NEWSROOM

1/1/2021 Effective Date - California Special Open Enrollment Window

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Aetna

Guideline:

Must be the sole carrier confirmed by an attestation form

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


Anthem Blue Cross

Guideline:

Must be the sole carrier

Must be complete at submission with all requirements in by 12/15 by 12 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 12/15 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 12/15 by 11:59 PM and approved by end of business day on 12/31

Recertification at renewal: Yes, to ensure group meets the definition of a small employer

Ancillary coverage will follow normal guidelines for participation and contributionAncillary 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 12/15 by 5 PM and must be approved by 5 PM on 1/21/2021

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

Must be submitted to Kaiser on 12/15 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
 

Special Open Enrollment Window

This guide has been created as a quick reference and does not replace the full underwriting guidelines published by each carrier
Please refer to the carrier guidelines for additional information

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