We all love choices, but the reality is navigating the complexities of health insurance can be overwhelming — for both you and your employees. Each of you is different; you have different health care needs, budgets, and preferences. The truth is, there is no single health plan that works for everyone. That’s what’s why we do things differently at CaliforniaChoice.
CaliforniaChoice offers HMO, EPO, and PPO coverage options from the state’s top health plans in a single program. And, we’re proud to announce the newest addition to the CaliforniaChoice program, Cigna + Oscar. In this series, we’re breaking it down for you and comparing key benefits of each of our participating health plans. The comparison below looks at how Cigna + Oscar compares to Anthem Blue Cross.
Cigna + Oscar
Partnering in 2020, Cigna + Oscar is designed to work for small businesses. It brings together the power of Cigna’s nationwide and local provider networks and Oscar’s member-focused experience. The companies offer affordable, seamless, fully insured health benefits for small businesses and their employees.
Cigna + Oscar Benefits Overview
- Integrated medical, behavioral, and pharmacy services
- Broad access to high-performing networks of doctors and hospitals
- Support from a dedicated concierge team assigned to members to help each understand available plan benefits and find care
- Digital-first support, featuring 24/7 telemedicine at no charge + easy ID card access
- Search tools to review health care providers, book appointments, find facilities, and check prescriptions
Anthem Blue Cross
Anthem Blue Cross is among the state’s top insurers, delivering health insurance coverage to millions of Californians. The insurer offers flexible, innovative benefits, health improvement programs, and simplified administration.
Anthem Benefits Overview
- One of the largest PPO networks in the country with access to more than 60,800 doctors and specialists in California
- Contracted with more than 90% of hospitals in California, including 400 acute care hospitals
- Strong network contracting with an average 60% hospital discount and 48% average provider discount
- Cost and care finder tools online and via the Anthem mobile app; it’s easy to compare costs for common services and procedures based on specific benefits; you can also check the quality of providers through ratings and member reviews
- PayForward gives you an opportunity to earn cash back when shopping at thousands of retailers; a separate Special Offers program includes discounts on healthy products and services
- Wellness programs and tools to help keep you active and fit
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 an EPO from Cigna + Oscar. Another employee might prefer a PPO plan from Anthem Blue Cross. With CaliforniaChoice, they both get what they want – plus others have the option to choose from 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:
- Health Net
- Kaiser Permanente
- Oscar Health
- Sharp Health Plan
- Sutter Health Plus
- Western Health Advantage
An employee benefits agent can help you learn more about all of the advantages and coverage options from CaliforniaChoice. If you do not already have an agent, we can help you can find one here.
If you offer one or more High Deductible Health Plan (HDHPs) to your employees, you may know that, while it lowers the monthly premium, it raises the deductible (i.e., you pay more for health services before an insurance plan pays). However, you may not know the advantages of pairing a HDHP with a Health Savings Account (HSA).
How It Works
For 2021, out-of-pockets costs on an HDHP cannot exceed $7,000 for self-only coverage or $14,000 and family health coverage. Still, that’s a significant amount of money for the average person. This where a HSA can help. Individuals with an HDHP (and a plan deductible of $1,400 for individual coverage or $2,800 for family coverage) can use an HSA to pay for eligible out-of-pocket health care costs, including the deductible.
What’s more, contributions made by employees to an HSA generally are not subject to federal income tax, nor state taxes in most cases. Earnings grow on contributions tax-free. And, withdraws are not taxed as long as funds are used to pay for qualified medical expenses. In addition, unspent HSA funds roll over at the end of the year, making them available for future qualified expenses.
That contrasts to a Flexible Spending Account (FSA), which is a “use it or lose it” account, although there is often a grace period of up to two and a half months during which an account holder can use unspent FSA money. This is separate and distinct from an FSA Run-Out Period, which allows employee claims for up to 90 days after the plan year ends – so long as expenses are incurred during the plan year, on or before December 31.
Retirement boost: After reaching age 65, account holders can use HSA funds to supplement retirement, although money is subject to income tax (at the federal and state level) if not used for medical-related expenses.
FSAs vs. HSAs
In addition to the roll over aspect of FSAs mentioned above, there are other differences between FSA and HSAs.
FSAs are only available through an employer, and an FSA cannot be established by a person who is self-employed or unemployed. If an employee leaves his or her employer, the FSA does not travel, too; funds are forfeited to the employer. Not so for an HSA.
An HSA can be set up through an employer, or independently through a qualifying financial institution. Bankrate.com published an article in 2020, How to choose the best health savings account, with other guidance on the topic.
Unlike with an FSA, if an employee leaves his or her employer, the HSA is portable. That means he or she can still take advantage of the accumulated funds saved after changing employers or retiring.
Qualifying HSA Expenses
Your employees can use HSA funds to cover a diverse array of medical, dental, and other health services. Under the 2020 COVID-19 relief program known as the CARES Act (Coronavirus Aid, Relief, and Economic Security Act), over-the-counter medications and other expenses also qualify as HSA expenses. Visit the IRS Newsroom for more information.
HSA Contributions and Contributors
Employees can contribute to an HSA until age 65. However, contributions are not limited to just employees. An employee’s family members and employer can also contribute to an employees’ HSA, so long as the combined contributions don’t exceed the annual limits shown below:
|HSA Contribution Limits for 2021||Self-Only Account||Family Account|
|Company + Employee Contribution Limit||$3,600||$7,200|
|HSA Catch-Up Contribution Limit for Employees Age 55+||$1,000||$1,000|
Note: Contribution limits are based on calendar year; allowable HSA contributions are prorated by the number of months an individual is eligible to contribute. Catch-up contributions are also prorated. Eligible individuals can contribute to an HSA at any time during the tax year, including up through the federal tax filing due date (April 15, 2022). HSA contribution limits typically change each year. Visit the IRS website for further information.
Additional HSA information from the IRS is available in Publication 969.
In comparison, the dollar limit for employee contributions to an FSA remains $2,750 for 2021.
Of course, forecasting health care expenses is not easy. Being able to carry over funds from one year to the next can make an HSA more attractive to employees than an FSA.
If you have questions, check out the Mayo Clinic article, Health savings accounts: Is an HSA right for you?, or 10 Things to Know About a Health Savings Account, published by the Balance.com, for additional guidance.
2021 is a big year for CaliforniaChoice. The state’s best small business, multi-carrier, employee-choice private health insurance exchange turns 25. That means CaliforniaChoice has been offering greater access to health care for a quarter of a century!
How It All Started
The CaliforniaChoice co-founders, John Word and Rusty Brown, recognized a need in the market. They set their sights on providing a health insurance option to small businesses centered on choice. Blazing new trails is never easy, especially in the health insurance industry, but their vision never wavered.
With determination and hard work, John and Rusty brought their vision to life in 1996, with the launch of CaliforniaChoice. Today, CaliforniaChoice is recognized as the nation’s most successful health exchange of it’s class. CaliforniaChoice currently serves 20,000+ groups and 335,000+ members. The exchange continues to flourish because it’s focused on meeting the diverse health care needs of employers and their employees throughout California.
More Coverage Options
CaliforniaChoice delivers more by offering you and your employees access to eight health plans. With CaliforniaChoice, you get greater access to more doctors, specialists, and hospitals – plus optional benefits and value-added extras. The current carrier roster includes:
- Anthem Blue Cross
- Health Net
- Kaiser Permanente
- Sharp Health Plan
- Sutter Health Plus
- Western Health Advantage
With CaliforniaChoice, each of your employees can choose the health plan that best meets his or her unique personal and family needs. For example, one employees might choose a PPO from Anthem Blue Cross because of a particular doctor or hospital in its network. A second employee might choose an Exclusive Provider Organization (EPO) plan from Kaiser Permanente or Oscar. A third employee, who rarely visits the doctor, might choose an HMO from Health Net, one of the available regional options. Another employee might choose an HSA-compatible HMO from UnitedHealthcare because of cost and tax considerations. Whatever your employees’ needs may be, it’s their Choice!
It doesn’t stop there. You get optional Dental, Vision, Chiropractic & Acupuncture, and Life Insurance for your employees, too. Even better, there are additional free benefits available to you, your business, and your employees through the CaliforniaChoice Business Solutions Suite and Member Value Suite.
One, Two, or Three Tiers – or All Tiers
For 25 years, CaliforniaChoice has offered access to more choice than any other program in California. You can choose up to four Affordable Care Act (ACA) metal tiers for your group’s coverage:
- Single Choice: Offers employees access to the health plans and benefits available in a single tier (for example, Silver)
- Double Choice: Offers employees access to the health plans and benefits available in two neighboring ACA tiers: Bronze and Silver or Silver and Gold or Gold and Platinum
- Triple Choice: Offers employees access to the health plans and benefits available in three neighboring ACA tiers: Bronze, Silver, Gold or Silver, Gold, Platinum
- Total Choice: Offers employees access to the health plans and benefits in all four ACA tiers: Bronze, Silver, Gold, and Platinum
Total Choice delivers for everyone:
- Provides the most plan choices and price points to satisfy diverse employee needs
- Employees can buy up or down, while you are still able to control costs for your business without limiting choice for employees
- Encourages participation by offering a lower-cost option for employees who want to enroll dependents
- There is no extra cost to offer Total Choice, and there’s no participation requirement for any tier. Your cost is the same whatever tier you choose because you select your own Defined Contribution (see “Greater Cost Control” below)
Technology to Make Choosing Easy
Not sure what plan you should enroll in? Not a problem. Our Smart Decision Technology tools to make it easy to find the health plan that best matches your or your employees’ health care needs:
- Plan Comparison Tool: Compare plans based on premium, overall costs (copays, deductibles, and out-of-pocket expenses), benefit type, and quality.
- Online Provider Search: Find the health plans that include your preferred doctors, look for a new doctor, or search by hospital, medical group, and provider network affiliations.
- Online Rx Search: Search for prescription drugs by brand or drug name, therapeutic class, or health condition. Find out which plans offer coverage for the prescriptions you need.
- Online Enrollment (OLE): Go paperless and let employees enroll online; it helps eliminate incomplete applications, reduces the number of pending items, and decreases your overall group enrollment processing time.
Greater Cost Control
CaliforniaChoice helps you control your employee benefits costs. That’s because you choose how much you want to spend on benefits with Defined Contribution.
You can choose a Fixed Percentage (50% to 100%) of a specific plan and/or benefit, or you can contribute a Fixed Dollar Amount for each employee. Your employees then apply your generous contribution to whichever health plan and benefits they prefer. If an employee selects a plan that costs more than your contribution, he or she simply pays the difference.
When you renew CaliforniaChoice, you have the option to adjust your Defined Contribution, giving you complete control over what you spend on employee benefits for another year.
CaliforniaChoice Helps Your Business
Offering a fully-loaded benefits package like CaliforniaChoice gives you a competitive advantage in recruiting and retaining the best employees. A survey by the Harvard Business Review found 88% of respondents would choose a job that offers a lower salary with better health, dental, and vision insurance over an opportunity with a higher salary but lesser benefits.
It doesn’t stop there either. With CaliforniaChoice, whether you have only a few employees or 100, you get a single monthly bill that lists all coverage selected, your contribution, and your employees’ deductions. It’s also easy to pay your bill and manage your benefits online at calchoice.com.
Talk With a Broker to Learn More
To find out more about how CaliforniaChoice can help you offer more choice to your employees – and while it continues to attract more members after 25 years – talk with an employee benefits broker. If you don’t currently have an insurance agent or broker, you can search for one here.
During the past 25 years, CaliforniaChoice has refined our program to address the changing needs of our members. Below are a few of our milestones.
CaliforniaChoice launches the first private health exchange in the history of California.
CaliforniaChoice co-founders John M. Word III and Edward J. “Rusty” Brown, Jr. receive the “Entrepreneur of the Year” award from Ernst & Young.
CaliforniaChoice earns the prestigious “Innovators Award” for true industry advancement from the Health Insurance Association of America.
CaliforniaChoice welcomes Kaiser Permanente and Western Health Advantage to the private exchange program.
CaliforniaChoice welcomes Anthem Blue Cross to the private exchange program.
CaliforniaChoice welcomes UnitedHealthcare to the private exchange program.
CaliforniaChoice welcomes Sutter Health Plus to the private exchange program.
CaliforniaChoice introduces the Automated Choice Profiler, which compares health plans and benefits. (Today, we offer a similar Plan Comparison Tool to assist in shopping and comparing plans.)
CaliforniaChoice launches an online enrollment solution to aid brokers, employers, and enrolling employees.
CaliforniaChoice welcomes Oscar to the private exchange program.
CaliforniaChoice introduces Triple Tier Choice to give employers and their employees access to plans and benefits in three Affordable Care Act metal tiers: Silver, Gold, and Platinum.
Membership in CaliforniaChoice reaches 300,000+ members enrolled through 18,000 employer groups.
CaliforniaChoice adds the ChooseHealthyTM program to its Member Value Suite, expanding its valued-added products and services available to members.
The Word & Brown Companies, including CHOICE Administrators, receive HITRUST certification, the most prestigious certifiable security framework for the health care industry.
CaliforniaChoice introduces Total Choice to give employers and their employees access to plans and benefits in all four Affordable Care Act metal tiers: Bronze, Silver, Gold, and Platinum.
Three new full-network PPO plans from Anthem Blue Cross, offering access to the Anthem Blue Cross Prudent Buyer network, are added to the options available to CaliforniaChoice members.
The Orange County Register recognizes The Word & Brown Companies – including CHOICE Administrators – as a Top Work Place in Orange County for 2020.
CaliforniaChoice launches its redesigned website featuring a streamlined, modern design and improved functionality for brokers, employers, and members.
CaliforniaChoice welcomes Cigna + Oscar to the private exchange program (for coverage effective in July 2021).
President Joe Biden signed a new COVID-19 relief package, the American Rescue Plan Act (ARPA), into law on Thursday, March 11, 2021.
The ARPA includes funding for a variety of programs, including:
- Expanded eligibility for the Small Business Administration (SBA) Paycheck Protection Program (PPP) plus additional PPP funding
- $28.6 billion for a restaurant revitalization fund, including a specific $5 billion allocation for firms with fewer than 10 workers and those with less than $500,000 in 2019 revenue
- $15 billion for the Emergency Injury Disaster Loan (EIDL) program, which provides long-term, low-interest loans through the SBA as well as $1.25 billion to fund shuttered venue operator grants
- Funding for 100% of COBRA insurance premiums for employees who lost their jobs because of the COVID-19 pandemic, and for their covered family members, through September – enabling them to stay on their previous company-sponsored health plan
- $1,400 payments to individuals earning up to $75,000 per year (or couples earning up to $150,000); some individuals and couples who received a prior stimulus check are not eligible for assistance under the ARPA
- A $300 weekly unemployment supplement through September 6, 2021
- $14 billion for COVID-19 vaccine distribution
For more information on the American Rescue Plan Act, link here to The Washington Post.