No DE 9C Promotion Promotions/Guidelines
Aetna
Guideline:
Groups of 6+ enrolled with prior coverage
The most recent prior carrier bill is required
Any employees not on the bill must have their full names written in with the reason they do not appear on the bill
Anthem Blue Cross
Promotion:
Groups of 3+ enrolled through Quarter 2 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 or payroll records
Blue Shield of California
Guideline:
Groups of 3-95 FT/FTE that have 3-95 eligible employees do not require a DE9C. Owners do not qualify towards the eligible FT/FTE employee count
DE9C will be required for groups with employees 65+ years old enrolling regardless of group size
DE9C will be required for groups with 2+ enrolling employees residing at the same address regardless of group size
Underwriting reserves the right to request the wage and tax information (DE9C, payroll) whenever necessary to determine eligibility
If a group is enrolling with Out Of State employees, companywide payroll may be requested to confirm 51%
eligible are in California
No DE9C guideline does not apply to groups with eligible employees who are 65+ years old, PEO, Union/Non Union, Start-Up, Spin Off and Multiple Employer groups
CaliforniaChoice
Guideline:
Groups of 6+ medically enrolling employees
The most recent prior carrier bill is required
Employees that are enrolling and 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 6/15/2021 effective dates
Quarterly Wage Report/DE9C not required for groups with 5+ enrolling
Waivers are required to determine participation
Virgin Groups are eligible
HMO Package through 6/15/2021 effective dates
Quarterly Wage Report/DE9C not required for groups of 6+ enrolled
Participation Attestation Form, Prior Carrier Bill and Waivers are not required
Virgin Groups are eligible
The HMO package is separate from the Enhanced Choice A and B packages
Mix and Match any plans from the HMO networks
HSP, EnhancedCare PPO, and Full Network PPO plans do not qualify for this promotion
Kaiser Permanente
Promotion:
Quarterly Wage Report/DE9C not required for 6 or more eligible with no end date
Business Documentation required (example: business license/SOI)
Start Up groups and groups leaving a PEO do not qualify for this promotion
UnitedHealthcare
Guideline:
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