re highlighting the key offerings of each of our health plans in our plan comparison series. This comparison features Western Health Advantage, available regionally in Northern California, and Anthem Blue Cross, available statewide.

Western Health Advantage

Since 1996, Western Health Advantage (WHA) has been a reliable health care partner to Northern Californians. Through its HMO network, WHA serves employers and individuals in Sacramento, Yolo, Solano, Napa, Sonoma, and Marin counties as well as parts of Placer and El Dorado counties. Supporting communities is one of WHA’s core values.

Western Health Advantage Benefits Overview

Anthem Blue Cross

Among the top insurers in the state, Anthem Blue Cross delivers health insurance coverage to millions of Californians. The insurer offers health improvement programs, simplified administration, and flexible, innovative benefits. 

Anthem Benefits Overview

The CaliforniaChoice Advantage

You can offer your employees coverage from eight health plans through CaliforniaChoice – so it’s easy to find one that best meets their unique needs. For example, one employee might select Anthem Blue Cross because it includes a preferred doctor, while another employee might choose Western Health Advantage because of its strong regional provider network. With CaiforniaChoice, they both get what they prefer, while other employees have access to six additional regional and statewide health plan options.

CaliforniaChoice offers other advantages, too. Like one monthly bill for all employees’ coverage, a Member Value Suite with discounts on gym memberships and fitness gear, a Business Solutions Suite that includes a no-cost Premium Only Plan, and a single email and toll-free phone number for customer care.

Visit our website again to see other CaliforniaChoice plan comparisons, including:

For additional information about CaliforniaChoice and its Member Value Suite and Business Solutions Suite, talk with your employee benefits agent or health insurance broker. If you don’t already have one, we can help you find one here.

If you’re among the groups offering your employees more health care choices using the CaliforniaChoice small group private health insurance exchange – or, if you’re considering employee benefits for the first time – you should know about the ChoiceBuilder ancillary benefits exchange.

ChoiceBuilder is a great complement to CaliforniaChoice, because ChoiceBuilder offers Dental, Vision, Chiropractic & Acupuncture, and Life Insurance through a single program. Coverage is available on either an employer-sponsored or voluntary basis, or a combination of the two. All employees’ coverage is billed together each month, so you don’t have the burden of dealing with multiple carriers’ invoices. There’s also just one employer application and one employee worksheet, plus one website to manage your ChoiceBuilder account.

It’s an ideal way to give employees access to more insurance without driving up costs for your business. That’s because ChoiceBuilder lets you select between Employer-sponsored coverage, which you decide how much you want to contribute to employee coverage, and Voluntary coverage, which lets employees enroll voluntarily at no cost to the business.

2021 Expansion

ChoiceBuilder is expanding in 2021 to offer coverage to groups of up to 500 employees (effective March 1, 2021, or later).

Coverage Choices

With ChoiceBuilder, you can choose from the following options for your employees:

Or, as previously noted, you can mix and match employer-sponsored and voluntary coverage, and share the costs on some insurance with your employees. If you choose, you can even offer ChoiceBuilder coverage to employees working less than 40 hours per week, as long as they work 20 or more hours weekly. Currently, ChoiceBuilder serves more than 8,000 California groups and 130,000+ members.

Diverse Carrier Roster

ChoiceBuilder offers a roster of insurers and administrators, as shown below:

Ask your broker about how you can make ChoiceBuilder your “go to” for ancillary benefits and your new full-service hub for Dental, Vision, Chiro & Acupuncture, and Life. ChoiceBuilder simplifies ancillary for you, so you can focus on your business and your customers.

Talk With a Broker to Learn More

You can offer ChoiceBuilder as a complement to health coverage through CaliforniaChoice, or as an add-on to health coverage available directly through a different program. ChoiceBuilder does not have to be added during your group’s traditional open enrollment period. In fact, some employees may appreciate the availability of ancillary apart from health coverage. ChoiceBuilder is available at any time. To get a quote for your business, ask your broker. If you don’t currently have an insurance agent or employee benefits broker, you can search for one here.

Following considerable negotiation, Congress voted December 21, 2020, to authorize additional funding for new COVID-19 assistance for businesses and individuals. President Trump put his signature on the bill on December 27, 2020, and applications for assistance resumed on January 11, 2021.

Part of the sweeping bill that includes emergency economic relief, government funding, and tax cuts, the legislation is one of the largest measures enacted by the U.S. House of Representatives and U.S. Senate.

The legislation includes an extension of federal unemployment benefits – providing $300 per week through mid-March to those laid off because of the coronavirus – as well as direct payments of up to $600 for individuals making up to $75,000 annually (or couples making up to $150,000) and an added $600 for each dependent child.

Other financial aid offered by the COVID-19 relief legislation includes:

The most significant aspect of the legislation for small businesses is
a revival of the Paycheck Protection Program (PPP), providing more than $275 billion to fund forgivable loans to qualified businesses hard hit by the coronavirus. The loan limit is $2 million, and businesses qualify based on their average monthly payroll in 2019, multiplied by 2.5 (or 3.5 if a qualifying restaurant or food-related business). This permits a business to secure a loan of up to 2.5 times its monthly payroll expenses. For example, if an employer had a monthly payroll of $100,000 in 2019, the business would qualify for a $250,000 loan. A qualifying restaurant or food business with a monthly payroll of $100,000 could qualify for a $350,000 loan.

Applications for first-time PPP applicants began January 11, 2021, through community financial institutions. Other financial institutions will begin taking applications later. Second Draw PPP loan applications began Wednesday, January 13, 2021, through community financial institutions only. 

To be eligible for a Second Draw PPP loan, a small business must have 300 or fewer employees – down from a 500-employee maximum in the prior program. Businesses have 24 weeks to use the funds, which can go toward payroll as well as rent or mortgage expenses.

Additional program details are available through a U.S. Small Business Administration office or participating institutions.

While we all await a decision from the U.S. Supreme Court on the constitutionality of the individual mandate provision of the Affordable Care Act (ACA), it’s important to remember that the ACA remains in force – and it continues to affect employers in California and nationwide.

Here are the ACA requirements that may affect your business in 2021:

Employer Mandate

The employer mandate in the ACA requires Applicable Large Employers (ALEs) to offer Minimum Essential Coverage (MEC) to their full-time employees and eligible dependents. An ALE is a business with at least 50 full-time employees, including full-time equivalent employees, on average during the prior calendar year.

If you are an ALE, and you fail to offer your eligible employees “affordable” coverage that provides minimum value to 95% of your full-time employees and their children (up to the end of eligibility when they turn age 26), you are subject to ACA penalties.

California Minimum Essential Coverage (MEC) Individual Mandate

The Minimum Essential California (MEC) Individual Mandate, which started in 2020, requires California residents to have qualifying health insurance for all months of the year, obtain an exemption to have insurance, or pay a fine to the California Franchise Tax Board when taxes are filed.

MEC can be employer-sponsored coverage, Individual and Family Plan (IFP) coverage, Medicare, or Medicaid (Medi-Cal in California), etc.

Federal Minimum Essential Coverage

Under the ACA, qualifying Minimum Essential Coverage (MEC) can be any of the following:

All ACA-compliant health plans have to include coverage for 10 Essential Health Benefits (EHBs):

No Mandate for Non-ALEs

If your business is not an ALE, there’s no requirement that you offer ACA-compliant health coverage to your employees. (If you’re not sure whether your business is an ALE, ask your employee benefits or insurance broker, or access the Employer Shared Responsibility Provision Estimator on the IRS website.)

Many times, regardless of group size, employers offer employee health benefits to help them attract and retain workers. While the unemployment rate is higher today than a year ago due to the impact of the coronavirus, [health insurance or unemployment???] rates are expected to decline as businesses reopen and hiring resumes. Employee health insurance can help you differentiate yourself as an employer, keep your employees happy, and offer you tax advantages, too. Businesses can generally deduct expenses for providing health insurance to employees and dependents on both their state and federal taxes.

In the 10 years since the ACA became law, the number of Californians without health insurance has declined dramatically. The rate of uninsured residents in California reached 12.4% in 2010 during the Great Recession, as compared to 7.2% in 2018.

Among those with health insurance, a majority get their coverage through their employer. According to the Kaiser Family Foundation analysis of 2019 data, California is among the states with the highest number of individuals with employer-sponsored health insurance: 18.3 million Californians, or 47% of those with health insurance.

Shopping and Comparing Plans

If you are interested in comparing the employee benefits options available in your area, one of the best ways to do so is to talk with a broker. The services are typically available free of cost, and consulting one can actually save you money.

That’s because a local broker will know your local marketplace, the HMO, PPO, and other options available, health care providers that are part of each health plan’s network, and the available value-added benefits.

If you do not have a broker, we can help you find one here.

In the weeks surrounding the November 3, 2020, election, many discussed what could happen under the new Biden/Harris administration. President Joe Biden was, after all, second-in-command during the Obama administration when the Affordable Care Act (ACA) was developed and first enacted.

According to health care policy experts interviewed by Fierce Healthcare, the new administration could move to shore up the ACA exchanges. That might include a change in subsidy eligibility, so more people qualify for tax credits that reduce their out-of-pocket premium cost. Changes could also include resumed funding for marketing of the federal and state exchanges, which was reduced by 90% in the past several years, as was funding for ACA navigators who assist with enrollments.

The Biden tax credit proposal put forth during the 2020 campaign would save nearly all current federal and state marketplace enrollees hundreds of dollars monthly – and likely push more into the individual marketplace, according to an analysis by the Kaiser Family Foundation.

In the final weeks of the Trump administration, the Centers for Medicare & Medicaid Services (CMS) announced several changes governing public health insurance exchanges, some of which are slated to begin this year and in 2022. While the Biden team may maintain some of the recent CMS alterations – like lower user fees – it may act to roll back others. That includes state waivers to test new options for their exchange populations and to collaborate with private firms to create “next generation exchanges.” Georgia has already received approval to transition from the Federally Facilitated Marketplace (FFM), www.healthcare.gov, to a state access model that enrolls consumers in coverage through private web brokers or directly with carriers.

The return of the Individual Mandate is likely to be reconsidered by Congress and the White House. You may recall that changes in 2017 eliminated the mandate as part of a GOP tax bill. That helped set up the legal challenge to the ACA, which is still being considered by the U.S. Supreme Court. (The assertion made is that the ACA is invalid in whole because the tax penalty for not having coverage is now zero.) A ruling could come any day – or as late as June 2021. Some analysts have suggested that immediate action by Congress could make the legal challenge moot.

The new administration could use executive power to undo the expanded availability of limited duration health plans enacted by President Trump. Federal laws currently allow for up to 36 months of non-ACA-compliant, short-term health care coverage. These plans are considered by some to be “junk” because of their limited coverage, pre-existing condition limits, or dollar amount caps on what’s included, which is why the California legislature banned limited duration plans as of 2019.

Renewed efforts to reduce prescription drug pricing is likely. According to reporting by NBC’s “Meet the Press” blog, President Biden could repeal existing law that bans Medicare from negotiating with drug manufacturers. His administration may also act to limit future price increases and push for competition among drugs that currently lack it.

While there was some advocacy by Democrats for a Medicare-like public option during the primary campaign, that seems far less likely now for a couple of reasons. While Sen. Kamala Harris was a proponent (before becoming Vice President), President Biden has always been less enthusiastic. Democrats have only a razor-thin edge in the U.S. Senate (50/50), with the new Vice President tipping the scale in the event of a tie vote. It’s important for the Biden/Harris team to push for proposals that can attract bi-partisan support.

COVID-19 was a top issue for voters in November, and a different approach to the pandemic is expected this year. According to the transition team, Biden and Harris have a seven-point plan to combat COVID-19, including:

  1. Access to regular, reliable, and free testing
  2. Increases in the supply of Personal Protective Equipment (PPE)
  3. Evidence-based guidance of how communities can navigate the pandemic
  4. Equitable distribution of treatments and vaccines
  5. Increased protections for older and higher-risk individuals
  6. New defenses for predicting, preventing, and mitigating pandemic threats
  7. Mask mandates nationwide

During the week of January 11, then President-elect Biden announced a new $1.9 trillion COVID-19 relief bill that includes planned investments in supplies for financially strapped hospitals, increased funding for vaccines and testing, as well as money to expand PPE manufacturing in the U.S.

Stay tuned to this blog for further updates as ideas turn into legislation and proposals work their way through the U.S. House of Representatives and U.S. Senate.

Everyone’s health care needs are different. That’s the idea on which CaliforniaChoice was built 25 years ago. CaliforniaChoice gives people the freedom to choose the health plan that’s right for them and their family. That’s because we offer access to eight premier health plans in a single health insurance program.

Understanding the key benefits of each of our plans is a critical part of the decision-making process. Our plan comparison series takes a closer look at what you can expect from each. This comparison highlights Health Net, available statewide, and Sharp Health Plan, serving the San Diego area.

Health Net

Established in 1977, Health Net of California is among the state’s largest health insurers. It offers a range of coverage options to millions of California residents. Within the CaliforniaChoice program, you and your employees can choose from 12 different HMO options.

Health Net Benefits Overview

Sharp Health Plan

Sharp Health Plan is the only local, commercial health plan serving San Diego since 1992. As a non-profit company, Sharp Health Plan gives back to the community by providing access to affordable health care of the highest quality, serving a variety of organizations ranging from small businesses to large employers to municipalities.

Sharp Health Plan Benefits Overview

The CaliforniaChoice Advantage

With CaliforniaChoice, you and your employees can find a health plan that best meets your needs. One of your employees might choose Health Net because of its statewide provider network. Another employee might prefer the benefits of a “hometown” health care provider like San Diego-based Sharp Health Plan. With CaliforniaChoice, they get the freedom to choose.

The advantages of CaliforniaChoice are not just for your employees. There are benefits for you, too — like the ability to manage all of your employees’ health insurance benefits in a single program and pay just one monthly bill. CaliforniaChoice also offers single source administration for enrollment, eligibility, and customer service.

Check back to see additional CaliforniaChoice comparisons for these health plans:

An employee benefits agent can help you learn more about all of the advantages and coverage options from CaliforniaChoice. If you do not have an agent, we can help you can find one here.

Health care is not one size fits all, which is why CaliforniaChoice gives you the freedom to choose from eight different health plans in a single program. While everyone loves choices, understanding the options and selecting a health plan that is right for you and your family can be a confusing process.

So, we’re breaking it down and comparing key benefits of each of our eight participating health plans. Below, we compare the benefits of Kaiser Permanente and Sutter Health Plus, two popular health plans available through CaliforniaChoice.

Kaiser Permanente

Kaiser Permanente was founded in 1945 and was one of the nation’s first health programs to offer comprehensive health care services on a prepaid basis.

Headquartered in Oakland, California, Kaiser Permanente’s innovative spirit drives the country’s largest non-profit health care organization – guided by physicians and focused on providing high-quality care to members.

Kaiser Permanente Benefits Overview

Sutter Health Plus

Not-for-profit Sutter Health Plus offers competitively priced HMO health plans in the Greater Central Valley, Sacramento, and San Francisco Bay Area. When you choose Sutter Health Plus, you gain access to a high-quality provider network that includes many of Sutter Health’s nationally respected and recognized hospitals, doctors, and other health care services – all at an affordable price.

Sutter Health Plus Benefits Overview

The CaliforniaChoice Advantage

With CaliforniaChoice, you and your employees have more choice – and the ability to find health insurance that meets your unique needs. One of your employees might choose a plan because of its broad PPO network. Another employee might select HMO coverage from a regional or statewide plan. With CaliforniaChoice, they both get what they need – while other employees have the option to choose from six other plans.

There are benefits for you, too – like a single monthly bill for all of your employees’ coverage and single-source administration for enrollment, eligibility, and customer care.

Check back to see additional comparisons on other CaliforniaChoice plans, including:

An employee benefits agent can provide you with more information about the advantages of CaliforniaChoice and the available coverage options . If you don’t already have an agent, you can search for one here.

Having health insurance choices is important. Health care is, after all, not “one size fits all.” Everyone’s needs are different. That’s why, at CaliforniaChoice, we give you and your employees the ability to choose from eight different health plans in a single health insurance program.

We’re looking more closely at each of those eight health plans in our comparison series – so you can evaluate the key benefits of each and determine what makes sense for your business.

This comparison will highlight Health Net, available statewide, and Western Health Advantage, available in Northern California.

 Health Net

Established in 1977, Health Net of California is among the state’s largest health insurers – offering a range of coverage options to millions of California residents. Within the CaliforniaChoice program, you and your employees can choose from 12 different HMO options.

Health Net Benefits Overview

Western Health Advantage

Since 1996, Western Health Advantage (WHA) has been a reliable health care partner to Northern Californians. Through its HMO network, WHA serves employers and individuals in Sacramento, Yolo, Solano, Napa, Sonoma, and Marin counties as well as parts of Placer and El Dorado counties. Supporting the communities is one of WHA’s core values.

Western Health Advantage Benefits Overview

The CaliforniaChoice Advantage

CaliforniaChoice gives you and your employees the ability to choose the health plan that meets your unique needs. For example, one of your employees could choose Anthem Blue Cross because of its PPO network. Another employee could select Western Health Advantage because of its 24/7 accessibility to nurses and doctors.

However, the advantages of CaliforniaChoice go beyond great health insurance options. There are extras for employers, too. CaliforniaChoice offers single source administration for enrollment, billing, eligibility, and customer service. You can manage all of your employees’ health insurance benefits in a single program – and pay just one monthly bill.

Check back to see additional plan comparisons, including:

Your employee benefits agent or insurance broker can help you learn more about all of the coverage options from CaliforniaChoice. If you don’t already have an agent, you can find one here.