California Carrier Partner Updates
Here is an overview of updates from our California carrier, health plan, and administrator partners. For details, click on the related link (if any).
Bonus Updates
- BEST Life
- Broker Bonus Program: Brokers can earn up to $500 with Fast Cash Bonus from BEST Life – plus an additional $100 bundling bonus new case submissions with a 12/01/2024-02/01/2025 effective date. Download the flyer for details.
- Health Net
- Small Group Broker Incentive: For sales with an effective date through January 2025, Health Net is offering a Peak Season Incentive. A special commission of 6% will apply for the life of each case with six or more enrolled subscribers. This offer does not apply to CaliforniaChoice business. Visit our Newsroom for more information.
- 2025 Large Group Incentive: Health Net brokers can receive 2% of paid premiums for 12 months for each new Large Group employer sold. Download the Health Net flyer for details by linking to our Newsroom post
- Kaiser Permanente
- Small Group Bonus: For new Kaiser Permanente groups with effective dates through January 2025, a Small Group bonus is available. Visit our Newsroom for details.
- UnitedHealthcare
- UHC Broker Trip Incentive: For all groups sold 12/1/2024 through 3/1/2025, UHC appointed brokers are eligible for one or more broker bonus. If you sell 25 or more lives (not subscribers) on a California-situs group, you will win a trip. Download the UHC flyer for details. Plus, if you sell a combined 100 or more specialty members, you can win extra flight vouchers. There’s no limit on these trips.
Medical Coverage
- Multiple Carrier and W&B Updates
- Q2 Quoting: We are now quoting 11 of our carrier partners for Q2 2025. Login and quote now – or contact us for quoting assistance. We’re here for you.
- Updated DE 9C Promotions and Pre-Sale FAQ: Underwriting has published updated No DE 9C Promotions/Guidelines and Carrier Pre-Sale FAQs. Download your copies today and discard any prior versions on your desktop or in your files.
- Medicare Part D Rx Coverage: Word & Brown has published new information concerning creditable vs. non-creditable Medicare Part D prescription drug coverage for California. Guidance is provided for multiple carriers. Download your Small Group or Large Group summary now.
- California Rx Tier Changes: Because of a change mandated by California legislation (AB 948), you can expect to see changes in some carriers’ Rx tiers and drug formularies. Some members may experience higher or lower copayments due to a drug’s tier change by their health plans.
- Aetna
- IPA Updates: Aetna has several new IPAs in Southern California: Alliance Health Systems (HMO, HMO Ded., and AVN); Blue Zones Marina, formerly Access Medical Alamitos, and Lakewood IPAs (HMO, HMO Ded, and AVN); and Blue Zones Health of CA (HMO, HMO Ded, and AVN).
- Anthem Blue Cross
- 2025 Plan Updates: Anthem has announced nearly a dozen plan discontinuations for 2025. Three PPO plans and eight HMO plans have been withdrawn; ask your W&B rep for details, or download the 2025 Anthem Medical Benefit Guide for Small Group ACA plans.
- Contract News: Anthem and Sutter Health have successfully negotiated a new contract. In addition, the previously announced termination of Sansum Clinic (effective 3/1/2025) has been withdrawn. Anthem has also reached an agreement to keep St. Joseph Health and its affiliates in network for 2025. Scripps Health and Anthem have failed to reach a new contract, and effective January 1, 2025, Scripps Health is out of network for Anthem members. Negotiations are ongoing.
- Blue Shield of California
- 2025 Large Group Plans: New Virtual Blue PPO savings portfolios are expanding in 2025 for Large Groups. Ask your W&B rep for details.
- 2025 Rx Updates: Starting this month, Blue Shield is adding Amazon Pharmacy to its member benefits, replacing CVS Caremark Mail Service Pharmacy, for Rx Home Delivery. Navitus is managing the BSC retail pharmacy benefit beginning in 2025; some independent pharmacies may no longer be available with the modified, more strict network pharmacy criteria under Navitus.
- CalCPA
- Quoting for 2025: CalCPA has added new plans for 2025, while discontinuing two PPO plans (Gold PPO 30/650 and Silver PPO 50/2500). Quoting is now available. Ask your W&B rep for details. Renewals are available in ShareFile.
- CaliforniaChoice
- Plan Updates for 2025: A few of CaliforniaChoice’s participating carriers are making changes this year. Health Net’s Salud HMO y Mas Network is adding 20 ZIP Codes. Kaiser Permanente’s Full Network is adding 14 ZIP Codes. UnitedHealthcare is making additions to its Alliance Network – with one ZIP Code added. Harmony Network added one ZIP and removed 437 ZIP Codes in Areas 2, 4, 5, 6, 7, 8, and 9. SignatureValue Network added one ZIP Code.
- Centivo
- Level Funding: Take advantage of Word & Brown’s exclusive GA agreement with Centivo. Offer your California groups a fully integrated, national health plan solution with Level Funded options, Rx rebates, PBM carve out, 100% surplus return, and more. Ask your W&B rep for details.
- Health Net
- Small Business Group 2025 Underwriting: Health Net has new underwriting guidelines for Medical and other products in 2025. Download the Enhanced Choice Guidelines.
- New Options in 2025: All Health Net plans this year will have a Chiro Rider option. The cost will be an additional $3.00 PMPM for both HMO and PPO plans. A new Doula Program is also now available. Download the English version or Spanish version of the consumer flyers to promote this Doula program to your clients.
- Optum Partnership: Health Net has announced its continuing partnership with Optum, ensuring all Health Net participating current products will remain in-network through December 31, 2026.
- Kaiser Permanente
- Updated Employer App: Kaiser Permanente has a new California Small Group application for 2025 Download your copy today.
- SIMNSA
- 2025 Coverage: SIMNSA Medical is on for 2025 quoting. Contact your W&B rep or log in now to start your quote request.
- UnitedHealthcare
- PPO Network Comparisons: UnitedHealthcare has released Q1 2025 PPO network comparisons for Northern, Central, and Southern California. Download copies from the Insurance Forms Library for the areas where you do business. A SoCal HMO comparison is also available.
- Choice Simplified/Relaxed Participation: Ask about UnitedHealthcare’s Choice Simplified Package and a staff model carrier relaxed participation promo available through 07/01/2025. There’s a minimum of 25% participation between carriers and five employees enrolling with UHC required. That excludes COBRA participants. Download the Choice Simplified flyer for network and plan details.
- HR Resources: UHC groups with level-funded plans can access MineralTM HR resources; ask us for details.
- Employer Application Update: UHC has modified its California Small Business Employer Application. The prior edition will only be accepted through 2/1/2025. Download the updated form now from the W&B Insurance Forms Library.
- Western Health Advantage
- Provider Network Update: Effective January 1, 2025, MarinHealth Medical Center is no longer a hospital partner to Meritage Medical Network, which is part of Western Health Advantage.
Ancillary & Other Coverage
- Ameritas
- Forms Update:
- The Ameritas microsite for Word & Brown brokers offers the most up-to-date Ameritas forms for California Small Group (2-100). Ameritas forms are no longer part of the Word & Brown Insurance Forms Library.
- Anthem Blue Cross
- Dental Rates and SIC Codes: Please keep in mind that Standard Industry Classification (SIC) codes impact rates. It’s important you list the appropriate SIC Code on the application to ensure quoted Dental rates are correct.
- Blue Shield of California
- Dental Plan Withdrawal: Effective January 1, 2025, Blue Shield has withdrawn the SmileSM Deluxe 50/1500/Ortho/MAC, Smile Deluxe Gold 50/1500/Ortho/U85/NR, and Ultimate Dental Plus PPO for Small Business 50/2000/Ortho/MAC/NR plans.
- ChoiceBuilder
- Ancillary for Up to 500 Employees: If your clients are looking for Dental, Vision, Chiro & Acupuncture, and Life, look no further than CHOICE Administrators. ChoiceBuilder offers both voluntary and employer-sponsored coverage. Ask us for details.
- Lincoln Financial Group
- Reduced Group Size: Lincoln Financial now write down to 50+ eligible lives for Accident, Critical Illness, and Hospital Indemnity. Coverage must be paired with two core lines of coverage (Life, Disability, Dental). Minimum 5+ lives participation. Ask us for details.
- MediExcel Health Plan
- Dental Plan Updates: MediExcel Dental Plan D100 has been discontinued for new business, but It remains available for renewals
- UnitedHealthcare
- Dental and Vision Rate Cards: UnitedHealthcare has published five new Dental Rate Cards and a Vision Rates Card for 2025; click below to download your regional edition(s).
- Activate the Savings Promo: Through 03/01/2025, UnitedHealthcare is offering a promo if you add Dental and an additional specialty plan to your group’s Medical offering. Download the “Save a bundle” flyer for details.
- United Concordia Dental
- EPO Update: United Concordia Dental’s new EPO product is now available for fully insured groups of 10+ employees. EPO members have the upfront cost of a copayment instead of coinsurance. No primary care dentist is required. Available in most states. EPO/PPO dual option (with minimum of 10+ employees enrolled). Pricing is slightly higher than a DHMO. A $50 deductible and $1,500 maximum apply to control costs.
- 2025 Reminders: Don’t overlook the advantages offered by UCD for 2025 coverage: a) book rates for Southern California groups of 2-50 enrolled employees (also available for 50+); b) one-page application and enrollment form for new groups; and c) choice of annual maximums, coinsurance, and affordable price points. Ask your W&B rep for details.
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