California Carrier Partner Updates
Here is an overview of updates and news you can use from our California carrier, health plan, and administrator partners. For details, click on the related link (if any), or contact your Word & Brown representative.
Bonus Updates
- Delta Dental
- 2025 Rewards: Delta Dental’s Small Business Broker Rewards Program offers a sales bonus and a retention bonus when you sell eligible groups of 2-99 lives. Earn a sales bonus of up to 5% plus a retention bonus of up to 3%. Ask your W&B rep or download the Delta Dental flyer for details.
- Health Net
- Large Group Incentive: For effective dates through 12/1/2025, Health Net is offering an incentive of 2% of paid premiums for 12 months for new, sold Health Net Large Group cases. Read our Newsroom post and download the Health Net flyer for details.
Medical Coverage
- Multiple Carrier and W&B Updates
- Q4 Quoting: Six of our California carrier and administrator partners are now quoting for the fourth quarter. Get a jump on peak season business; contact your W&B rep or login and start quoting today.
- Large Group Updates: Word & Brown has updated its Large Group Participation Guidelines and Large Group Plan Offerings.
- IVF Coverage Implementation Delayed: California's In Vitro Fertilization (IVF) coverage mandate that was scheduled to take effect July 1, 2025, has been postponed. It will now take impact plans issued, amended, or renewed on or after January 1, 2026. Once fully implemented, California SB 729 (as amended by budget trailer bill SB 116), Large Group health plans must include IVF. Small Group plans must include an IVF option. For more information, refer to the recently updated Compliance column by Paul Roberts in the Word & Brown Newsroom
- Aetna
- Sutter Health Agreement: Aetna and Sutter Health have finalized a new multi-year agreement for Aetna members enrolled in commercial HMO, EPO, and PPO health plans. Previously, Aetna HMO members in Northern California were advised of a new doctor assignment effective July 1, 2025; however, with this new agreement, members can keep their Sutter health physicians.
- Anthem Blue Cross
- Out-of-State Percentage Update: Anthem has reset the rule to allow a 49% maximum for out-of-state employees. Web quote users must verify whether a group meets other rules and criteria and use “By-Pass” when quoting. If you need assistance, we are happy to help – just ask.
- Select HMO Network Update: Providence Health (Orange County) is joining the Anthem Select HMO network in July. Added medical groups as part of this expansion include Providence Affiliated Physicians Mission; Mission Heritage Medical Group; Providence Affiliated Physicians St. Joseph; St. Joseph Heritage Medical Group; Providence Affiliated Physicians St. Jude; St. Jude Heritage Medical Group; and St. Mary High Desert Medical Group.
- Blue Shield of California
- Contract Negotiations: Blue Shield of California (BSC) and University of California Health (UC Health) reached a new contract agreement this month for Small Group and Large Group commercial PPO and HMO members as well as Individual & Family Plan members. Hoag Clinic has also reached a new agreement with BSC, so commercial HMO, PPO, and Medicare Advantage members can continue to use Hoag facilities.
- Member Health Assessments: Blue Shield has started an outreach campaign to promote preventive care and encourage members to utilize their annual health assessments. Some BSC members will receive calls, emails, letters, and text messages as part of the outreach. You may wish to make your groups aware of this potential planned outreach to members. Gift card incentives are a component of the outreach campaign.
- CalCPA
- Health Rate Change: New rates for CalCPA have been entered into W&B’s quoting system and are available for groups effective 9/1/2025 through 12/31/2025.
- Health Net
- Rx Benefits: Health Net offers members two ways to save on prescription drugs: the Maintenance Choice Program at CVS Pharmacy and the Mail Service Program through CVS Caremark. Download the flyer today.
- Underwriting Promo: Health Net’s Underwriting promotion has been extended into Q4 for groups with 10 enrolling subscribers. No DE 9C, no payroll, and no ownership docs are required. No waivers. No participation percentage required. Contact your rep for details.
- Sharp Health Plan
- Updated Employer App: Visit our online Insurance Forms Library to download the latest Sharp Health Plan Small Group employer app. The new form must be used for cases effective 7/1/2025, or later.
- UnitedHealthcare
- Choice Simplified/Relaxed Participation: Ask us about the UnitedHealthcare (UHC) Choice Simplified Package and a staff model carrier relaxed participation promo available through 7/31/2025. There is a minimum of 25% participation between carriers and five employees enrolling with UHC required, excluding COBRA participants. However, there is no minimum CA employee enrollment required. Download the Choice Simplified flyer for details.
- New Level-Funded Plan: The UnitedHealthcare Surest® Level-Funded Plan is now available for California groups of 5+ employees. Reach out to your W&B rep for info on this dynamic copay plan combining transparency, flexibility, and predictability.
- Q3 Heat Maps: Heat maps for Q3 are now available for UHC PPO and HMO products; download your choice of four PDFs: PPO Northern California; PPO Southern California; PPO Monterey, Santa Cruz, and Fresno; or HMO Southern California.
- Alliance Reminder: UHC reminds brokers that the Alliance HMO is only available to employers with 1-100 employees in Fresno, Kern, Kings, Los Angeles, Madera, Orange, Riverside, San Diego, San Luis Obispo, and Ventura counties. The brochure shows both Large Group (101+) and Small Group (1-100).
- Employer App: A new Employer Application for Small Business is available. “Old” forms will be accepted through August; however, UHC will only accept the new form with an effective date after 09/17/2025. Download your copy today and be sure to throw away copies of any prior editions.
Ancillary & Other Coverage
- CaliforniaChoice
- Pet Insurance: CaliforniaChoice members now have access to premier pet insurance at discounted rates. Multiple options are available from Spot Pet Insurance and MetLife. Encourage your groups’ members to log into the Member Value Suite at CalChoice.com for information.
- Humana
- Vision Reminders: Humana’s Vision Plus plan offers a $0 eye exam, extra $50 frame allowance, nationwide provider network, (including independent, retail, and online options), fixed prices on lens options, plus polycarbonate for children under age 19 at $0 copay. Ask us for details
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