Dickerson Update July 19, 2018

Dickerson Update July 19, 2018

This week, Dickerson announces new forms, new products and multiple updates from Anthem, Blue Shield, Health Net and more.

Click here to view as a webpage.

Group Updates


Anthem and The IHC Group (IHC) have partnered to offer IHC Small Group Balance, new products which can help offset an ACA plan’s high deductible and provide additional financial protection in the event of an accident or critical illness. These products are designed to work alongside existing medical coverage or as stand-alone coverage and allow employers to:
Lower major medical premium while still providing solid benefit plans
Round out the benefit package to increase retention
Anthem manages the Small Group medical product and all related services, and IHC manages the Balance product and all related services such as broker on-boarding, claims, customer and broker support and commission payment.

For more information about plans and rates click here. To get appointed today, please contact your Dickerson Account Executive.

Anthem is also excited to announce that PrimeCare Medical Network rescinded its notice of termination. PrimeCare Medical Network includes medical groups located in Riverside, San Bernardino, and San Diego counties.

Blue Shield

Blue Shield will implement a new policy for collection of past due medical premiums before approving new medical coverage. This policy is permitted under the federal Market Stabilization Rule and aligns with its existing policy for specialty-only groups. The Master Group Application and Group Administrator Guide have been updated to include notification of this policy.
This policy update includes the following:

The employer must have received notice of the payment policy before the coverage canceled.
Only premiums that were due to Blue Shield within the 12 months preceding the effective date of new coverage can be collected.
Blue Shield must apply the payment policy uniformly to all employers regardless of health status and consistent with nondiscrimination requirements.
Blue Shield is required to pay claims for services during the month(s) of coverage for which past due premiums are collected.

This policy will apply to all groups completing a fourth-quarter 2018 Master Group Application with effective dates of October 1, 2018, and on. Underwriting will work with the producer of record and Blue Shield representative to collect any past due amounts for impacted groups. Contact your Dickerson Account Executive today for more information on Q4 2018 small business plans, products and promotions.

Renewal kits are now available on Shield Renewals for your October and November clients. Group-level changes can be made now through the Small Group Online Renewal (SGOR) tool beginning July 19. December renewals will be available next month.

Choice Builder

Choice Builder® new business quoting is now available for 10/1/18. New business updates include benefit changes, in which VSP® Vision Care Standard Progressive Lenses are now covered in-full for all plans when visiting an in-network provider.

Health Net
For those who may not know, Health Net added access to Heal’s on-demand doctor house calls to its PPO plans back in May. As of July 1, members in the SELECT/ELECT 2 (PPO) tier of its Elect Open Access (EOA) and SELECT (POS) plans for groups of all sizes also will be able use Heal’s services. Click here for more information and steps on how to get started.

Oscar Health

As a Q3 promotion, Oscar Health announced it will be relaxing some of its underwriting rules to make Oscar easier for you to sell! The below underwriting promotions will apply to enrolled groups with effective dates through 9/15/18.
  • Relaxed participation rules for groups with less than 100 employees at all locations. Only the employees within Oscar’s service area (Los Angeles and Orange Counties: rating regions 15, 16, 18) will be counted toward participation.
  • No DE 9C required. 
  • Group must enroll 5 or more employees. 
  • Group must supply the prior carrier’s bill, and 80% of employees on the prior bill must match the enrollment.
  • IFP coverage is a valid waiver. 
  • Employees with individual coverage, with or without a subsidy (APTC), are considered a valid waiver.
To learn more about this promotion, please contact your Dickerson Account Executive.

Carrier Forms Updates

Be sure you download the latest carrier forms from Dickerson’s new Forms Finder here.
In some instances, carriers will not accept older versions as of 10/1/18.
Blue Shield
Blue Shield has released its revised forms for a 10/1/18 effective date.
  • Master Group Application 
  • MGA spreadsheet
  • Group Information Update Form

There were no changes to the Request Contract Change, Subscriber Change Request or Employee Enrollment form except for the effective date that displays at the top of each form.

Please note the following important information:
  •  MGA Form #C15385 – Underwriting will require the October 2018 version for 10/1/18 and later effective dates, no exceptions
  • Group Information Update Form #A44464 – Underwriting can accept both October 2017 and October 2018 versions for 10/1/18 and later effective dates
  • Employee Enrollment Form #C12914 – Underwriting can accept all 2018 versions (January, April, July, and October) for 10/1/18 and later effective dates
  • Request for Contract Change (RCC) Form #15782 – Underwriting can accept the July 2018 and October 2018 versions for 10/1/18 and later effective dates
  •  Subscriber Change Request (SCR) Form #C675 – Underwriting can accept all 2018 versions (January, April, July, and October)

Cal Choice

Only updated applications for 10/1/18 will be accepted beginning with 10/1/18 effective dates. Earlier versions will not be accepted.

Oscar Health

To save you time and make your enrollment process even easier, Oscar Health is now introducing writable PDFs for business enrollment, employee enrollment, ACH authorization and employee waivers.

Free Compliance Services From Dickerson
Dickerson is a proud partner with HR Service Inc., offering your clients a self-service SPD and compliance notice generator at no charge to you or your groups placed through us. For more information on this service, contact us today at sales@dickerson-group.com or (800) 457-6116. To download our flyer, click here.
HR Service, Inc. continually updates the SPD Wrap document and compliance notices whenever there are legal requirement changes and, on occasion, to make enhancements. You and your clients always have the most up-to-date information with Dickerson.

Industry Events/Professional Development

All Things Compliance (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

Medicare 2018 Mini-Bootcamp
Los Angeles County:
Tuesday, July 24, 2018 @ 1 – 2 pm
Click here to register
Wednesday, August 15, 2018 @ 1 – 2 pm
Click here to register
Inland Empire:
Wednesday, July 25, 2018 @ 2 – 3 pm
Click here to register
Orange County:
Tuesday, August 14, 2018 @ 1 – 3 pm
Click here to register

Stop by Dickerson’s booth at the following events:

CAHU Health Care Summit
August 7-9, 2018
Hilton San Diego Bayfront
1 Park Blvd.
San Diego, CA 92191
Click here
to register

OC/IE/SD Medicare Summit
August 22 & 23, 2018
45000 Pechanga Pkwy
Temecula, CA 92592
Click here
to register