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Carrier Updates 4.17.17
by Rosa Tessandori » Friday, April 21, 2017 6:03 PM


 Producer News Online

  • Q3 Rate Action:  Average quarterly rate increase PPO +3.1%, HMO +2.8% and 0% on specialty benefits.  View the rate guide.
  • Emergency Room Member Outreach Campaign: Take a peek at a few of the campaign examples on how to reduce unnecessary ER expenses.
  • Real-Time Enrollment:  Communications begin in April 2017.  Beginning July 1, 2017, the Anthem standard will be to submit new enrollments, changes and terminations online through EmployerAccess, also known as the Employer Portal.
  • Special Benefits Broker Guide:  Your guide to everything about dental, vision, life and disability.
  • Webinar- Health & Wellness:  Invite your clients to a 30-45 minute webinar Wednesday April 19, 2017, 11 a.m. Pacific Time.


  • Q3 Rate Pass:  No rate increase for medical and specialty plans.
  • "No DE9C":  Program is continued through August 2017.  
  • Relaxed Participation:  Program is continued through August 2017, view the flier.
  • July Renewals:  Kits are available online to download, mailed copies go out to the employer on April 21st.
  • Trio ACO HMO Updates: Incentive program begins in May, dual HMO option alongside Access+ HMO reminder and don't forget to use the Trio Zip Code finder tool.
  • Specialty Benefits:  Additional details coming soon on the Small Business Bundled Savings program.
  • Teladoc: Clients have access to Teladoc upon renewal.  Other value added features include Wellvolution, ID protection, Healthquity and Blue Shields Updated mobile app.


      Producer Alert
  • Quoting Package Update:  Multiple options now included in one proposal.
  • Preventive Screening Changes:  Updated breast cancer and cholesterol screenings and changes to medications for cholesterol and cardiovascular disease.  ACA update on statins eligible for coverage at zero cost-share.
  • Health Discount Program: UnitedHealth Allies offers savings from 10% to 50% on health and wellness related products.
  • Self Funded Specialty Benefits:  View the updated portfolio.
  • Member Websites Enhanced: View the enhancements. 
  • Pharmacy:  View the PDL Tracker recap of changes.

View Document
Carrier Updates 4.10.17
by Rosa Tessandori » Friday, April 14, 2017 3:40 PM

  • Reduced Participation: This promotion has officially been extended through September 30, 2017. The official producer alert and flyer are expected to be released soon.
  • Q3 Rate Pass: BSC announced there will be a rate pass for all third quarter 2017 medical and specialty plans. Rates vary by region and rate tables can be found under Plans & Rates on Broker Connection.
  • Expo: Wednesday April 19, 2017 – Registration at 7:30 am, event from 8:00 am – 3:30 pm. Attend the Sacramento Association of Health Underwriters Business Development Expo. View the Flier.

View Document
Carrier Updates 4.3.17
by Rosa Tessandori » Tuesday, April 04, 2017 10:31 AM


Producer Alert


·         Q2 Amended SOBs and EOCs: Updated documents will reflect endorsements for 15 benefit changes.  Small business customers will only receive endorsements that impact plans to which they subscribe.  A list of the changes is also attached.  

  BLUE SHIELD OF CA 51 – 100

  • Life Insurance Quick Match Program:  Provides streamlined underwriting by matching  renewal rates from the group’s current life insurance company. For New and existing groups adding life with effective dates of April 1 through June 1, 2017.   View the announcement.


  • UHC’s April Webcast:  Registration is not required but space is limited so join early!  Topics will include: ACA Updates, 7/1 CASB Portfolio Changes, ACEC, Ancillary, UBES Free Services (COBRA, FSA 7 PTP), Wellness.  When? Wednesday, April 12 @ 2 p.m. PDT.  View the Flier for details.


  • Single Payer Conference Call/Workshop: CAHU's Vice President of Legislation, Dave Fear, Jr., is calling upon all CAHU members to participate on a conference call/workshop, Thursday, April 6 @ 3:00pm, which will focus on strategies to defeat SB 562 --  current Single Payer legislation.   Please click here and register to ensure your spot on the call!


View Document
Carrier & Compliance Updates 3.27.17
by Rosa Tessandori » Friday, March 31, 2017 6:04 PM


Website Update
  • New Look for BSC: Blue Shield has updated their website, all new pages means all new links. Visit Producer Connection today and get acquainted.

Broker Update
  • Heal™ - In-Home Care Benefit: Blue Shield introduces Heal™, PPO members can access on-demand visits to a member's home, office or hotel. Available in limited areas: Oakland, Berkeley, San Francisco, the Peninsula, San Jose, San Diego, Los Angeles and Orange County.
  • "No DE9C" Extended: Through June 2017 effective dates, groups with 10 or more enrolling in medical coverage can submit a completed and signed Eligibility/Participation Attestation and the billing statement from the group’s prior carrier in lieu of a DE9C.
  • The Trio Qualification Tool: The quick and easy way to see if the Trio ACO HMO plan is a good fit.
  • Renewal Kits: May and June kits are available for download in Producer Connection site.
  • Member Level Changes: Utilize Employer Connection Plus for your adds, terms and changes.
  • Wellness Discounts: See the list of available discount programs and vendors like ClubSport, Weight Watchers, 24 Hour Fitness and more.
  • BlueCard Services: Provide employees with access to quality care with best-in-class solutions worldwide.
  • "NEW" Blue Shield Global: Introducing the new Blue Shield GeoBlue Plans: Global Core, Global Traveler and Global Expat plans available for purchase by Individuals, employers and academic institutions.
  • Trio for Travelers: With Trio, unlike non-Blue carriers’ narrow network plans, members have access to a national and worldwide provider network through BlueCard.
  • Ethics: The Ethisphere Institute has named Blue Shield of California one of the World’s Most Ethical Companies for 2017.
  • Cal Index Becomes Manifest MedEx: Cal INDEX announced it is merging with the Inland Empire Health Information Exchange to create one of the nation’s most comprehensive health information exchanges (HIEs).


Producer News

  • Zero $0 Consultations: Do you have employees with family members not enrolled in the group medical plan? Offer employees access to unlimited free phone consultations with HeatthiestYou (HY). Offer it on a voluntary basis or on a contributory basis, either way it's a great deal! View the Overview flier and Spring Fever flier.


Compliance Alert
  • Excepted Benefits: Discussion of new guidelines affecting Short-Term, Limited-Duration Insurance, Travel-Insurance and Similar-Supplemental-Health Coverage under Excepted Benefit Rules. Click here, to review.

View Document
Carrier Updates 3.20.17
by Rosa Tessandori » Friday, March 31, 2017 5:40 PM


Formulary Updates
  • 2017 Formulary Change Reminder: New groups in 2017 will be accessing the Aetna CA Small Group Value Formulary. Existing business will transition upon their 2017 renewal. To view the formularies, go to:
  • 2017 Quarterly Formulary Changes: Drug list updates will now occur January 1, April 1, July 1, and October 1. These changes will apply to all members on the date of the change. Impacted members will be notified of upcoming drug list changes by e-mail or letter, and updating will be posted on Aetna's web pages.


View Document
Carrier Updates 3.13.17 Part 2
by Rosa Tessandori » Tuesday, March 14, 2017 3:11 PM


Partner News
  • Directors Corner: Thanks from CCSB in increasing sales 26% over 2015 numbers. Expect a spring marketing campaign focused on the Small Business Federal Tax Credit designed to drive traffic to the CCSB website and increase engagement with small business owners. Reminder of the recent changes to the delinquency notice policy.
  • New Monthly Direct Client Communications: In February, CCSB kicked off a new communications initiative targeting active inforce groups. By communicating directly with clients, CCSB objective is to highlight program benefits, resources, and to share important information to ensure that clients get the most value out of their small business health program. This month, clients will receive a message titled, “Navigating Your Company's Monthly Billing Statement” which educates employers on the most asked about sections of the invoice. For a preview of the March message, click here.
  • CCSB Spring Marketing Campaigns: To view a sample of the optimized Facebook, Twitter, and Google Search content as well as supporting research, reference the CCSB Spring 2017 Campaign Strategy Outline.
  • Tax Credit Postcards: In addition to the spring marketing campaigns, the Covered California for Small Business SHOPWorks program has updated its tax credit postcards just in time for the 2017 tax season. Reference the SHOPWorks Flyer for information on how to order your customizable postcards to target small businesses in your area at little to no cost to you! Get leads by working with a tax professional, To search for a list of tax preparers in your area, visit the California Tax Education Council (CTEC) website.
  • Qualifying Life Event Matrix: If employees or their dependents experience a qualifying life event, they can enroll in a CCSB health insurance plan outside of your client’s normal open enrollment period. In most cases, employees or their dependents must report changes and select a plan within 60 days of the qualifying life event. For more information on qualifying life events, reference the Qualifying Life Event Matrix on the Covered California website. 
  • CCSB Responds to Concerns Regarding Delinquency Policy Change: In a response to agent and customer feedback, CCSB has revised the initial delinquency notification policy and will send employers the initial notice of delinquency, but not employees. Read more here
  • Small Business Health Care Tax Credit: Covered California for Small Business is the only place where your small business clients could be eligible for a federal tax credit. For more information, please reference the CCSB Tax Credits Resources.
  • The Future of Technology in Small Group Health Insurance: In case you missed it, check out “The Future of Technology in Small Group Health Insurance,” an article in the February edition of California Broker by Kirk Whelan, Director of Outreach, Sales, and Small Business for Covered California.
  • 3rd Quarter Rate Update: Effective July 1, 2017 UHC will increase their HMO rates by 7.1% and PPO rates by 3.2%, on average. UHC is confident these rate actions will align them closely with the California market and keep them positioned for long-term rate stability. To read the full release, click here.
Broker Connection
  • Member Annual Dental Notice: UnitedHealthcare will mail a notice to California health maintenance organization dental subscribers in late March regarding of the procedure for processing and resolving grievances. This mailing is informational only. No action is required from subscribers. 
  • Website Update: Effective April 15, Employer eServices® will no longer support Internet Explorer® (IE) browsers 10 and lower. Newer browsers offer increased security and protection. Users should upgrade their browsers to IE 11 prior to this date. For more information, please contact your UnitedHealthcare representative.
  • New SBC Template Effective April 1: View guidelines for providing the applicability dates and details for the new 2017 Summary of Benefits and Coverage template and uniform glossary. Learn more.
  • Annual Privacy Notice: UnitedHealthcare's Financial Information Privacy Noticewill be sent to fully insured dental and/or vision plan subscribers beginning late March, as required annually under the Gramm-Leach-Bliley Act. Learn more.
  • New "Step-up Preventive" Dental Benefit Design Now Available: A new progressive dental benefit design, "Step-up Preventive," is now available for Dental Preferred Provider Organization and Dental In-Network Only plans. Learn more.
  • Specialty Medication Prior Authorization Requirement: UnitedHealthcare commercial plans are implementing new notification/Prior Authorization requirements for administration of Exondys-51, Xolair, and Inflectra. Learn more.

View Document
Carrier Updates 3.13.17 Part 1
by Rosa Tessandori » Tuesday, March 14, 2017 2:23 PM


2nd Quarter 2017 Updates

  • Rate Impact Updates: View details regarding the medical quarterly and annual rate impact, as well as the dental rate changes.
  • Aetna Providence Network: In addition to Santa Clara County IPA and MemorialCare, Aetna is introducing a new collaboration between Aetna and Providence Health & Services that brings the triple aim of accountable care (better health, better care, and better cost) to more members in the greater Los Angeles area for May 1 effective dates.  
  • Open Access Managed Choice Network (OAMC/MC):  View the latest network additions in the Los Angeles area.
  • Underwriting: No current underwriting updates.
  • New Business Submission Deadlines:   The cut-off date is the 1st of the month, groups received after the 1st of the month are considered a late submission and will be moved to the next effective date. 


  • Anthem Broker News Sign-Up:  Sign up to receive any new or late breaking news via email by clicking on the below link and entering your name and email address.  Visit the Anthem Email Preference Center to sign up or update/change your email preferences at anytime.
  • Formulary Update:  Beginning March 1, Anthem individual and employer-sponsored health plans will cover the authorized generic (AG) form of EpiPen on Tier 1. This change applies to the National, Essential, Preferred, Generic Premium and Select Drug Lists.  Epinephrine coverage for emergency treatment of allergic reactions, including anaphylaxis.  For additional information,  click here to view the full Sales Call announcement.


Producer Alert

  • The Trio Qualification Tool:   Trio ACO HMO plans offer integrated care with lower premiums and out-of-pocket costs than most of their non-ACO plans. Also, you now have an easy way to check if the Trio service area is a fit for your clients – the Trio qualification tool. Watch the one-and-a-half minute video demo to see how quickly and easily the Trio qualification tool can match the Trio service area to your client's employee census. The tool also displays which medical groups would be assigned to employees based on their ZIP code.  Learn more about Blue Shield’s Trio plans and use the tool at

Producer Alert

  • Corporate Office is Moving:  Blue Shield will move its corporate headquarters from San Francisco to Oakland.   The move will take place in mid-2019, and nearly all executives and staff will move from 50 Beale Street in San Francisco to the new location at 601 12th Street in Oakland.   This move is designed to reduce administrative costs while we position ourselves to grow in membership. 

View Document
Carrier Updates 3.6.17
by Rosa Tessandori » Wednesday, March 08, 2017 10:53 AM


  • Easy Renew:    Visit, your one stop shop to access the 2017 Underwriting Guidelines and so much more.
  • Dual PPO Network Option:  Reminder that the promotion ends 3/15/17.
  • Renewing Groups:  Want to add or downgrade a medical plan?  Change the anniversary month? Want to know when the changes can be effective and what forms to use?  Refer to pages 19-22 of the January 2017 Underwriting Guidelines for general instructions.  Reminder, requests for anniversary changes must be received by Anthem generally no later than the 15th of the month prior to the requested effective date. 


Broker Update -Small Group

  • Message from the Senior Vice President:  Nitin Bhargava looks back at successful 2016 open enrollment period and is looking forward to continued growth and success in 2017 with Trio ACO at the forefront.   BSC reinforces its commitment to providing access to affordable, high-quality care.
  • Bronze Plans Highlights:  The Bronze 5100 PPO now includes three office visits prior to the deductible, providing greater value for your clients. Previously the Bronze 5100 plan required members to meet their deductible for office visits (outside of preventive care). The Bronze Full PPO Savings 4500 & Bronze Full PPO Savings 5500 plans can be integrated with H.S.A. Administration services provided by Health Equity.
  • Sorela Health:  These programs offer lifestyle coaching and weekly courses on nutrition, exercise and stress management, all geared toward reducing the risk of type 2 diabetes. Blue Shield members can be referred by a physician and can also enroll in any program after completing a risk assessment at
  • New Palliative Care Program:  In January, Blue Shield of California began offering their fully insured Sacramento-area plan members a new, home-based palliative care program as a benefit.  Palliative care focuses on providing relief from the symptoms and stress of serious illness with the goal of improving quality of life for both the patient and the family.  Blue Shield’s new program offers home-based palliative care visits by a care team that includes a physician, nurse, social worker, home health aide and chaplain.  For more information, please read the press release announcing the new program, available on Blue Shield’s Media Center.
  • Updated Broker Portal:   Producer Connection will now be Broker Connection and is being updated and upgraded. 
  • Post Enrollment Materials:  Access your clients’ post-enrollment materials online. Once your clients’ post-enrollment materials for any respective month are ready, they will be posted on Shield Renewals in our Renewal Center, the same site where you access your clients’ renewal packets. 
  • Updated Forms for Q2:  The Master Group Agreement (MGA), Employee Enrollment Form, Request for Contract Change and Subscriber Change Request forms have been revised for Q2 2017.  Submissions using outdated underwriting forms will pend until the updated forms are submitted. You can find all of the up-to-date materials at Producer Connection - Forms.
  • Teladoc Member Email Outreach: New and renewing groups members can save time and money by using the embedded Teladoc benefit.  There are no additional charges for this service.  Member copays are just $5 on most plans (H.S.A. plans are at a higher $40 copay until the deductible has been met).  View the Teladoc flyer for more information.   Members in groups with January and February 2017 renewal or effective dates will receive emails from Teladoc on how they can begin using this service.
  • BSC Vision Plans:  BSC offers one of the largest vision provider networks.  Click here, to access rates and plan information.
  • ID Monitoring: Blue Shield medical plan members can now get identity protection services such as identity repair assistance, identity theft insurance, and credit monitoring, offered at no charge. These services are accessible on line by visiting or by calling (855) 904-5733, 6 a.m. to 6 p.m. Monday through Saturday.


Partner Alert

  • Delinquency Policy:  Employees will no longer receive a CCSB delinquency notice when an employer has missed their initial payment deadline.   

View Document
CaliforniaChoice Retro 1/1-6/1 Benefit Changes
by Rosa Tessandori » Wednesday, March 08, 2017 10:04 AM


Benefit Changes Retroactive 1/1/17 - 6/1/17

To comply with California Department of Managed Health Care requirements, various plan benefits were retroactively revised. CaliforniaChoice emailed employers a list comparing the incorrect quoted benefits vs the final corrected benefits,
 click here to view the list.  Rates for these plans did not change.

Plans quoted through EBIX/HealthConnect prior to February 24, 2017 and plans quoted through the CaliforniaC The 1/1/17 – 3/1/17 SBCs, EOCs, Employee Enrollment Guides and Benefit Summary Guides previously available on the CaliforniaChoice website  may contain incorrect plan information. Corrected documents will be posted once received.  The 4/1/17 – 6/1/17 documents are not yet available, but will contain the correct plan information once posted on the CaliforniaChoice website. hoice quote system prior to 12:00 pm on Tuesday February 24, 2017, contain the incorrect benefit information.  

CaliforniaChoice and the applicable carriers, are not sending members a notification of the change.  Employers are responsible for notifying affected members.   Employees enrolling or renewing who are affected by the benefit changes and may have received a CaliforniaChoice quote, Enrollment Worksheet, SBC, EOC, Employee Enrollment Guide or Benefit Summary Guide containing the incorrect benefit information, should be provided the following two documents:

Members remaining enrolled in a plan affected by a benefit change, will automatically have their claims reprocessed and a revised Explanation of Benefits (EOB) will be mailed out to the member as applicable.

Members affected by a retro benefit change can request a plan change.  However, all requests are subject to review.  Requests should be submitted as soon as possible.  

For instructions on how to submit a plan change request, for a side by side comparison quote of the affected plans, or if you have any other questions or concerns regarding this matter, please contact your Rogers Benefit Group Sales Representative or email/call our main office. 

View Document
Carrier Updates 2.27.17
by Rosa Tessandori » Wednesday, March 01, 2017 9:49 AM


  • Health Net Off Cycle Rate Change:  Effective May 1, 2017, Health Net has issued off cycle second quarter rate changes that will impact Covered California for Small Business renewals and new business with effective dates of May 1, 2017 and June 1, 2017. April rates will not be affected.

  • Specialty Medications:  Effective Jan. 1, UHC requires prior authorization for the new specialty medications: Probuphine (buprenorphine) subdermal implants, Cinqair® (reslizumab) and Nucala® (mepolizumab), Ocrevus™ (ocrelizumab), and Gonadotropin-releasing hormone analogs.  For more information, visit UHC's Specialty Pharmacy Information Center or contact your UHC representative.
  • 2017 Specialty Product Bonus Program:  Earn bonuses on new and renewing sales of dental, vision, basic life, supplemental life, short-term and long-term disability, critical illness protection, accident protection, and hospital indemnity protection.  View the bonus brochure.
  • Broker Webinar Training: Learn more about UHC's quoting tools and other broker resources on United eServices®  Date:  Tuesday, Feb. 28.   Time:  11 am to Noon  ET.  Register here. 
  • Employer Webinar Training:   Your clients can better administer their benefit programs on Employer eServices® by attending a UHC informational webinars.  Groups 2-99 Thursday, March 9, 2017 at 11 a.m. ET.  Register here .  Groups 100+ Tuesday, March 14, 2017 at 11 a.m. ET.  Register here.  Note:  Dial-in information will be sent via email three to five days prior to the webcast.
  • Telemental Health:  To improve access to care, Optum Behavioral Health has expanded its telemental health network to over 3,000 behavioral providers including AmWell and Doctor on Demand psychologists and psychiatrists. For more information, click here.
   Webcast Invite
  • Webcast Wednesday, March 8th at 2:00 p.m. (Pacific):  UHC's Northern California 1-100 Sales Team will be hosting a 2017 Webcast for their GA and Broker partners.  Registration is not required but space is limited, so please join the webcast early. Please refer to the attached flyer for details. The following topics will be discussed during the Webcast:   2017 Portfolio Refresh, How to Submit a Renewal, How to Use United eServices, and Upcoming SBC Changes. 

    View Document
    Carrier Updates 2.21.17
    by Rosa Tessandori » Friday, February 24, 2017 1:48 PM


    • Updated CA SB Toolkit: The attached Benefit Grid Toolkit includes slight updates to the HMO plans approved by the Department of Insurance and the Department of Managed Care.


    Producer Online News

    • Oroville Dam Emergency: To assist members impacted by the Oroville Dam emergency, Anthem has relaxed some of their guidelines for; filling an Rx, time limits on prior authorizations/pre-certification/referral requirements, replacement of DME that is damaged or lost, and has extended claims filing deadlines. Refer to the announcement for applicable dates and a list of plans/coverages excluded from the relaxed guidelines. For additional information or support, members can call the Member Services number on their ID card or select Customer Support on the Anthem website.


    Producer Alert

    • 1099-INT Forms: In January 2017, Blue Shield of CA sent some members a 1099-INT form in error. The forms were meant for providers. Members will receive a letter next week, with a corrected 1099-INT form. Blue Shield did not send or report any information on the erroneous 1099-INT to the IRS, so members do not need to take any action.


    • New 4/1/17 Network Availability Grid: This new comparison provides a snapshot view of the CaliforniaChoice carriers with a listing of plans by tier and their network assignments. It’s a quick, easy way to see how the dozens of plan options under CaliforniaChoice break down by PPO, EPO, HSP, HMO, and carrier. View the announcement and access a link to the comparison.


    • 2017 DME List: All Kaiser Small Business plans cover “base” durable medical equipment items that are essential health benefits. View the attached flyer, for a list of plans that cover “supplemental” durable medical equipment.

    View Document
    Carrier & Compliance Updates 2.13.17
    by Rosa Tessandori » Monday, February 20, 2017 2:35 PM


    Producer News Online
    • Metallic Dental Complete PPO Plans: Sold only through California general agents effective April 1, 2017. For details, view the metallic dental plan details flier. Your RBG Quote team is ready to assist with requests for a Metallic Dental Complete PPO quote. Don't forget about Anthem's 5% bundling discount.
    • 2017 Commission Payment Schedule: The schedule shows the key dates in 2017 when your commission statements will be posted on your producer website, when electronic fund transfers (EFT) will take place (for those on direct deposit), and when commission checks will be mailed (for those not on direct deposit). View the schedule.
    • Blue View Vision: Reminder, quote using enrolled lives, not eligible lives. 
    • Dual PPO Network Option Promotion Ending Soon: Effective March 15, 2017, the Dual PPO Network Option Promotion* for new Small Groups will end. Submit forms for renewing or already renewed groups before the deadline. 


    Producer Alert
    • Employer Connection Plus (EC+): Tips, in case an employer is having trouble logging into the site.
    • 1095-B Forms: Members should have begun to receive their form as of February 6.


    Broker Notification
    • Network Availability by Carrier & Plan Summary: Download a copy and easily compare 4/1/17 plans, networks and metal tiers.

    Tailored Benefit Bundles 
    • Simply Smart: Bundles dental and vision for groups 10-99. View the pre-built MetLife simply Smart Bundles.
    • MetLaw: Simply Smart Bundles also gives you the exclusive option to offer a voluntary legal services plan for groups 10-99.
    • 2-year Rate Guarantees: Lock in pricing for your clients for 24 months across bundled products.
    • Multi-Product Bonus:  Sell a dental plan and at least two new coverages and earn an additional one-time payment of 1.5%.  View the details. 

    Compliance Notice
    • It's The Law: TASC can help you stay protected all year, every year with their wide selection of compliance services to handle the work and worry for you. Let TASC be the compliance expert so you don’t have to. View info on the eight different pre-packaged compliance bundles.


    Compliance Alert
    • FMLA and Benefits Plans: This article examines the rules for participants going on an unpaid Family and Medical Leave Act (FMLA) leave. Regulation 1.125-3 summarizes employees’ rights to continue or revoke coverage and cease payment for Healthcare flexible spending accounts (FSAs) when taking an unpaid FMLA leave and specifications for participants returning from leave.  

    View Document
    Carrier Updates 2.6.17
    by Rosa Tessandori » Tuesday, February 07, 2017 11:11 AM

    January Broker Update
    • Note of Thanks: Jim Elliott (VP & GM Core Accounts, Small Business Market, Producer & Channel Partner Relations) extends his thanks to the broker community.
    • Employer Connection Plus (EC+): The Blue Shield of CA online employer portal, is removing from the website the ability to submit enrollments that are due to loss of coverage or due to court orders. Instead, administrators will be required to submit these enrollments via paper. Blue Shield of CA will provide a notification when this change is implemented and reflected on EC+. 
    • SGOR Tool Online: The Small Group Online Renewal Tool is up and available for use to submit contract changes online.
    • 1095 Forms: BSC will mail members their copies of the 1095-B form by January 31, 2017. Employers may request a copy of the 1095-B forms to assist with filling out the employer 1095-C forms by calling Employer Services at (800) 325-5166.
    • Q2 - What’s New 4/1/17: View the guide for details. 
    • April Renewals: Visit the Renewal Page on Producer Connection to download your clients’ renewal kits.
    • Trio Network: Visit for a complete listing of Trio covered zip codes and ACO providers. Areas with recent network expansion include San Diego, Riverside, San Bernardino, San Mateo and Nevada Counties.
    • 2016 Medical Loss Ratio Rebate (MLR) - Employer Survey: In December 2016, Blue Shield emailed the 2016 Medical Loss Ratio (MLR) employer survey to fully insured client groups (small and large). On February 6, 2017, Blue Shield will resend a copy of the 2016 Medical Loss Ratio (MLR) employer survey letter to fully insured client groups that did not respond to the original survey request. Employers can provide the requested information by going to or by faxing the form back to (855) 895-3497. Survey information is required by February 24, 2017.
    • Teladoc: Is now included in all new 2017 plans and upon renewal for existing groups. Teladoc is a cost-saving service with $5 copays for most plans (except HSA's). Find out more about Teladoc.
    • Wellvolution: Is now included for groups effective and renewing as of November 1, 2016. This service is available for members 18 years of age and older. Wellvolution assists members with measuring their well being and in addressing specific health concerns such as preventing diabetes. Visit for more information (login required).
    • Diabetes Prevention Program (DPP): The DPP can help members lose weight, adopt healthier habits and reduce the risk of developing type-2 diabetes. This benefit is available at no cost to members and is included in all medical plans upon renewal, beginning November 2016. Visit for more information.
    • Quitnet: Effective January 1, 2017 for all groups, regardless of the renewal date, will include nicotine replacement therapy (NRT) at no additional charge.

    Quoting Updates
    • Two New Enhancements: You can now create a "New Hire" Worksheet and run table rates with contributions.

    View Document
    Carrier & HR Compliance Updates 1.30.17
    by Rosa Tessandori » Monday, January 30, 2017 2:53 PM

    Health Equity Employer Portal Webinars
    • Webinar Dates: Join Health Equity, Blue Shield of CA's HSA partner, for an introduction to their employer portal. Health Equity will demonstrate the key functions of the Employer Portal including the various options for making contributions. Please register for the date that best suits your schedule.

    4/1/17 New Plan Options
    • 5 New Plan Options: Effective April 1, 2017, the following new plans have been added to the California Choice portfolio: UnitedHealthcare (UHC) HMO C: Bronze Metal Tier, Alliance Network; in southern California Sharp Health Plans: HMO D: Bronze Metal Tier, Premier Network; Sharp Health Plan: HMO C: Silver Metal Tier, Premier Network; Sharp Health Plan: HMO C: Gold Metal Tier, Premier Network; Sharp Health Plan: HMO C: Platinum Metal Tier, Premier Network. View the Private Exchange Guide and Fast Facts Flyer.

    Program Highlights and Guidelines
    • Highlights: Choice Builder® offers employers with 2-199 employees the nation’s premier dental, vision, chiropractic, and life carriers: Ameritas, Anthem Assurity, Delta Dental, Eye Med, Landmark, MetLife and VSP. In addition, groups receive access to two value add services, the Cal Perks entertainment discounts and the HR AsnwerLink HR Support Center Library.
    • Guidelines: Employer eligibility at initial enrollment requirements, plan availability, new hire waiting rule options, orthodontia availability and plan comparison of plans.

    From the News Desk
    • Executive Order: President Trump signed an Executive over for minimizing the ACA’s fiscal burdens. For employers, the effects of the Executive Order will not be immediate. Employer obligations under the ACA, such as the employer mandate and reporting, cannot be undone without revising regulations. For now, the employer mandate and employer reporting requirements remain in effect and employers should continue to comply with all provisions of the ACA.

    Federal Law Alert
    • OSHA 300A Forms Must Be Posted by February 1: The Occupational Safety and Health Administration (OSHA) mandates that all employers who are required to maintain the OSHA 300 Log of Work-Related Injuries and Illnesses post a summary of the previous year’s log between February 1st and April 30th each year, even if no incidents occurred in the preceding calendar year.

    View Document
    Carrier & HR Compliance Updates 1.23.17
    by Rosa Tessandori » Monday, January 30, 2017 2:41 PM


    Agent Newsletters
    • Identity Protection Services Due to Expire Soon: Individuals impacted by the 2015 cyber attack against Anthem were offered two years of AllClear ID Credit and Identity Theft Monitoring Services (called PRO). That two-year time frame is coming to a close.
    • January MyAnthem News: The January issue of our employer newsletter is now ready for your Small Group clients.
    • California Medi-Cal,  What You Need to Know: California’s Medicaid program is called Medi-Cal. Medi-Cal is free or low-cost health benefits for children and adults with limited income resources. Find out more about how this program works and how it may help your Individual clients.


    Producer Alert - 2nd Quarter Product Cycle
    • Rate Action: PPO 0.8% increase and HMO 4.3% rate increase. 
    • Continued Easier New Group Installation: Through April 1, 2017, groups can choose either no forms for employees enrolling in an other carrier's HMO or no DE9C - for groups with 10 enrolling employees that complete an Eligibility/Participation Attestation form. 
    • Relaxed Participation Guidelines: Available through June effective dates. Requires only 25% employee participation (minimum of five enrolled employees for medical plans).
    • Renewals Online: April Renewal Kits are available online on the BSC Renewal Site. Submit member level changes through Employer Connection Plus. Kits will be mailed to clients January 20th. The Small Group Online Renewal (SGOR) tool will be available in mid-February for Q2 renewal changes.
    • Benefit Summaries: Benefit Summaries are being updated on Producer Connection to reflect some benefit changes pending regulatory approval. When approved, details of these endorsements will be sent to you soon in a separate communication. The Spanish versions of the 2017 Benefit Summaries have not yet been updated to reflect these changes, but we expect to have them also posted on Producer Connection by the end of January.
    • Trio ACO HMO: The Trio ACO HMO network continues to be expanded with new providers and in new regions. to see if your clients are in a Trio coverage area. The Trio ACO plans can be offered alongside the full Access+ HMO® network for greater member options.
    • Dental Network Expansion: BSC continues to expand their PPO provider network and has the second largest dental HMO network in California. Specialty rates remain steady making it the perfect time for employers to offer specialty benefits alongside Blue Shield medical plans or on a standalone basis.
    • Value Adds: Remember that clients have access to Teladoc, Wellvolution, ID protection, HealthEquity, and Blue Shield’s updated mobile app. Your clients can learn more about these programs and take advantage of them by visiting

    • Retro Changes - Extended Deadline: For new and renewing 12/1/16 and 1/1/17 groups, to ensure that all of their customers are set up correctly, UHC is extending the deadline for eligibility changes from 30 days to 60 days. The deadline for December 1, 2016 eligibility changes is January 31, 2017 and the deadline for January 1, 2017 eligibility changes is February 28, 2017. This opportunity is time sensitive and no further eligibility corrections will be made once the extended deadlines have passed. Outside of these two effective dates the normal 30 day limit will apply.

    HR ANSWERLINK - HR Support Center

    Federal Law Alert
    • New Form I-9: The new Form I-9, released November 14, must be used as of Sunday, January 22, 2017.

    View Document
    Carrier Updates 1.17.17
    by Rosa Tessandori » Friday, January 20, 2017 10:19 AM

    • Second Quarter Rates Available for Quoting: Rate pass for both PPO and HMO. For renewing groups, the average net rate effect for all regions combined will be 1.1% increase for PPO and on average a decrease of -3.0% for HMO.

    Producer Alert
    • Merger - New Comprehensive Health Info Exchange: The California Integrated Data Exchange (Cal INDEX, founded by Blue Shield of California and Anthem Blue Cross) and Inland Empire Health Information Exchange (IEHIE) today announced a planned merger that will create one of the nation’s most comprehensive nonprofit health information exchanges (HIEs). HIEs help improve the quality of the patient experience, support collaboration and coordination and improve efficiencies. HEIs will also make it easier for doctors, hospitals and other care providers to securely review, analyze and share medical information across the health care system.
    Producer Alert
    • Second Quarter Rates Available for Quoting: Rates for Q2 effective dates are available for quoting and downloading. PPO will experience a 0.8% across all regions. HMO will experience 4.3% increase across all regions. 
    • April Renewals: Kits are available for downloading on 1/13/17. Member level changes can be submitted through Employer Connection Plus starting 1/18/17. Printed renewal kits will be mailed out on 1/20/17.


    New Carrier
    • MetLife: If your new and renewing groups are considering Dental for 4/1/17 (or later), they now have a new option, Choice Builder. MetLife is joining Choice Builder with three Employer-sponsored Dental PPO plans and one Voluntary Dental PPO plan. View the Delta Dental and MetLife comparison.
    • Second Quarter Rates Available for Quoting: Great news, UHC CA Small Group 1-100 will be having a Rate Pass Q2 2017.

    View Document
    Carrier Updates 1.9.17
    by Rosa Tessandori » Wednesday, January 11, 2017 10:10 AM

    Producer Alert
    • Sutter Health Contract: New 3-year agreement signed effective January 1, 2017!

    Partner News 
    • Enhanced Agent Portal: Website improvements are expected for release in the first quarter of 2017. Expected enhancements will include processing client renewals, submitting eligibility changes, access commission information and other time saving capabilities.
    • .Enhanced Employer Portal: Later in the year, employers will be able to pay premiums online, update employee information, download side-by-side comparison worksheets of their benefit plan options and much more.
    • Nonpayment of Premiums - Policy Change: Effective January 1, 2017, the statement of consequences will be enclosed with the employer's invoice and serves as the first notice of delinquency.
    • Carrier ID Cards: Carrier partners of Covered California for Small Business are now given the option to either continue printing ID cards with the Covered CA logo or remove the logo altogether. Thus far, Blue Shield of California (PPO plans only) and Health Net have confirmed that they will remove the Covered CA logo from their ID cards in early 2017.
    • No Out-of-State Participation Requirements: Covered California for Small Business has eliminated membership participation requirements across states, so long as the business’s headquarters are registered in California.
    • General Agent Partners: GA's are here to help, readily available services include: prospecting, pre-screening, underwriting, quoting, pre and post-sales support, enrollment, customer service, renewal support and other resource materials.
    • PEO's: CCSB is a great place for placing your Professional Employer Organizations, read the alert and see why.
    • Updated Eligibility Guidelines: The Covered California for Small Business Enrollment & Eligibility Guidelines were recently updated and are now available for download under the Agent Sales Tool Kit.
    • 2017 Health Plan Change Summary Now Online: View a side-by-side comparison of the 2017 plan benefits, 2017 Health Plan Change Summary.
    • Customized New Hire Employee Worksheets: Receive a customized new hire worksheet within 48 hours of your request.

    View Document
    Carrier Deadlines for January 1, 2017 SG Contracts
    by Rosa Tessandori » Wednesday, January 04, 2017 9:36 AM

    If you have not yet submitted your 1/1/17 small group cases, please submit your case(s) as soon as possible. This will allow the RBG underwriting department the opportunity to scrub the group and request missing information prior to submission to the carrier.

    Several carriers now require us to submit groups via their carrier portal, which extends the amount of time needed for our office to meet the carriers' deadlines for submission of new groups.

    RBG must submit your January 1, 2017 Small Group Case(s) to the applicable carrier by the following due date and time*:

    Due January 9th by 12:00 p.m.
    o Blue Shield of California

    Due January 9th by 5:00 p.m.
    o Anthem Blue Cross of CA
    o California Choice
    o Kaiser Permanente
    o United HealthCare

    Due January 11th by 5:00 p.m.
    o Covered CA**

    Due January 13th by 5:00 p.m.
    o Choice Builder**

    *Aetna submission cut-off date was December 30, 2016
    ** Special Extension

    At the time of submission to the carrier, the group must be "complete". A "complete" submission must include all required documents such as: the employer application, reconciled DE-9C (when required), employee applications, ownership documents and a binder check (if required).

    Carriers are also expecting that the group will be "clean" and not require needing to obtain a long list of missing information. Any grace period for missing information will be determined by the carrier upon recipient and review of the case.

    We greatly appreciate your business during this busy time of year and your assistance in meeting the carrier deadlines.

    View Document
    Carrier Updates 1.3.17
    by Rosa Tessandori » Tuesday, January 03, 2017 8:37 PM


    • Annual Notifications: Insured subscribers (excludes Shared Advantage, ASO, Medicare, and FEP) will receive the annual notification notice (attached) by December 31, 2016. The annual notice helps Blue Shield to satisfy federal, state, and NCQA/HEDIS requirements for notification to subscribers. The communication covers the following topics: standards for timely access to care, personal benefits information, preventive health guidelines, member rights & responsibilities. It also includes information on programs to help manage chronic conditions, quality improvement and patient safety, utilization management, and case management as well as information on language assistance, privacy practices, filing grievances, becoming an organ donor and coverage for mastectomy-related services for breast cancer. 

    Producer Alert
    • Sutter Health Contract: Negotiations continue, but the existing contract has expired and Sutter Health is no longer a Blue Shield in-network provider as of January 1, 2017. In the interim, Blue Shield and Sutter Health have agreed to a six-month transition period (through June 30, 2017) to help ensure uninterrupted care for members. For members with questions about Sutter Health and their access to care, Blue Shield has set up a dedicated phone line (888) 852-5345 from 8:00 a.m. to 5:00 p.m. Monday through Friday to address their concerns. View the notice for additional transition details.   

    View Document
    Carrier & Compliance Updates 12.27.16
    by Rosa Tessandori » Friday, December 30, 2016 12:55 PM


    Online News
    • Limited Promotion - Dual PPO Network Option Effective 1/1/17 through 3/15/17: New, renewing and groups requesting an early renewal, can offer both the Prudent Buyer and Select PPO network plans for a limited time.


    From the President's Desk
    • Message to Brokers and Employers: Emails were sent to brokers and employers with a message reassuring them that despite any changes the Trump administration may bring to healthcare reform, that small group health insurance benefits through CaliforniaChoice are safe. In addition, the notice to brokers also included a notification that effective 4/1/17, Aetna will no longer be a contracted provider.


    Compliance Update
    • CA State Automatic-IRA Effective 1/1/17: The Automatic IRA has been proposed as a way for the roughly half of U.S. workers that are not offered a 401(k) or any other type of employer-sponsored plan to save for retirement. However, in California, enrollment is postponed until regulations governing the program are adopted. The California program, titled the California Secure Choice Retirement Savings Program, phases in participation based on employer size. In addition, the DOL safe harbor prohibits employer contributions to auto-IRAs and requires that employers fulfill only “ministerial” (clerical) tasks. Note, employers always have the option of maintaining their own plan. Noncompliance may result in penalties and voluntary participation in Auto-IRA Program may create an ERISA plan.

    Compliance Alert
    • New Type of HRA for Employers with less than 50 FT Employees: On November 13, 2016, President Obama signed the 21st Century Cures Act. Among a variety of healthcare provisions, this legislation establishes a new type of health reimbursement arrangement (HRA) called the Qualified Small Employer Health Reimbursement Arrangement (QSEHRA). The provisions for QSEHRAs are effective for plan years beginning on or after January 1, 2017. 

    View Document
    Carrier Updates 12.19.16
    by Rosa Tessandori » Thursday, December 22, 2016 10:15 AM


    Producer News Online
    • Small Group Q4 2016 Update - From the desk of Joe Greenberg:  Read a short synopsis on Anthem's success in Q4-2016 and 2016 overall, as well continued expansion of services and tools in 2017. Via the Anthem Educational Blog, you can keep up to date with Anthem's new communication outreach program for new group administrators and continued political updates and other news 
    • 2017 H.S.A. Plan Changes: The 2017 Silver H.S.A. plan will have a three tier deductible and three tier out-of-pocket maximum (OOP). In addition, the deductible and OOP will now be embedded. RBG side note: The current version of the benefit summary contains an error in the footnote section which is expected to be corrected in the coming weeks. The footnote erroneously indicates that for a family "one member must satisfy their individual deductible and one member, (either same or other family member) must satisfy the individual out of pocket amount. Click here to view the summary.
    • December Webinars: No RSVP required, just click to join the meeting at the scheduled time. Small Group updates 12/22 9:30 a.m. PST, click here and LiveHealth Online 12/28 9:30 a.m. PST, click here. Test the links before joining.
    • Online Small Group Renewals: Renewals are now available online, but groups must first register on EmployerAccess. View the flier.
    • Online Tool Enhancements: View reports to identify who is turning 26 or 65 up to one year in advance; Dental and vision quote updates; Enhancement to the Small Group Details screens; Bill History screen enhancements and more.

    Broker Update
    • Client News: Responding to ACA questions following the presidential election.
    • Broker Tools: ABC's and 123's of HMO's and PPO's - Health care basics for your clients and the 2017 updated MGA.
    • Reminders: Broker of Record changes; CVS flyer - the sequel; Renew all of your Q1 clients now. 
    • Member Benefits: Find a doctor and holiday gifts with the Blue Shield mobile app; Viva la Wellvolution!; and Teleport to a physician with Teladoc.

    Broker News
    • 2017 Santa Cruz County - Small Group Bonus Program: Eligible groups need a physical headquarter address in Santa Cruz County. Note: Some groups headquartered in Monterey County that have employees living in Santa Cruz County also are eligible. The bonus program runs from January 1, 2017, to June 1, 2017. The bonus amount is $50 per Kaiser Permanente member (based on the member count as of the effective date for the new group). The bonus applies to all channels (including Covered California Small Business and California Choice).

    Broker Connection
    • Various Updates: View the Prescription Drug List (PCL) changes for 1/1/17-6/30/17; IRS Extends Deadline for form 1095, the new deadline is March 2, 2017, however the deadline for 10945 reporting has not changed; Learn about the UHC weight loss program for groups 51+; New Musculoskeletal value-based care payment program; Value-based Care report results; The Member Disclosure Notice was mailed the week of November 28; and read about the origination and prevention of opioid abuse.
    Important Billing Update 
    • Remittance Mailing Addresses Change for Non-Medical: Per the notification included in the July 2016 Invoice mailing, the mailing address for UnitedHealthcare Life, Disability, Critical Illness and/or Accident Coverage has been changed. View the update for the new mailing addresses for regular and overnight mail and handling of checks mailed to the old address.


    • Compliance Corner: COBRA Q&A; 2016 IRS instructions for reporting COBRA coverage on 1094 forms; 2017 FSA plan limits; and PCOR fees rise.
    • News & Trends: OCR pays closer attention to small HIPAA breaches; and Better informed employees make better benefit choices.
    • Behind the Scenes: WageWorks holiday supply drives for local charities

    View Document
    2016 Holiday Schedule
    by Rosa Tessandori » Thursday, December 22, 2016 9:57 AM

    View Document
    HR On-Demand by HRAnswerLink & RBG Discounts
    by Rosa Tessandori » Thursday, December 22, 2016 9:43 AM

    HR AnswerLink:  HR Support Center and HR On-Demand
    Looking to provide your clients an additional service that increases your value to them while having it pay for itself?

    Make yourself indispensable, offer your clients and prospects access to HRAnswerLinks' 24/7 HR Support Center Library, and then let it help pay for itself through subscriptions to HR On-Demand - which provides live HR consulting, or you can choose to pay for your clients' HR On-Demand subscription at a special broker discounted rate.
     Rogers Benefit Group offers agents an affordable discounted package: 
    • $99 HRAnswerLink Setup Fee - provides an HRAnswerLink site branded with your logo.
    • $100/month subscription - allows you to share the HRAnswerLink 24/7 library, the HR Support Center, with 100 users at no additional charge. It also provides broker access to the HRAnswerLink upgrade package which includes the: Analytics Dashboard, Website Marketing Tools and Prospect Communications Tools
    • Allow clients to upgrade their HRAnswerLink subscription to include HR On-Demand at a discounted rate of $39/month/user, while you earn a %15 revenue share per subscription, or provide HR On-Demand to your clients at the special broker discounted rate of $19.50/month/user.

    What does the HR AnswerLink 24/7 HR Support Center include?
    • Templates to create your own customizable employee handbook and job descriptions
    • Quick guides and checklists on common HR topics, including Health Care Reform, Hiring, Termination, and more
    • Extensive, easy-to-understand federal and state law libraries
    • Training videos and HR podcasts on various HR Topics
    • 3-minute HR audit to help quickly identify HR compliance gaps
    • Weekly HR Snapshot emails featuring a Q&A on trending HR topics.
    • Timely HR Articles

    What does HR On-Demand include?
    • Unlimited live “Ask the Pro” consulting
    • Employee handbook development
    • Custom job descriptions and HR documents
    • Free quarterly harassment prevention training
    Interested in learning more?
    • Watch this two-minute video, and
    • Reply to this email/RBG Tip Sheet, or email your RBG sales representative

    View Document
    Carrier Updates 12.12.16
    by Rosa Tessandori » Thursday, December 22, 2016 9:37 AM


    Broker Update
    • Secondary Contract Changes - To submit secondary changes during the same renewal period for groups already renewed online through (SGOR), email or fax a completed Request for Contract Change form with a note indicating “Unable to submit via SGOR”. Submit changes via email to or by fax to: 855-808-8598.
    • Pending Enrollment for New Members - Delays in processing applications may result in members incurring out-of-pocket expenses. Once installed, members can file a medical or Rx claim, view the Broker Update to access links to forms. Once members have registered, submitted claims can be tracked via the Blue Shield Mobile app.


    Partner News
    • Santa Cruz – CCSB is a winning combination in the Santa Cruz area.
    • 51-100 Group Segment – Read the article titled “The Evolution of ‘Large Group’ and Its Opportunities.”
    • 2017 Health Plan Change Summary – This summary provides a side-by-side comparison (year-to-year) of health plan benefits.
    • 2017 SBCs – Visit to download copies today. 
    • Employee Only Contracts – Offering an Employee Only contract allows family members who qualify, to continue qualifying, for and Advanced Premium Tax Credit (APTC). Groups with 50 or more FTEs, the contract must include coverage for the employee and child(ren). Note, no employer contribution is required for child(ren) coverage.
    • Customized New Hire Employee Worksheets – Receive a customized new hire worksheet within 48 hours of your request.
    • Payroll in Lieu of DE9C for New Businesses – Don’t have a DE9C because your group is too new? Not a problem, in lieu of a DE9C, submit 2 weeks of payroll.
    • Big Shifts in Plans Effective 1/1/17 – View what’s expanding and what’s going away.
    • Special Enrollment Period (SEP) – Deadline to submit an SEP group is December 15, 2016.
    • Broker Incentive Program -The fourth quarter Agent Incentive Program, combines sales for multiple agents from the same agency. The program ends January 1, 2017.

    Small Business Employer Briefing
    • Online Account Service Tool – View the new employer dashboard, it shows key account information at a glance. 
    • Retro Terminations – Kaiser will not retroactively terminate subscribers prior to the month the request to terminate is received. All subscriber terminations will be effective in the month Kaiser receives the termination request (i.e. if received by 8/31, the term can be retro to 8/1), or a future term date if requested.
    • Employer Identification Number (EIN) – View the MEC Reporting Guide to learn more about Kaisers’ ACA EIN and SSN/TIN data collection procedures.
    • Current Forms – Visit for the most current form and avoid processing delays when submitting enrollments or changes.
    Small Business Online Update
    • 2017 Renewal Packet Error – The Plan Highlights section at the end of the 2017 renewal package is incorrect. Please go to the Plan highlights and rates page to view the correct 2017 Plan Highlights.

    View Document
    Carrier & ACA Updates 12.5.16
    by Rosa Tessandori » Monday, December 12, 2016 7:44 PM

    What You Need to Know - Q4 2016 & Beyond
    • 2017 Portfolio & Marketing Materials: View the announcement or visit Easy Renew to download copies.
    • Q1 2017 Rates: Download a copy today.
    • Census Tool: Use it to get same-day turn-around approval on your groups.
    • Online Member Enrollment: This new feature will become available as soon as possible in the 1st Quarter of 2017.
    • EmployerAccess Enhancement: Soon groups will be able to provide their membership via a configured census that they download themselves, and then upload back into EmployerAccess once complete.
    Producer Alert
    • New Mobile App Sweepstakes: To encourage members to download the improved mobile app, letters are in the mail this week and the week of December 12th. Members will automatically be entered when they download the new mobile app and log in from any device. The sweepstakes will include weekly drawings for $100 Amazon gift cards, and a grand prize drawing of two $250 Amazon gift cards.
    Earn an Additional One-Time Payment of 1.5%
    • Multi-Product Advantage: Sell a dental plan and at least two new coverages from two or more of the different product groups, and you could earn an additional one-time payment of 1.5% of the annualized premium for each product sold. Groups with 10-99 employees are eligible for the Multi-Product Advantage discounts.
    E is for ERISA
    ACA Reminder
    • Form 1095 - Employee Statement: Deadline extended from January 31, 2017 to March 2, 2017.
    • Form 1094 - Transmittal and Accompanying Forms 1095: There is no extension to the filing deadline. The deadline to file with the IRS by paper is February 28, 2017, or by E-File on March 31, 2017.
    • Powerpoint: This brief presentation covers changes to transition relief, new reporting codes, "Good Faith Relief" and provides other helpful hints.

    View Document
    Carrier & ACA Updates 11.28.16
    by Rosa Tessandori » Thursday, December 08, 2016 6:07 PM

    Missed the November 17, 2016 Webinar? View the "November Small Group Business Update Guide"
    • New Email Address  - Contact customer service at 
    • EOCs - Now online, no more mailed copies.
    • Special Open Enrollment (SEP) for Small Groups only for 1/1/17 Effective Date - Complete submission of all employer and employee forms are due 12/15/16. Employee minimum participation and employer contribution requirements are waived. All other underwriting requirements still apply.
    • 2017 Rx Changes - The Select Drug List will replace the National formulary and will apply to all plans in the 2017 portfolio. Members with an impacted drug will receive a notification in the mail.
    • SBCs - View instructions on how to download them.
    • Relaxed Participation Through 3/15/17 - Reduced to 30% participation when 5 or more enroll.
    • DE9C Not Required with 6 or More Enrolling Through 3/15/17 - Groups with prior carrier coverage must submit prior carrier bill. Excludes virgin groups. 
    • HMO Dual Network Selection Through 3/15/17 - Offer one or both HMO networks. All groups must select only one PPO Network.
    • Same Day Turnaround for New Business Enrollment - Case must use the Census Enrollment Tool, case must be clean with no missing information or documents.
    • 2017 New Plan Offerings - 4 new HMOs and 1 new PPO plan.
    • Discontinued Plans and Networks effective 1/1/17 - No more HRA plans and no Priority Select Network.
    • 2017 Pharmacy Changes - New 90 day retail benefit and copay changes.
    • 2017 ACA to ACA Mapping Grid - Now available on Easy Renew, click here.
    • 2016 Updated SG HMO Network Guide - Includes a list of participating medical groups and Independent Practice Associations for CaliforniaCare, Select HMO and Priority Select HMO, click here. Reminder, effective 1/1/17 contracts, there will only be two HMO networks, not three.
    • Renewal Reminders - view/download renewals through Producer Toolbox and utilize the Easy Renew website.
    • Groups 51-100 Renewing January 2017 – Large group renewals were automatically issued on October 4, 2016, which included a Renewal Acceptance/Attestation Notification. If the Acceptance/Attestation is not received, a small group renewal will generate and the transition to small group will automatically commence during the 1st week of December.
    • How to Make a Plan Change at Renewal - 1) Use the applicable plan change request form, 2) Get a letter on company letter head or 3) Complete the renewal packet forms and have the group sign it. Send requests to
    • Best Way to Submit Small Group Employee Changes and Enrollments - Submit changes 1) Using the E-Submit web portal, New to E-Submit? View the E-Submit Guide, 2) Fax forms to 855-750-2227 or 3) Email them to
    • 2017 Renewal Quote Enhancements - Several new features have been added or updated, making it easier to renew your group and submit plan change selections.
    • Early Renewal/Anniversary Date Change Cut-off Dates - View the cut-off dates for requesting an early renewal (only allowed once in a 12-month period).
    • LiveHealth - Board-certified doctors are available online 24/7 to assess your health condition and even provide a prescription. Prescription availability is defined by physician judgment and state regulations. View the LiveHealth flier. Currently available on all PPO plans. Available to new HMO contracts effective 1/1/17 or to existing HMO groups upon renewal. Want to "meet" a doctor to see how the service works? Email and ask for a coupon.
    • Anthem Connect Team - View contact information for the California Connect Team for new business and renewals.
    • 2017 Small Group Guide - Now available to order.
    Broker Alert
    •  ACA - Responding to ACA questions after the Presidential election.
    Federal Law Alert
    •  ACA Reporting - IRS extends the due date to distribute ACA form 1095-C/1095-B to employees from January 31, 2017 to March 2, 2017.
    Compliance Alert
    • PCORI Fees - For plan years ending on or after October 1, 2016 and before October 1, 2017, the fee is $2.26. Prior rate was $2.17. Fees are required for all group health plans including Health Reimbursement Arrangements (HRAs), but are not required for Healthcare flexible spending accounts (FSAs) that are considered excepted benefits.

    View Document
    Carrier Updates 11.21.16
    by Rosa Tessandori » Thursday, December 01, 2016 9:39 PM


    Diabetes Awareness Month  
    Anthem Whole Health Connection: Anthem Whole Health Connection is a no-cost, value-added service for clients with an Anthem medical, wellness and one or more of the following Anthem products: pharmacy, dental, vision and disability. 

    Small Group Business Updates-Webinar
    Technology Tools: Wednesday November 30, 2016 9:30 am PST – RSVP not required, space is limited. Join the meeting , Dial In: 1-866-308-0254, Conference Code: 8057135146.


    Broker Update

    CVS Pharmacy effective 1/1/17
    Relaxed Participation Requirements Extended through March 31, 2017
    New Year, New Forms: New 2017 MGA and Employee Enrollment forms.
    February and March Renewal Kits: Available for downloading through Producer Connection.
    • Nondiscrimination Notice: A new mandate as of October 16,2016 requires Blue Shield of California include a nondiscrimination notice in all significant communications and publications. Blue Shield will include the mandate in required publications so you do not need to try to determine which materials are “significant communications and publications.”
    • Age/Rate Calculation Correction for New Groups Only: For new groups enrolling on or after September 1, 2016 – new hires are rated using “age at time of enrollment”. Groups with prior effective dates, new hire enrollments continue to be rated using “age as of the renewal date”. Correction of the rating error for groups with effective dates prior to September 1, 2016 is expected by Q2 2017.
    • Sell Access+ HMO and Trio ACO HMO Side by Side
    Multiple ID Cards in December

    Preventive Care Outreach Campaign – PPO and Select PPO Members
    • Campaign Launched November 3rd 
    • Opt-out Options are available by email or phone
    Sutter Health Continued Negotiations
    Negotiations Still in Progress
    Portal Home Page and Find a Doctor Web Pages Updated
    1/1/17 New HMO Enrollees - Participants are being assigned an alternate in-network PCP.
    • Current HMO Members with Sutter prior to 1/1/16 - Notification of a contract termination has not yet been issued.

    Producer Alert

    • 2017 Producer Agreement: The new Producer Agreement and the 2017 Commission Schedule are now available on Producer Connection. 


    Compliance Update
    • Wellness Sample Notice: New sample notice effective January 1, 2017.
    • COBRA Tip: Employer options for tailoring the sample notice.

    View Document
    RBG Tip Sheet - Carrier Updates 11.14.16
    by Rosa Tessandori » Wednesday, November 16, 2016 7:06 PM

    Producer Alert
    • Sutter Health Negotiation Update: Blue Shield of CA and Sutter Health continue to engage in discussions to renew the existing contract which is set to expire 12/31/16. Customarily, Blue Shield issues a notice to HMO members of a change in their provider assignment due to the expiring contract 60 days prior to the change. However, at this time, Blue Shield has not yet issued letters to impacted members, this is subject to change based on the progress of the negotiations. All new Blue Shield HMO members who enroll with a Sutter-affiliated PCP with an effective date of January 1, 2017 or later, will manually be reassigned an alternate, in-network PCP and will receive their member ID cards reflecting the alternate doctor and not the Sutter Health provider they originally selected. A buck slip will be inserted into the ID card mailing to explain the reason for this change. If the contract is renewed, HMO members who were switched to a non-Sutter PCP must contact the Customer Service number on their ID card if they would like to switch back to a Sutter affiliated PCP.
    Employee Informational Flier
    • Teladoc: Effective 1/1/17 for new groups, and at renewal for existing groups, Members will have access to Teladoc services which provides unlimited access to U.S. board-certified doctors 24/7/365 to resolve non-emergency medical issues through phone or video consults. Small Business PPO Savings plans are a $40 copay prior to the deductible and once the deductible is met, a $5 copay will apply. For all other Small Business HMO and Full PPO Plans, visits are a $5 copay and are not subject to the deductible.

    Partner Alert
    • Our Work Continues - We Are Open for Business: Your client’s Covered California for Small Business coverage is not in jeopardy. We encourage them to renew into their existing plan or shop for a new plan that best fits their budget and the needs of their employees. Employers with more than 50 FTE employees shouldn’t risk a financial penalty by not providing affordable health coverage.

    View Document
    Carrier Updates 11.7.16
    by Rosa Tessandori » Wednesday, November 16, 2016 7:01 PM

    Producer Alert
    • CVS - Pharmacy Management Program & Mail Order Change (revised)
    Partner News
    • 4th Quarter Agent Incentive Program
    • Online Broker Renewal Function
    • Sales Tip: No Participation requirements among carriers.
    • Account Management Team
    • Special Enrollment Period
    • Two Full Network PPO Carrier Options Effective 1/1/17
    • Out-of-State PPO Coverage
    • Blue Shield of CA HMO Plan and Networks Changes
    • Kaiser Expands into Santa Cruz and the surrounding area effective 1/1/17.
    • California Dental Network: New carrier effective 1/1/17
    • Discontinued Dental Plans
    • Discontinued Blue Shield Medical Plans
    Broker Briefing
    • 2017 Small Group Commissions:
    • KPIF Open Enrollment Materials
    • Updated Underwriting Guidelines 
    • Small Business Service Contracts
    • Small Business Service Tips

    View Document
    RBG Tip Sheet - Aetna Quoting Tool Webinars
    by Rosa Tessandori » Friday, November 04, 2016 12:28 PM

    Learn different ways to quote in Producer WorldSM

    Don't miss this webinar

    Are you a broker who sells Small Group ACA new business? We've moved to a broker self-serve model for new illustrative quotes with January 1, 2017, effective dates.

    Join us for an important webinar and learn several ways to get an ACA quote.

    You'll learn to:
    • Access Quoting and Renewal System (QRS) through Producer World to get a quote
    • Find our quoting tool, QRS, in different ways
    • Find ACA rate sheets on Producer World 
    We're offering webinars for three weeks in the hope you can find a convenient day to attend. Just view the attached to register.

    View Document
    Carrier Updates 10.31.16
    by Rosa Tessandori » Monday, October 31, 2016 5:50 PM

    • LiveHealth Online: Currently available on all PPO plans. Available to new HMO contracts effective 1/1/17 or to existing HMO groups upon renewal. LiveHealth includes 24/7 online physician consultations and psychology consultations 7 a.m. to 11 p.m., 7 days week.

    Producer Alert
    • Sutter Health Negotiations – Current contract expires 12/31/16. Negotiations are under way to try to renew for a 1/1/17 contract.
    Broker Update
    • MLR Rebates
    • First Month Rate Flexibility
    • BSC & CVS
    • Census Tool – Employer Connection Plus Report is back!
    • Trio Digital Campaign
    • No HMO for out of state – Employer Connection Plus Error
    • Relaxed Participation – Extended (updated notice coming soon, new extension through 3/31/17)
    • 4th quarter flexibility – Cut-off dates are Nov 7th by noon and Dec 7th by noon (RBG must receive submission with enough time to review prior to submitting to BSC)
    • Web launch online user tool – new tools
    • ACA-26 rule
    • Seeing HMO Specialist – self refer for a consultation (not services)
    • Expanding Specialty Benefits- increased PPO network, Rollover Rewards, 2-year life guarantee for new groups
    • Sutter Health Plus Network Map: View the map and the Bay Area Provider Directory (directories change frequently, always remind participants to verify a provider is contracted before receiving services).
    • List of Annual Limits: The IRS has released some of its 2017 limits, a few are still pending. View the list.  View FSA & HSA 2017 Limits.

    View Document
    RBG Tip Sheet - Carrier Updates 10.25.16
    by Rosa Tessandori » Thursday, October 27, 2016 9:00 AM


    Easy Renew
    • 2017 Documents now available on Easy Renew: Our 2017 Small Group Guide, along with other helpful 2017 materials, can be found on Easy Renew. We are also working to upload these materials to Producer Toolbox, and to CustomPoint to make them available for ordering.


    Producer Alert
    • CVS - Pharmacy Management Program & Mail Order Change: Starting January 1, 2017 for new and current members, CVS Health will manage Blue Shield's national retail pharmacy network, and become our exclusive mail order pharmacy for Commercial and Medicare plans and our specialty pharmacy for Commercial plans, The Blue Shield network retail pharmacies will be nearly unchanged and will continue to include all key chains such as CVS, Walgreens, Rite-Aid, Costco and many others. Members currently using the mail order service can expect to receive notification 60 days in advance of the changes by mail and telephone.

    PCA Instructions and Form
    • Prior Carrier Accumulation - Deductible Credit: For new groups with prior group coverage moving to Blue Shield of CA, members can complete the attached form to request credit for their prior medical deductible. Members must complete the form and submit a copy of their most recent Explanation of Benefits (EOB). Credit can be given for members going from PPO to PPO (H.S.A. to H.S.A.) or HMO to HMO. We do not give credit for members moving from HMO to PPO or PPO to HMO. Credit for separate pharmacy deductible is not given. Credit for Maximum Out of Pocket met is not given. Refer to the Blue Shield of CA Evidence of Coverage (EOC) for additional details.


    Broker Announcement
    • Ameritas Voluntary PPO - Takeover on Major Wait: New groups effective 11/1/16 electing Ameritas Voluntary PPO with 10 or more enrolling and have had their prior plan for 12 months or more are eligible to have the 6-month wait on major services waived for all enrolling. View the notice.
    • New - Anthem Blue Cross PPO Dental: Effective 12/1/16 effective dates, Choice Builder is now offering Anthem Blue Cross PPO dental - Platinum, Gold and Silver/Voluntary options. View the notice.

    View Document
    Carrier Updates 10.17.16
    by Rosa Tessandori » Tuesday, October 18, 2016 1:35 PM


    Producer Online News

    • 2017 Small Group Portfolio Changes: 
    • Silver HSA Plan Modifications 
    • Discontinued Plans: Gold HSA, HRA Plans and Priority Select HMO Network Plans


    Making it Easier To Do Business Through March 15, 2017:
    • Participation: For groups of 5+ enrolled reduced to 30%.
    • DE9-C: Not required for groups of 6+ enrolled.
    • HMO Network Option: Dual option now available.
    • Valid waiver: Individual covered is considered a valid waiver
    • Anniversary Date Changes: January anniversary date changes are due 12/28/16.
    Broker Blast
    • 2017 Q1 Rate Action: PPO -1.2% & HMO -4.6%. Also view the Annual Rate Change and Quarterly Rate Action 18-month history.
    • Renewal Package Changes: Small Group renewals have been refreshed and easier to understand including plan names alongside plan codes and easier alternative plans selections.
    • Broker Reference Materials: 2016 Rate Guide and 2016 Plan/Package Guide
    • New Plan Offerings: (1) HMO Plan, (1) PPO Gold Plan, (2) Silver HMO Plans and (1) Silver PPO Plan.
    • ACA Fees suspended for 2017: ACA fees have been suspended for 2017 so you will see them zeroed out on renewals.
    • Pharmacy Changes: New 90 day retail benefit & tiered generic drug copays.
    • Electronic EOC's: Starting 12/1/2016, members will receive electronic EOCs that they can access online under "My Plan Documents". The group administrator will continue to receive paper copies.


    Producer Alerts:
    • 1/1/17 Rates Available for Quoting!
    • Q4 New Business "Cut Off" Times: November and December new business submissions due no later than noon on the 5th business day of the respective month.
    • Digital Roadshow Link: Listen to it today!
    • ACO Digital Campaigns: Launches Tuesday, October 18, 2016, is statewide, with an additional focus in Southern California.
    • Member App and Portal: Launches October 16, 2016, includes a redesigned online experience and new mobile apps for Apple and Android users and more.
    Small Business Rate Cycle January
    • 2017 Rate Action: PPO Plans from -0.3% to +0.5% (including HSA-compatible plans); HMO Plans from -1.8%to +0.9%. Varies by plan (not by rating region).January 2017 Renewal Packets: Available for download October 18th.
    • Average Quarterly Rate Increase: View a list of factors on the product cycle home page.
    • Annual Customer Rate of Change: Will vary significantly by customer.
    • Covered CA: New Full PPO Network Blue Shield Plans will be offered for each metal level beginning 1/1/17. Consequently, the Narrow Network PPO Bronze 60 plan is being withdrawn from the market.
    • Commissions: 5% First Year and 5% Renewal Years.
    • Start-Ups: Groups that have been in business for less than four weeks, are now eligible if at least five (5) or more employees are enrolling and the business has been operating for at least one pay period. All other small group underwriting requirements still apply, refer to the "New Guidelines" for details. For start-ups with less than five (5) enrolling, refer to the "Underwriting Guidelines" .

    What’s New for Small Businesses in 2017
    • New HMO Pairing Options: Customers may purchase both Trio ACO HMO plans and Access+ HMO plans side by side.
    • Teladoc: Access board-certified doctors 24/7/365 a year. Teladoc offers unlimited visits and is not subject to the deductible with all Small Business HMO and Full PPO Plans with a $5 copay. Small Business PPO Savings plans are a $40 copay prior to the deductible and once the deductible is met the $5 copay will apply. 
    • Dental PPO: Network expansion by 40%.
    • Wellvolution: The Blue Shield of CA Online wellness program.
    • HealthEquity: Is the preferred Blue Shield of CA HSA administrator.
    • Identity Protection Service: Free to active BSC members.

    2017 Packages for Small Business
    • Participation Requirements
    • Rating Information
    • View Package Options for Medical and Ancillary
    • New Group Submission Checklist
    • Helpful Hints For A Complete Submission

    HMO Network and Plan Package Guide
    • Access+ HMO: Blue Shield’s largest HMO Network
    • Local Access+: Subset of Access+
    • Trio ACO HMO: Most Narrow Network, now available in 22 counties.

    View Document
    HealthiestYou - "Premium Holiday"
    by Rosa Tessandori » Thursday, October 13, 2016 4:27 PM


    Help employees save time and money!

    With HealthiestYou, you can connect to a doctor for treatment, diagnosis and
    prescriptions, 24 hours a day, 7 days a week over the phone or via the mobile app.

    Receive 2 months free if booked for a November 1st effective date or 1 month free if booked in December!

    See attached:
    • Overview Flier
    • Holiday Premium Flier
    • Price Sheet
    Have questions? Contact your RBG sales representative today!

    View Document
    Tip Sheet - Blue Shield MLR Rebates
    by Rosa Tessandori » Tuesday, October 11, 2016 11:27 AM

    Blue Shield of California owes rebates to approximately 30,000 small business policyholders in plans regulated by the Department of Managed Health Care (DMHC). As required by law, rebates will be paid by September 30, 2016 to Small Business contract holders (businesses, not individuals) in those plans with the rebates based on their premiums paid in 2015. A list of your impacted clients will be available in the next 2 weeks.
    Contact Producer Services (800) 559-5905 for details on your impacted clients. 
    View the attached PDF for:
    • Links to Blue Shield MLR fliers
    • Employer Compliance Tips

    View Document
    RBG Tip Sheet - Medicare Part D Creditable Coverage Notice Due 10/15
    by Rosa Tessandori » Tuesday, October 11, 2016 11:19 AM
    Center for Medicare & Medicaid Services 
    Creditable Coverage:
    The Medicare Modernization Act (MMA) requires entities (whose policies include prescription drug coverage) to notify Medicare eligible policyholders whether their prescription drug coverage is creditable coverage, which means that the coverage is expected to pay on average as much as the standard Medicare prescription drug coverage. For these entities, there are two disclosure requirements:

    1- Written disclosure notice to all Medicare eligible individuals annually who are covered under its prescription drug plan, prior to October 15th each year and at various times as stated in the regulations, including to a Medicare eligible individual when he/she joins the plan. This disclosure must be provided to Medicare eligible active working individuals and their dependents, Medicare eligible COBRA individuals and their dependents, Medicare eligible disabled individuals covered under your prescription drug plan and any retirees and their dependents. In addition, if it is known that a spouse or dependent that is Medicare eligible resides at a different address from where the participant/policyholder resides, a separate notice must be mailed directly to that spouse or dependent.

    2 - Entities should complete the Online Disclosure to CMS Form to report the creditable coverage status of their prescription drug plan. The Disclosure should be completed annually no later than 60 days from the beginning of a plan year (contract year, renewal year), within 30 days after termination of a prescription drug plan, or within 30 days after any change in creditable coverage status.

    To comply with the first requirement, many employers provide this notice as part of the annual open enrollment and new hire packets, and then provide a reminder letter in October. Employers should keep a copy of the letter as well as a record as to whom the letter was provided, when it was provided and the method of delivery. For additional compliance details, refer to the 2007_2.15 Guidance - Disclosure of CC to Medicare Part D Eligible Individuals (pages 12-13) provided below.
    View attached PDF for:
    Links to additional resources
    Links to 2016 & 2015 Carrier Lists of Medicare Creditable Coverage Status 

    View Document
    Carrier Updates 10.10.16
    by Rosa Tessandori » Tuesday, October 11, 2016 10:54 AM

    • 2016 Online Roadshow: If you missed this year's Blue Shield small business webinar, listen now! 
    • New Hire Rating: Effective 9/1/16, new groups with Blue Shield will have their new hires rated based on their age at time of enrollment. Existing groups will continue to have their new hires rated based on their age as of the groups last renewal. View PDF for details.


    Partner Alert
    • January 1/1/2017 Rates: Now available for quoting.
    • Blue Shield PPO: Full-Network plans now available effective 1/1/2017. Includes all metal tiers and also available to out-of-state employees.
    • Blue Shield Trio HMO: Available effective 1/1/17.
    • Kaiser: Coverage expanded to Santa Cruz and the surrounding area.
    • California Dental Network: New carrier effective 1/1/17.

    • Start-up Groups: Effective immediately in the 4th quarter, UHC will now accept a start-up with at least six weeks of payroll. View PDF for details.

    View Document
    Carrier Updates 10.3.16
    by Rosa Tessandori » Tuesday, October 04, 2016 8:22 AM


    • Producer Online Tools: October 5th, 2016, 9:30 am PST
    • Census Enrollment & Employer Access: October 19th, 2016, 9:30 am PST

    Producer Online News
    • Mail and Email Campaigns: Renewing Groups will receive a mail campaign to contact their agent and an email quiz to tailor campaigns to a group's interest. 
    • Transformation Central: Access resources to help with your renewal such as the Plan Comparison Tool, SBC's and SOB's
    • Online Therapy Visits: Starting October 1, 2016, employees in our groups who have Anthem’s Employee Assistance Program (EAP) as part of their medical benefit can get free online therapy visits through LiveHealth Online. 
    • Producer Toolbox Videos: How to Create Delegate Users, How to set up Quick Links on your Toolbox home page How to default the setting on the "Current Business Tab" to Small Group. Renewal Packet Enhancements: Starting with December small group renewals with 51 to 100 employees, you will find the Medical Benefit Selection form. For January renewals and beyond, you will continue to see additional enhancements, including the ability for you to click directly on your electronic copy to get more detail on a specific plan. 
    • Updated 2016 Small Group HMO Network Guide: The HMO Network Guide for small businesses with 1 to100 employees shows the participating medical groups and independent practice associations (PMGs/IPAs) that are part of these networks. 


    Small Business 4th Quarter Update

    • Relaxed Participation: Extended through December 31, 2016. For medical contracts, only one carrier is allowed to be written alongside a Blue Shield of CA plan. Promotion requires a minimum of 5 enrolled or 25% of the total number of eligible employees, whichever is greater. Ancillary (alongside medical or standalone) is also reduced to 25%, but Blue Shield must be the sole carrier.
    • Extended Signature Dates: A completed application will be good for three months from the date of signature for effective dates of Oct. 1 through Dec. 15, 2016.
    • Initial Premium Flexibility: For the fourth quarter, only 25% of the first month's rate is due upon the application with the remaining balance due upon the groups’ first month's billing date (i.e., a Dec.1 effective date group will be billed in mid-November for the unpaid dues).
    • Groups 10+ Enrolling: DE9C not required, in lieu of the DE9C, groups must submit an attestation form, download the form. Underwriting reserves the right to request a DE9C at any time. Groups 1-9 enrolling, DE9C is still required.
    • Refusal of Coverage Forms: For groups alongside another carrier, the other carrier's bill will be accepted in lieu of a completed Refusal of Coverage form. If the other carrier has not yet issued a bill, a copy of the employee applications for the other carrier will be accepted.
    • Special Enrollment Period (SEP): New group applications received between Nov.15 and Dec. 15, 2016, requesting a Jan. 1, 2017 effective date, are eligible for coverage without meeting the minimum participation and contribution requirements. All other underwriting requirements apply. The group must meet the minimum participation requirements upon renewal to continue coverage.


    Additional Updates

    • Fourth Quarter Master Group Application - Revised: The original fourth quarter 2016 Master Group Application didn’t include the option of selecting up to 19 Off-Exchange plans. The revised Q4 MGA is posted on Producer Connection. If you have a version of the application without this option listed, and your clients want to choose up to 19 plans, simply write in “Selected plans” where the Off-Exchange plans are listed and then mark each of the plans the group is selecting.
    •  Flier - Keep your Blue Shield Coverage: Educational flier for small businesses to use with any employees who may be losing their employer-sponsored Blue Shield coverage. The flier explains options under the Affordable Care Act and how members can remain covered with Blue Shield of California if they wish. We encourage you to download the flier.
    •  Medical Loss Rebate Checks: Groups eligible for a rebate have begun to receive their rebate checks in the mail. A list of your impacted clients will be available in the next 2 weeks. For details on your impacted clients contact Producer Services. 

    Life Insurance Updates

    • Competitive Rates and 2 Year Rate Guarantee: Blue Shield life insurance rates for small business are more competitive than ever. Give your small business clients the convenience of easy administration with a total benefits package from Blue Shield of California Life & Health Insurance Company. Request a quote today. 

    101+ Pulse

    • New Interactive Broker Guide: Introducing an interactive ePDF Broker Guide with convenient navigation and search features that will make it easier to find the plan information you need with just the click of a link or button.
    • New Full PPO Standard ASO: Available for smaller Core clients (101-299 lives).

    • Jackpot Bonus 51+: Earn $50 per enrolled employee on 4th quarter groups with 51-100 enrolling. View the flier for applicable rules.
    • Two New Western Health Advantage Plans: Effective 12/1/16 two new plans are available, they are the Western Health Advantage (WHA) Gold HMO D (Gateway 2000 HSA) and the Gold HMO C (Gateway 4010). View the flier.


    • Delta Dental – 2 Year Rate Guarantee: Available to all groups sold through 12/1/2016. 
    • Delta Premier Network: The Premier Network is available on the Delta Platinum PPO Plans. The Gold PPO plans utilize the standard PPO Network. 
    • No waiting periods on Major: Available for groups with 2 – 199 lives, even for "virgin" groups. 
    • Husband / Wife Groups: Choice Builder can enroll husband/wife groups, however it requires that they enroll separately. 
    • Voluntary Portfolio: Available for groups 5 – 199.
    • Life Commissions: 10% flat.
    • Quoting: 24 hour turnaround.
    • Summary of Plans: View a benefit summary listing for Choice Builder Plans.

    View Document
    Carrier Updates 9.26.16
    by Rosa Tessandori » Tuesday, September 27, 2016 8:46 AM

    • Revised Oct & Nov Renewals: Aetna recently implemented a 0.7% reduction to the 4th quarter rates in all 19 rating areas for our CA Small Group customers enrolling in or renewing Aetna HMO networks and plans, including HMO plans offered on CalChoice from October - December 2016. Due to the timing of the 0.7% rate reduction for the Aetna HMO plans, October and November renewals will be reprocessed to reflect the reduction to the renewal rates and mailed to customers. The December renewals reflect the updated HMO rates. View the details here.

    • 5% bundling discount: Your clients can save 5% on their dental, vision and life premiums when they buy dental and add vision and/or life coverage.
    • Save up to 12.5% on dental and 5% on vision with Med-Lock pricing: Discount applies when Anthem Health and Dental and/or Vision enrollment match – member for member.

          Compensation Tool Updates 
    • Timing of Commission Payouts: no more advanced commission payments.
    • Partial Commission Payment Error: September error for some subscribers who pay the 15th of the month.
    • Missing Customers: Two reasons why a customer may not have appeared on your September statement: 1) commission were paid in the prior statement period or 2) customer premium had not yet been paid for that bill period. 

         Broker Compensation Tool FAQs
    • Download Commission Statements
    • Excel Option
    • Who Has Access to View Commission Statements?
    • Who to Call for Help?
    • and more...

    • Commission Changes: Effective 10/1/16 commissions for new groups 51-100 eligible employees will be a flat 5% of premium. Effective 1/1/17 all small groups 1-100 eligible employees will be a flat 5%. View the Medical Payout Schedule for groups with aggregate premiums higher than $1,000,000, schedules for renewing groups, dental payout and Medicare plan commissions.

    View Document
    Carrier Updates 9.19.16
    by Rosa Tessandori » Monday, September 19, 2016 1:40 PM

    •  REMINDER -Health Plan Docs by Email and Online Only: Starting in September, Small Business customers will receive their post-enrollment materials via links in an email sent directly to them. Brokers will have access to the post-enrollment materials via the Shield Renewal Center. View the SB Update. 
    • Two New Western Health Advantage Plans: Effective 12/1/16 two new plans are available, they are the Western Health Advantage (WHA) Gold HMO D (Gateway 2000 HSA) and the Gold HMO C (Gateway 4010). 

     News Release 9.15.16 
    • Rate Changes: Statewide average rate increase is less than 6%. 
    • Expanded Coverage Choices for 2017: Blue Shield of CA expands to Full PPO network statewide and will offer the HMO Trio Network. Kaiser Permanente moves into Santa Cruz.
    • Processing Update: New groups are being enrolled within three days of filing an application.
    • New General Agent Relationship: Rogers Benefit Group effective immediately!
    • Return of Existing Carriers for 2017: Blue Shield of California, Chinese Community Health Plan, Health Net, Kaiser Permanente, Sharp Health Plan and Western Health Advantage.
    • End of the Temporary Reinsurance Program: Review of Impact on the market.
    • Federal Tax Credits: Some small business may still qualify for the Federal Tax Credits.
    • Family Dental Plans: Covered CA Plans are not required to include Family Dental Coverage. Carrier/network options include Access Dental, Delta Dental, Liberty Dental, Dental Health Services, Premier Access Dental and California Dental Network.
    •  Updated 2016 Underwriting Guidelines for Medical Carriers

    View Document
    RBG Bulletin 9.15.16 - Blue Shield, Download 12/1 Renewal Packets Today!
    by Rosa Tessandori » Thursday, September 15, 2016 11:00 AM

    12/1/16 Renewal Packets can be downloaded as of today! (9/15/16)
    Log in to Producer Services:
    >Click on “Renewal & Post-Enrollment packets”
    >Search for your group, then download the renewal packet.

    Requests for Emailed Copies of the Renewal
    Requests to have the renewal packet emailed to the agent by Producer Services cannot be accommodated until the packet has been mailed to the group (on or after September 22, 2016). Until then, packets are only available by downloading via Producer Connection.

    Renewal Training Resources
    Visit the Small Business Online Tools Resource Page to access:
    • Online Renewals Quick Start Guide for instructions on how to add/delete plans to the employer contract. In addition, once the renewal is submitted, you can enter employee level changes including adding and deleting dependents from coverage.
    • FAQ's for Small Group Online Renewal Tool
    • Video - Access Online Renewals and Employer Connection Plus (1:26)

    Still Have Questions?

    Contact Producer Services at 800-559-5905 for step-by-step assistance.

    View Document
    Carrier Updates - 9.12.16
    by Rosa Tessandori » Wednesday, September 14, 2016 4:38 PM


    • Small Group Eligibility Mailbox Changes: Please note that effective immediately, the shared mailbox and e-mail address used for inquiries and issues associated with Anthem CA Small Group Plans has been changed. Going forward, please use the following e-mail address: 

    • 2016 Deductible and Out-of-Pocket Credit Reference Sheet: CalChoice Reminder that members can be eligible for deductible credit when moving from one plan to another. View the attached grid for effective dates 8/1/16–12/1/16. This document is also available after logging in at / Download Forms / Broker.

    • General Marketing Materials: View the 7/1/16-11/1/16 Rate and Benefit Summary Guide and the Employer and Employee Forms. Rate and Benefit Summaries for 12/1/16 will be updated within a few weeks, Choice Builder will be adding NEW CARRIERS shortly !!!! 

    • NEW!! Rogers Benefit Group is now Contracted with Covered CA: Looking at Covered CA as an option? Effective with 10/1/16 effective dates, Rogers Benefit Group can now help you place business with Covered CA.
    • Agent Incentive Program: Get the full details on the “Three Ways to Earn More” for contracts with effective dates 10/1/16 – 1/1/17.

    • 4th Quarter Broker Bonus Flyer: The bonus is available for new medical groups with up to 100 eligible that are sold with effective dates from 10/1/16 through 12/31/16. View the criteria to qualify: New Sales Bonus Flyer.

    View Document
    RBG Bulletin - Introducing Covered CA
    by Rosa Tessandori » Wednesday, September 14, 2016 4:23 PM

    Great News!

    Rogers Benefit Group is now able to immediately begin assisting in selling and placing business with Covered CA for 10/1/16 effective dates.

    What are some of the unique features of offering Covered CA?
    • Multi-carrier choice portfolio that helps eliminate the need to market and change carriers every year.
    • Kaiser Parity Pricing.
    • Full network PPO with HealthNet, including Platinum plans. *If your client is currently with HN PPO, their deductible and OOPM can rollover.
    • Blue Shield of California (limited network). In some regions, the network is very competitive.
    • Employee-Only coverage which allows dependents to be eligible for subsidies on the Individual Exchange.
    • No admin or late fees charges
    • Small Business Tax Credits to those groups that qualify.
    • Competitive commissions
    • View the New - Agent Incentive Program : Get the full details on the “Three Ways to Earn More” for contracts with effective dates 10/1/16 – 1/1/17.
              o Earn up to $7,000 per group
              o Earn Additional Cumulative Production Incentives for Groups 1-100
              o Plus earn a very competitive Standard Commission starting at 6.5%

    So hurry, don’t wait to send us your groups to quote today!

    View Document
    Carrier Updates 9.9.16
    by Rosa Tessandori » Thursday, September 08, 2016 10:12 AM


    4th Quarter Updates:

    • Q4 Rate Changes/Impact
    • Underwriting Review & Changes
    • Participation Requirements
    • Out-of-Area Dependents
    • Product Portfolio Change 
    • SBC & Plan Documents 
    • Benefit Toolkit/UW Guide/Checklist/Forms 


    Producer News Online:
    • New Email Address for SG Eligibility
    • Electronic Certificates of Coverage
    • Santa Clarita Pilot of PayForward
    • Health & Wellness Employer Email Series
    • Producer Talk Webinars
    • Producer Toolbox Video Series


    • Digital Broker Roadshows
    • Reduced Staff Labor Day Week
    • Ancillary Off-Cycle Up-Sell Changes
    • Commission Reports Available Online 9/5/16
    • Commission Calculation Changes
    • Discontinued Vision Plans
    • No More Mail and no More DC-ROMs

    View Document
    Carrier Updates 8.29.16
    by Rosa Tessandori » Monday, August 29, 2016 4:46 PM


    Producer News
    • Submit Groups Early: Anthem is accepting 12/1/16 groups beginning 9/1/16.
    • Delayed First Month's Premium for New 12/1/16 Groups: December premiums not due until 11/21/16.
    • New Forms: Forms submitted on or after 9/15/16 for 10/1/16 effective dates must use the new 7/1/16 dates forms. Forms dated 1/1/16 will no longer be accepted. 
    • DE-9C's: Not required for groups with 6 or more enrolling. 
    • Relaxed Participation Through 12/1/16: For groups with 5 or more enrolling in medical or specialty (dental and vision) plans minimum participation is reduced to 30% at inception and renewal/recertification. 
    • No Required Participation for 1/1/16 Effective dates: Under Annual Open Enrollment from 11/15 - 12/15 for a 1/1/17 effective date, participation requirements are not enforced. All other underwriting requirements must be met.
    • Dual HMO Networks Option: Groups can offer up to two HMO networks, in any combination. This does not include PPO plans.
    • Same-Day Turn-around: Groups submitted with fully completed paperwork before 8am Monday - Friday can receive same-day review and approval.

    • Member Discounts: Blue Shield members can save money! Find smart ways to stretch your health plan budget now. ® on health and wellness programs, from vision care discounts to health clubs and even Weight Watchers. View Flier.
    • Commissions Paid by Electronic Funds Transfer Only:  Effective 9/1/16: To ensure that your commission payments are not disrupted, sign up for direct deposit through the Producer Connection. New System Launch expected 9/6/2016. View Flier.

    • FSA Promotion: Now is the time to save on your FSA program plus get a free Transportation Benefits Plan. Apply before 9/30/2016. Set up fee is waived; First year renewal fee is waived; 2-year rate guarantee; MGA must be received no later than 09/30/2016 for effective dates to 01/01/2017. View Promotion Flier, TASC Admin Features Flier and View Mobile App Claims Submission Flier.

    View Document
    Carrier Updates 8.22.16
    by Rosa Tessandori » Thursday, August 25, 2016 7:07 PM

    • Online Renewal Tip: "Select All" reminder. When renewing your groups using the Online Renewal Tool, even if a group already has "Select All" as part of their existing contract, it must be selected again when renewing online. 

    • Renewal proposals online: Simply login or register at to get started. You can download and save each Renewal Proposal as a PDF including all Employee Renewal Enrollment Worksheets.

    • Dental Packages: Move to Choice Builder now and give start a new plan year max, then on January 1st, start a new max all over again. 2 – 199 EE’s Sponsored or Voluntary Products, No De9c required – Mix and Match DHMO AND PPO.

    View Document
    Carrier Updates 8.15.16
    by Rosa Tessandori » Wednesday, August 17, 2016 4:22 PM


    SG ACA Business Updates
    New Case Submission Policy: Effective 10/1/16 submission cut-off dates are 1st of the month for 1st of the month and 15th of the month for the 15th. Groups submitted after the deadline will roll to the next available effective date.
    Renewal Policy Change: Effective 10/1/16 Aetna must receive written confirmation in advance of the customer renewal date for all Aetna small groups (1-100). Written confirmation may include signed renewal acceptance from the customer delivered by mail, fax or email to the Aetna Client Manager. Premium received in advance of the renewal date will also be considered renewal acceptance. If we haven't received written acceptance of the renewal, or renewal alternates, we will initiate termination of the policy for nonpayment.


    Small Group Updates
    New Applications: Please note: Anthem will no longer accept the 1/1/16 applications starting with 10/1/16 effective dates. Applications must be received by Anthem by 9/15/16. Please destroy and replace any of the 1/1/16 applications with the new revised 7/1/16 applications. Access them on Producer Toolbox or Easy Renew.
    Video: Making it easier for SG Employers to do business with Anthem. View the video.
    Webinar - Producer Talk: Small Group Dental Competitive Trends. Thursday, August 18. Register Today
    Webinar - 30-Minute Group Renewals: How to get them and quoting options - Wednesday, August 10th 9:30 am PST. Register Today..
    Webinar - Why Sell Small Group Anthem: Wednesday, August 24th 9:30 am PST. Register Today.


    Small Business Update (updated flyer coming soon)
    Relaxed Participation: The promotion has been extended through December 31, 2016 for Groups with 5 or more enrolled employees. The participation requirement is only 25%! The updated producer alert and flyer are expected to be released soon. In the interim, view the existing flyer for reference.

    Producer Alert (reminder)
    Commissions Paid by Electronic Funds Transfer Only - Effective 9/1/16: To ensure that your commission payments are not disrupted, sign up for direct deposit through the Producer Connection. Brokers who do not provide their electronic information will not receive commission payments until they do so.


    Small Business Advantage
    • Broker Bonus: Groups 10-99 employees, sell a dental plan and at least two new coverage from two or more of the different-product groups for an additional one-time payment.

    View Document
    Carrier Updates 8.8.16
    by Rosa Tessandori » Wednesday, August 17, 2016 3:53 PM


    Broker July Update:
    • More plan pairing options
    • System issue impacts new enrollee rates
    • Pay premiums online
    • Renew Early and Save
    Producer Connection:
    • Pediatric Dental: Remind your small business clients about value of the embedded pediatric dental and vision benefits.
    • Voluntary Benefits Bonus Program: For group with effective dates 8/1/16 - 1/1/17, Humana has rolled out their richest small group bonus plan ever!! View their Bonus Program Flyer.
    • Why Humana?
    • Voluntary Benefits: Humana offers Accident and Cancer/Critical Illness Plans
    • Humana Vision: In addition to our retail chains and local optometrists members can get their Glasses Online, as well as their contact lenses. Our Network has grown by 20% and the network name is now Humana Eyemed Insight, view the Humana Vision Plans.
    • HRAnswerLink: Join us for an introduction to HRAnswerLink's Robust Branded HR Services / Rogers Benefit Group Partnership.
    • Quote Request Reminders: For faster turnaround times on your early renewal quote requests, please provide a current census and billing statement. What do we need to quote a group? See our Quote Request Form. Turnaround times on quote requests vary based on demand. Get them in early!

    View Document
    Carrier Updates 8.1.16
    by Rosa Tessandori » Wednesday, August 03, 2016 9:32 AM


    Early Renewals Requests for 9/1/16 Effective Dates: Forms are due today 8/1/16. If you need more time, contact your RBG Representative for instructions. Missed our blast on submitting an Early Renewal Request from last week? View the attached flier. Renew your 4th Quarter PPO clients effective 9/1/16 and help them save. For a general overview of the rate impact for select PPO plans, view the attached chart.


    • Renewals Online (New!): Your Upcoming renewal proposals are now available online. Log in or register at to download your packets.
    • 10/1 and 11/1 Rates Available for Quoting
    • Updated Forms for 10/1 and 11/1: Employer Form and Employee Form.

    HEALTH NET 101+

    Broker Blog Update

    • Enhanced Choice Portfolio: New Rate Guarantee - 2nd year rate cap option, PPO Only Package Option - allows up to three PPO's and Broker Bonus for qualifying groups with 7/1/16 - 12/1/16 effective dates.


    • HRAnswerLink Webinar: Join us for an introduction to HRAnswerLink's Robust Branded HR Services / Rogers Benefit Group Partnership.

         o August 3rd – Wednesday at 10:00 AM to 10:30 AM (PST)
         o August 10th – Wednesday at 10:30 AM to 11:00 AM (PST)
    • Quote Request Reminders: For faster turnaround times on your quote requests, please provide a current census and billing statement. What do we need to quote a group? See our Quote Request Form. Turnaround times on quote requests vary based on demand. Get them in early!
    • UHC4me Tool: Everything you need to know about UHC in one presentation. 

    View Document
    Carrier Updates 7.25.2016
    by Rosa Tessandori » Wednesday, August 03, 2016 9:16 AM


    Small Group DE9C Requirements: Attached is the quick and easy-to-use RBG Guide on the DE9C Submission Requirements for the small group carriers.
    HRAnswerLink: Join us for an introduction to HRAnswerLink's Robust Branded HR Services / Rogers Benefit Group Partnership.  
         o July 27th – Wednesday at 9:30 AM to 10:00 AM (PST)
         o August 3rd – Wednesday at 10:00 AM to 10:30 AM (PST)
         o August 10th – Wednesday at 10:30 AM to 11:00 AM (PST)
    View HRAnswerLink Fliers: HR On-Demand Difference, The Essential Package and Critical HR Tools at your fingertips.


    Binder Checks No Longer Accepted: Beginning September 1st, Principal will no longer accept binder checks on new cases. Since having moved to electronic submission of new case paperwork, the binder check creates a challenge. Employer should pay as billed after the case and coverage are installed. There are multiple payment options available, including one-time electronic payment, scheduled recurring payments, and check payment by billing stub.

    View Document
    Deadline Reminder for BSC 9/1/16 Early Renewals
    by Rosa Tessandori » Monday, July 25, 2016 7:30 AM


    Why should I consider Early Renewal for my Blue Shield of CA Small Business Groups?
    • Your clients could save money by renewing in September instead of December. See the enclosed chart for an estimate. You can also discuss this with your RBG sales rep.
    • You avoid the "December Rush"
    • Renewing early will secure a 12-month rate guarantee that is usually well below the 4th quarter renewal increase.
     What should I do now?
    • Review the attached chart for an estimate of possible rate action. Some rates are going down, and others see slight increases. Most early renewals are advantageous from a rate standpoint but can vary by area, plan, and census.
    • Visit with your groups about their preferences based on the above. Most groups will want to consider this action. Even new groups are eligible, as long as they have been with BSC for at least 6 months.
    • Get specific rate information by sending us the current enrollment census and we’ll run you a quote.
     What’s the Deadline?
    • A completed Plan Year/Contract Year Change Form must be in our office by Monday August 1st at 2:00 p.m.
    • Send them to:
    • If you miss getting the change request to us by the above date and time, it can be submitted directly to BSC no later than 5 p.m. on Monday August 1st to:
    o Email:
    o Fax: 855-808-8598

    View Document
    Carrier Updates 7.18.2016
    by Rosa Tessandori » Monday, July 25, 2016 7:20 AM

    Producer News Online
    • Q4 Rate Release: Rates are now available for quoting.
    • Newly Added - 6 New Sutter HMO Providers: Effective 7/1/16,
    • 7/1/16 Small Group Guide: The 2016 Small Group Guide has been revised to reflect mid-year changes to our product portfolio (effective 7/1/16). Download the guide. A few of the portfolio enhancements include: 1 new full network PPO Platinum Pan and 1 new full network HMO Platinum Plan. 4 new plan offerings within the PPO Gold metallic tier option that provide lower deductibles. 4 new plan offerings within the PPO Silver metallic tier option that provide lower deductibles.

    Producer Connection 4th Quarter Update
    • New - HMO Plan Pairing: Starting in October, sell Blue Shield Trio ACO HMO plans alongside Access + HMO plans.
    • New - Match Your H.S.A. Compatible Plan with HealthEquity: Blue Shield will share eligibility and claims data with HealthEquity for a seamless process. Signing up is easy, employers just check the box on the master group application (MGA). Available for Bronze Full PPO Savings 4500/30% and 5500/40% OffEx plans.
    • Specialty Plan Rates: No increase
    Medical Plan Rates: Increases vary by region and plan. Most areas starting at 5%-8% above 3rd Quarter Rates (actual increases vary by plan and region and group demographics).
    • Renew early and save! Form due 8/1/6 for a 9/1/16 early renewal date. Download the Plan Year Contract Change Form.

    Producer Alert
    Commissions Paid by Electronic Funds Transfer Only - Effective 9/1/16: To ensure that your commission payments are not disrupted, sign up for direct deposit through the Producer Connection. Brokers who do not provide their electronic information will not receive commission payments until they do so.

    Small Business Paperless Update
    • October Renewal Packets: Errors in packets made available on Producer Connection on 7/1/16. Corrected Packets now available on Producer Connection. This error was caught prior to printed copies being mailed out. Visit Producer Connection to confirm you have downloaded the corrected copy.
    November Renewal Packets: Available on Producer Connection as of 7/15/16. Employer printed copies to arrive the week of July 25th.

    View Document
    Carrier Updates 7.11.16
    by Rosa Tessandori » Friday, July 22, 2016 9:53 AM


    Producer News (view the full newsletter)
    Q4 Rate Reduction: .4% average rate reduction. In certain regions, the decrease averages more than 5% on both HMO and PPO plans (rate actions will vary by region, network and other dynamics). Rate release expected by 7/15.
    7/1/16 Small Group Guide: The 2016 Small Group Guide has been revised to reflect mid-year changes to our product portfolio (effective 7/1/16). Download the guide. 
    New Reinstatement Requirements Effective 7/1/16: Small Groups that cancel due to nonpayment and reinstate without a break in coverage will be required to set up recurring monthly payments to prevent future cancellations.
    Dental Rate Reduction Effective 9/1/16: Anthem’s lower Dental Complete rates go live on July 1, 2016 for September 1, 2016 effective dates.
    Josie's Story: Learn how Anthem Case Managers offer support when diagnosed with a life threatening disease.
    Disability Coverage Available Effective 6/1/16 Groups (10-50 EE's): Beginning with June 1, 2016 effective dates, short-term and long-term disability are now available on the Small Group Quoting Tool (SGQT).


    2017 Pulse Broker Guide: View the new interactive PDF. Download a copy today!

    New Group Application Effective 7/1/2016: KP Small Business has an updated version of the New Group Application. Until further notice, KP will accept the January 2016 and the July 2016 versions concurrently. Please be sure to check the Forms Validation Matrix if you are in doubt or you believe you have an old form. Remember, only forms listed on the Forms Validation Matrix without an expired date are valid.  

    View Document
    Carrier Updates 7.5.2016
    by Rosa Tessandori » Monday, July 11, 2016 9:51 AM

    Small Business Paperless Update 
    • Q4 Early Rate Release - rates are available for quoting.
    • Q4 Mandatory Online Renewal Changes vs allowable Paper/Fax/Email/Mail Changes - Group renewals submitted to BSC via fax/email/mail may be rejected for processing, if rejected, the Broker of Record will be notified via email.
    • Tutorials on how to renew your group through Producer Connection - the quickest most efficient way to renew any group is through the Producer Connection Renewal Center. Review the Quick Start Guide for step-by-step instructions:
    • Help Your Clients Manage Their Group Online - Employers add/cancel/change coverage for new and existing members. As their broker of record, update the groups renewal plan selection online, once processed by BSC, notify the employer they can now access their renewal plan(s) and log in to Employer Connection to process employee renewal changes. Review the Quick Start Guide for step-by-step instructions,

    View Document
    Carrier Updates 6.27.16
    by Rosa Tessandori » Tuesday, July 05, 2016 7:31 AM


    Renewals: Submit renewal changes via eList Tool. Visit Aetna's Producer Portal to download a current copy of the e-List Tool. The eList Tool is a macro-enabled replacement of the eList template. This tool is to be used for New Business/Renewal submissions with 2-100 eligible employees. New versions are available at different times so always download a new tool for each case. View the Renewal e-List Tool training presentation.


    Broker Update
    For Groups with 10+ enrolling - No More DE9C's: Starting August 1, 2016 through February 1, 2017 for groups 1-100. Group must have minimum 10 enrolling, have prior coverage and submit a completed attestation form. The attestation form will be available 7/1/16 on Producer Connection.
    Pre-Enrollment System: New system goes live mid-summer, more to follow.
    Post Enrollment Materials: Available online later in summer.
    Sales Cycle Materials: Coming in July.
    Rate Tables: Available on line, click here.
    Inaugural Mission Report: View and share all of BSC's efforts in fulfilling their 2015 fulling their 2015 mission.

    View Document
    Carrier Updates 6.20.2016
    by Rosa Tessandori » Thursday, June 23, 2016 7:10 PM

    • Rate Action and Renewal Update: Small Group Rate Reduction - 2.71% reduction to the 3rd quarter rates in all 19 rating areas for CA Small Group customers enrolling or renewing in an Aetna Managed Choice® or Open Choice® PPO (MC/OAMC/SavingsPlus/PPO) plan from July – September 2016. Revised Renewals for July & August - Due to the timing of the 2.71% rate reduction for the Aetna Managed Choice (MC) and Open Choice PPO plans, the July and August renewals will be reprocessed to reflect the reduction to the renewal rates and mailed to customers.
    • Dental Total Average Employee (TAE) Letters to Employers: AB1962 California state law requires annual reporting of Medical Loss Ration (MLR) by dental plans. To comply, Aetna is mailing letters to plan sponsors with fewer than 200 employees. Employers are requested to respond by August 12, 2016. Group size reporting is determined by how many employees the plan sponsor had in the year before the loss ratio experience year. Learn more about - AB1962.

    • Self Service Phone Guide: Fast and accurate information 24 hours a day, 7 days a week. You can access Account billing, application status, eligibility information, member benefits information and forms.


    • Online Enrollment: Streamline your group enrollments. It's easy to set up and easy to track enrollments, Get started today – click here for more details.  

    View Document
    Carrier Updates 6.13.16
    by Rosa Tessandori » Thursday, June 23, 2016 7:04 PM


    • SBC Template Changes - The Departments of Health and Human Services (HHS), Labor (DOL) and Treasury have released new Summary of Benefits and Coverage (SBC) templates, instructions, and Uniform Glossary. Changes are effective 4/1/17, Aenta will implement changes effective 1/1/17.


    • Producer Talk Webinar - A 30 minute webinar-on-the-go , where Anthem provides you with the details of working with the Anthem Connect Team. They're your concierge producer call center that helps you provide the best value to your small group clients at every stage of the dental, vision, life and disability sales cycle. Read more about it and register today.
    June 23rd
    11:am Pacific Time
    30 minutes.

    UHC 100+

    • Discount Package - The more you bundle, the more you save. Savings start at $5 per employee per month up to $15 per month.

    View Document
    Carrier Updates 6.6.16 & SAHU EXPO 6.16.16
    by Rosa Tessandori » Wednesday, June 08, 2016 9:20 AM

    Producer OnLine News
    • Small Group Census Tool - New and improved. 
    • Electronic Debit Payment Updated Form - Download the form.
    • Enhanced Personal Health Care Program (EPHC): Helps eliminate unnecessary treatments and resulted in savings of $14.8 million in just one year. Visit for more on Anthem’s Enhanced Personal Health Care program.
    • Renewing from Large Group to Small Group: Marketing infographic to help groups understand differences in rating structure, employee birthday rate changes at renewal, plan mapping etc.


    Producer Alert
    • 2015 Mission Report: This report highlights our commitment to providing quality health care at an affordable price: Mission Driven, Good Corporate Citizen and Steward of Resources. 

    Broker Connection
    • Preventive Care Changes eff 10/1/16: View the list . View the full set of UnitedHealthcare’s Preventive Care Services Coverage Determination Guidelines (CDG), 
    • July 18-22 Knowledge Institute Training: An entry-level training program those new to the health care industry.
    • Pharmacy - Drug Patent Expirations: View the list of expiring patent drugs and commentary on the expected impact.
    • Optum's Wellness of Workplace Study: The gap between employer goals and reality.
    • June is Men's Health Awareness Month: 5 Ways to Take Charge.


    SAHU EXPO 6/16/16

    When:  Thursday, June 16
    Doors Open 8:00 a.m.
    Program: 8:30 a.m. to 4:00 p.m.

    Where:  Citrus Heights, Community Center

    6300 Fountain Square Dr., Citrus Heights, CA 95621

    For more Information and to RSVP, view the attached flier

    View Document
    Carrier, HR & ACA Updates 5.31.16
    by Rosa Tessandori » Thursday, June 02, 2016 9:56 AM


    Q3 Update:
    • Rate Changes - HMO's 0 to -2.54% rate change, PPO's 1.5% to 5.2% rate change. 
    • Best Selling Plans - view the list.
    • Benefit Toolkit Updates
    • SBC's, Plan Documents and Certs - available on line for certain 2016 plans.
    • Pick-5 Program - For new and renewing groups. 
    • Early Renewal Requests - 60 day advance notice required
    • E-List Tool - now available for renewals
    • Member Enrollment Brochures - are available for order on Producer World.
    • Broker Bonus - reminder
    • Dental - DMO reduced copays


    Broker Update:
    • Specialty Benefits Alignment Requirements for Large Group and Small Group contracts: Blue Shield Large Group medical customers with 51–100 eligible employees that are moving to Small Group medical coverage this year, must also move any existing specialty coverage to Small Business specialty benefit plans.
    • Blue Shield Jumps In Market Share - Blue Shield now ranks #1 in the state market for PPO Small Group membership.
    • Identity Theft Protection - Available at no cost to all eligible health plan members. NEW, Employee Marketing Flier available.
    • Renewing Early Can Help Select Groups Save - With recent favorable rate actions and newly embedded pediatric dental rating, changing renewal months may be beneficial to many of your groups. The renewal change request must be received at least 30 days prior to the first day of the requested change.
    • Updated Producer Agreement - Download the most current copy on Producer Connection, with updated commission information which only affects Small Business and IFP brokers. Commission Schedule Changes: Effective July 1, 2016 small group commission schedule is 5%. Effective September 1, 2016 commission will no longer be paid on ACA Taxes and Fees.


    HR News Alert:
    • Changes to Federal Minimum Wage & Overtime Rules for "White Collar" Workers - In order to qualify for exemption from FLSA Minimum wage and overtime requirements, white collar salaried exempt employees must earn more than $913 per week (previously $455 per week) in addition to meeting other FLSA/DOL job responsibility requirements. Changes are effective December 1, 2016.
    • 2017 HSA Contribution Limit and Minimum Deductibles - HSA Contribution Limits $3,400 for self-only coverage and $6,750 per family. Minimum deductibles $1,300 for self-only coverage and $2,600 per family. Maximum out-of-pocket (OOP) maximums $6,550 for self-only coverage $13,100 per family.
    • ACA ALE (50+ FTEs) Employer Reporting Deadline May 31, 2016 - Employers with 50+ Full Time Equivalents (FTEs) are required to issue 1094 and 1095 C (or B) forms and must file completed forms to the IRS by the designated deadline. For Employers filing electronically, the deadline for reporting to the IRS is June 30, 2016.
    • SBC Template and Related Documents Effective 4/1/2017 - New Versions Finalized.

    View Document
    Carrier Updates & SAHU Expo
    by Rosa Tessandori » Tuesday, May 31, 2016 9:56 AM

    • Small Group Life Insurance: Add Life w/ AD&D coverage to existing medical groups at any time. Groups with 10+ employees are eligible for composite rates.


    • Facilities Updates: 2017 - look for Kaiser to expand into Santa Cruz, Scotts Valley, and Watsonville area. Services will include primary care, telemedicine, select specialty services, lab, pharmacy and radiology. Now Open - South Sacramento Urgent Care New facility for non-emergency medical conditions that require care. St. Joseph's Medical Center in Stockton now partnering with Kaiser Permanente to offer emergency and other hospital services. San Leandro Facility is now performing elective full spectrum hip and joint replacements.

    • Bonus Program effective 7/1/16: The new Multi-Product Advantage bonus is designed especially for groups with 10-99 employees. Sell a dental plan and at least two additional new coverages from two or more of the different product groups, and for groups meeting the qualifying criteria, earn a one-time additional broker bonus of 1.5%.
    Expo June 16, 2016
    8:30 a.m. - 4:00 p.m.
    Citrus Heights community Center
    Join SAHU for an action packed agenda designed to expand and diversify your business.
    Featuring headliners from Moss Adams, Health Equity and JH Tackett, along with a special keynote by none other than industry guru Kevin Trokey. Also presenting is our very own, Craig Gandy - Sacramento Regional Sales Manager, on how your agency can improve back office productivity, quality and processes.

    View Document
    Carrier Updates 5.17.16
    by Rosa Tessandori » Wednesday, May 18, 2016 7:31 AM


    Producer Online News

    • Dual Network HMO Promotion: For small groups with effective dates June 1 - September 15, 2016, you can offer up to 2 HMO networks.
    • DE9C No Longer Required: For groups with 6 or more enrolled employees effective now through September 15, 2016 effective dates.
    • Same Day Turnaround Times for Enrollment: Submit a complete group (all required documents) by 8 a.m. PST Monday-Friday and be approved by the end of the same day.
    • E-Submit Tool: Use E-Submit for member level maintenance transactions for small group plans. Use it to submit new employee applications, information change forms, deletions and other eligible changes on existing groups. E-Submit is a convenient way to digitally submit applications and maintenance paperwork for Small Group business.
    • Billing Status Screen Errors in Producer Toolbox: IFP and SG incorrect billing status errors. Late Payment Alerts have been turned off.


    Producer Alert

    • Commission Schedule Changes: Effective July1, 2016 small group commission schedule is 5%. Effective September 1, 2016 commission will no longer be paid on ACA Taxes and Fees. View the: 2016 Amended Commission Schedule


    Broker Bonus Alert
    • Broker Bonus: For new groups 51-100 enrolled in medical through June 1, 2016, earn up to $50 per employee.  

    View Document
    Carrier, ACA & Underwriting Updates 5.9.16
    by Rosa Tessandori » Tuesday, May 17, 2016 12:09 PM

    • Relaxed Participation: Extended through September 30, 2016 for Groups 1-100 eligible employees with 5 or more enrolled employees. The participation requirement is only 25%!
    • Identity Repair and Monitoring Services: Available at no charge effective 5/2/2016 to active BSC members. Services provided by AllClear ID. For services call 855-904-5733. Active members are also eligible for Credit Monitoring Services, to register visit the BSC AllClear ID webpage for more information.
    • Webinar: 2016 Updates, New Product Portfolio, Wellness Program & Underwriting Updates Thursday 5/19/16 9:00 a.m. RSVP
    • RBG Medical Underwriting: Side by Side Comparison
    • HR360 ACA Provisions: Eliminations, Delays & Extensions Chart

    View Document
    Carrier Updates 5.2.16
    by Rosa Tessandori » Thursday, May 12, 2016 7:24 PM

    Producer News
    • Reminder Q2 Rate Pass: Take advantage of the existing rates before Q2 expires.
    • Same Day Enrollment: Groups submitted by 8 a.m. PST are eligible for same day approval. Requires a completed new business submission packet and must use the Census Enrollment Tool.
    • Relaxed Participation: Still in effect through Q2. 30% participation for five (5) or more enrolled in Medical or Specialty (Dental & Vision).
    • Valid Waivers: Effective 4/1/16 Individual coverage, On and Off Exchange , now counts as a valid waiver.
    • New Billing Process: Effective 5/1/16 invoicing and payments are only available online. Make sure groups are registered to receive an email notification that their invoice is ready. If they prefer to opt out of the online only invoice and payments, groups must email Anthem to let them know!
    Broker Update
    • OnlineTools: Make business easier with the Online Renewal Tool, Employer Connection Plus, and Member Site.
    • Chiropractic Benefit Reminder: HSA-compatible plans do not include a chiropractic benefit
    • Producer Alert:
    • Renew Early: Do you have a group with a large population of children covered by pediatric dental? Renew early and your group could save big! Requests for contract changes must be received by BSC 30 days prior to the requested effective date.
    • Updated Forms:  Master Group Application (MGA), effective 4/1/16  &  Request for Contract Change (RCC), effective 4/1/16
    • Q3 Broker Bonus Program: Groups 1-100 Eligible Employees: Groups sold with effective dates from July 1, 2016 - September 30, 2016 are eligible. Read about the two criteria you have to meet to qualify.

    View Document
    Carrier & HIPAA Updates 4.25.16
    by Rosa Tessandori » Tuesday, April 26, 2016 11:21 AM


    2016 1-100 Portfolio Benefit Grid - It has been approved! Attached is the updated benefit grid toolkit.


    Producer Online News
    • Small Group 2016 Q3 Rates 1-100 Released
    • 2016 Q3 Mid-Year Portfolio Enhancements.
    • 2016 Select Drug List
    • Disability Coverage for small groups (10-50) 
    • Small Group ACE Broker Program
    • Small Group Quoting Tool Enhancements for Dental.
    • Pharmacy Home Program.

    • Dental - Enhanced Triple Choice Options (reminder)


    Broker Connection:
    • View the latest prescription drug list updates. PDL Tracker
    • Learn about the RX Mail Service changes that take effective 7/1/2016 

    If your group uses CONEXIS as their TPA, they may have received a compliance notice that indicates that U.S. Department of Health & Human Services (HHS) will begin Phase 2 of HIPAA audits later this year. Only "covered entities" and "business associates" are potentially subject to the audit. View the CONEXIS compliance Update.

    Logically, the next logical question is " Who/What is a covered entity?" View the RBG Tip Sheet for a quick review.

    View Document