California Special Open Enrollment Window
Aetna
Guideline:
Must be the sole carrier confirmed by an attestation form
Must be complete at submission with all requirements in by 12/15 midnight – no exceptions
Recertification at renewal: Yes, to ensure group meets the definition of a small employer
Ancillary coverage will follow normal guidelines for participation and contribution
Anthem Blue Cross
Guideline:
Must be the sole carrier
Must be complete at submission with all requirements in by 12/16 by 5 PM
Dental/Vision will participate in Special Open Enrollment. Specialty lines must have a minimum of 2 employees enrolled on each specialty line selected
Recertification at renewal: No
Blue Shield of California
Guideline:
Can be written alongside another carrier’s HMO only, another carrier’s HMO and MediExcel only, or another carrier’s HMO and SIMNSA only
Regular underwriting guidelines apply
Must be submitted to Blue Shield by 5 PM on 12/31 and approved within 30 days of submission Dental/Vision follow medical. Life does not follow medical
Recertification at renewal: At the carrier’s discretion
CaliforniaChoice
Guideline:
Must be the sole carrier
Cases must be submitted to CaliforniaChoice on 12/16 by midnight and approved by end of business day on 12/31
Contingent approvals will be allowed
Recertification at renewal: At the carrier’s discretion
Ancillary coverage will follow normal guidelines for participation and contribution
Health Net
Guideline:
Does not require to be the sole carrier
Cases must be submitted to Health Net on 12/16 by 5 PM and must be approved by 5 PM on 1/21/20
Recertification at renewal: At the carrier’s discretion
Ancillary coverage will follow normal guidelines for participation and contribution
Kaiser Permanente
Guideline:
Does not require to be the sole carrier
Cases must be submitted to Kaiser on 12/16 by 5PM
Recertification at renewal: Yes, to ensure group meets the definition of a small employer
Ancillary coverage will follow normal guidelines for participation and contribution
UnitedHealthcare
Guideline:
Does not require to be the sole carrier with staff model carrier (can write alongside two staff model carriers)
Requires at least 5 CA employees to enroll with UnitedHealthcare if writing alongside another carrier
Must be complete at submission with all requirements in by 12/15 at 11:59 PM – no exceptions Recertification at renewal: Yes, to ensure group meets the definition of a small employer
Ancillary coverage will follow normal guidelines for participation and contribution
Western Health Advantage
Guideline:
Does not require to be the sole carrier
Case must be submitted to Western Health Advantage on 12/15 by midnight – no exceptions
Recertification at renewal: Yes, to ensure group meets the definition of a small employer