NEWSROOM

Aetna

Guideline:

DE9C/Quarterly Wage Report not required for groups of 6 + enrolled with prior coverage

Prior Carrier Bill is not required

DE9C/Quarterly Wage Report and/or Payroll may be requested at the carrier’s discretion at any time

Anthem Blue Cross

Promotion:
DE9C/Quarterly Wage Report not required for groups of 3+ enrolled through Quarter 3 2021 effective dates

Copy of last month’s Prior Carrier Bill is required for all products selected

Payroll records are required for employees not listed on the Prior Carrier Bill

Excludes Virgin Groups

New groups without prior coverage will need to submit DE9C/Quarterly Wage Report and/or Payroll

Blue Shield of California

Guideline:

DE9C/Quarterly Wage Report not required for groups of 3-95 FT/FTE that have 3-95 eligible employees

Owners do not qualify towards the eligible FT/FTE employee count

No DE9C/Quarterly Wage report guideline does not apply to PEO, Union/Non Union, Start-Up, Spin Off and

Multiple Employer groups

DE9C/Quarterly Wage Report will be required regardless of group size for the following:

• Groups with eligible employees who are 65+ years old
• Groups with 2+ enrolling employees residing at the same address
• Groups with “Other” as their Legal Entity Type
• Groups of 1 enrolling

Underwriting reserves the right to request DE9C/Quarterly Wage Report and/or Payroll whenever necessary to
determine eligibility

Blue Shield may require the most recent Companywide Payroll Journal Report for groups with eligible Out of State employees to confirm 51% of all eligible employees reside in California

CaliforniaChoice

Promotion:

DE9C/Quarterly Wage Report not required for groups of 6+ medically enrolling employees

The most recent Prior Carrier Bill is required

Enrolling employees that are not listed on the Prior Carrier Bill will require one full run of payroll showing eligible hours and wages

Groups with a lapse of coverage of more than 3 months are not eligible

Health Net

Enhanced Choice A and Enhanced Choice B Package through September 30, 2021

DE9C/Quarterly Wage Report not required for groups of 5+ enrolling

Waivers are required to determine participation

Virgin Groups are eligible

HMO with 6 Package through September 30, 2021
DE9C/Quarterly Wage Report not required for groups of 6+ enrolled

Waivers are not required

Virgin Groups are eligible

The HMO with 6 package is separate from the Enhanced Choice A and B packages

Group may only Mix and Match any plans from the HMO networks

Kaiser Permanente

Promotion:

DE9C/Quarterly Wage Report not required for 6 or more eligible with no end date

Business Documentation is still required (Example: Business License/SOI)

Start-Up groups and groups leaving a PEO do not qualify for this promotion

UnitedHealthcare

Guideline:

DE9C/Quarterly Wage Report not required for groups of 10+ eligible employees

Completed and Signed Participation Certification Form is required

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