Dickerson Update June 29, 2018

Dickerson Update June 29, 2018

Time is flying by and the year is halfway over! Here’s a sneak peek at what Anthem and Blue Shield have coming in 4th quarter, plus some quick regulatory news.

Click here to view as a webpage.


Anthem reports that it will have a rate pass, on average, for Q4. For PPO plans, the average rate changes are 0.4% quarterly and – 1.4% annually. For HMO, the quarterly rate change is – 3.1% and annually, it is -3.7%. Click here to quote now.
As a reminder, relaxed new business underwriting guidelines continue through 12/15/18 effective dates.
  • 25% participation for groups of 5 + enrolled subscribers
  • 65% participation for groups of 1-4 enrolled subscribers
  • DE9C not required with 6 or more enrolling. Groups with prior coverage must submit prior carrier bill.
  • Valid Waivers: Individual coverage both on and off the Exchange will be accepted as a valid waiver
  • Dual HMO Networks: Groups can select both HMO networks to be offered alongside each other

For more information, click here.

Anthem Blue Cross has renewed its Commercial Hospital Agreement with Valley Children’s Hospital and with St. Agnes Medical Center effective July 1, 2018. Valley Children’s Hospital is in Madera County and St. Agnes Medical Center is in Fresno County.

Once both institutions have been reinstated, Anthem will notify all parties who received a termination letter (members, clients, brokers, agents, and physicians). For more information, please contact your Dickerson Account Executive.

Blue Shield

Blue Shield announced a statewide average rate action of 0% for its small business plans in Q4.
  • HMO rates, including Trio, decrease 2.1% in the fourth quarter, annualized for a 1.8% increase in 2018.
  • PPO rates increase 0.7% in the 4th quarter, annualized for a 3.7% increase in 2018.
  • Statewide average rate action for all plans is 3.1% for the year.
4th quarter 2018 average
All plans 0.0% 3.1%
PPO plans 0.7% 3.7%
HMO plans -2.1% 1.8%

Blue Shield Q4 rates will be available at www.thebrokersga.com beginning in early July.
As a reminder, small groups that have terminated their PEO arrangements are not eligible for the “No DE9C” promotion that is currently in place. In addition to standard underwriting requirements based on the number of enrolling employees, Blue Shield also requires of these groups:
  • A copy of the letter sent from the PEO to the group verifying the cancellation of the leasing arrangement
  • A copy of the group’s payroll register

Should payroll not yet be processed, a copy of a payroll register from the PEO that separates the formerly leased employees by business location will be required.

Lastly, Blue Shield will enhance its Employer Connection Plus (EC+) for a more user-friendly experience, including improved site functionality for mobile devices, new features and self-service capabilities for managing group benefits.

The site’s resource page provides the information you need to take advantage of the enhanced capabilities Employer Connection Plus offers, such as:

  • FAQs
  • Broker and Employer access instruction training videos
  • Registration for an online guided tour
  • Recorded webinar sessions
  • Administrator’s Guide
No action is required for now, so stay tuned for future updates. To learn more about this update, click here

Regulatory Update: IRS Announces…

This just in: the IRS has announced the 2019 limits for contributions to health saving accounts and high deductible health plans. For the 2019 calendar year, an HDHP is a health plan with an annual deductible no less than $1,350 for self-only plans and $2,700 for family coverage.

Keep in mind that annual out-of-pocket expenses cannot exceed $6,750 for self-only plans and $13,500 for family coverage. For individuals with self-only coverage under a HDHP, the 2019 annual contribution limit to an HSA is $3,500 and for an individual with family coverage, the HSA contribution limit is $7,000.

No change was announced to the HSA catch-up contribution limit, which remains at $1,000 for individuals that are 55 or older.

More news from the IRS…The ACA affordability percentage for Applicable Large Employers for 2019 has gone from 9.56% to 9.86%. In order for a plan to be “affordable” under the ACA requirements for employers with 50 or more full-time equivalent employees, the employee-only premium for the lowest cost plan offered cannot be more than 9.86% of the employee’s income in 2019.

Industry Events/Professional Development

Pants on Fire – Agent Ethics (2 Hour CE, #366831)

Tuesday, July 10, 2018 @ 9 am – 12 pm
Dickerson Training Room
1918 Riverside Dr.
Los Angeles, CA 90039
Click here
to register

ERISA and Other Compliance Issues (2 Hour CE, #368191)

Orange County: Monday, July 23, 2018 @ 8:30 am – 11 am
Click here
to register
Los Angeles County
: Tuesday, July 24, 2018 @ 9:30 am – 12 pm
Click here
to register
Inland Empire
: Wednesday, July 25, 2018 @ 8:30 am – 11 am
Click here
to register