New California Law SB 1375 – Affects Many Small Firm’s Group Health Insurance

The new California Law, SB 1375, was signed by Governor Brown on September 22, 2018 and will affect many small firm’s group health insurance. SB 1375 changes the Health Insurance Code to reclassify certain small employer groups as individuals. The affected firms will have to obtain individual health insurance in 2019, rather than the small employer group plans they currently have. Individual health insurance is typically more expensive with less provider network and benefit plan choices than small group plan offerings.

Fortunately, for CalCPA members and their firms, CalCPA Health received certain exemptions from SB 1375, which generally allows us to treat the affected firms as groups, and not as individuals. Commercial carriers (Blue Shield, UnitedHealthcare, Anthem, etc.,) must comply with the new regulations and reclassify these groups as individuals.

SB 1375 defines groups that consist entirely of owners/partners, and/or W-2 employees that are spouses of owner/partners, as not eligible for group health coverage. Even though these entities may be classified as employer/employees by other regulations, (e.g. Workers’ Comp, payroll tax, etc.,) SB 1375 specifically states they do not qualify for group health coverage and may only purchase individual plans.

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Anthem Blue Cross Supporting People Affected by California Wildfires

Anthem is taking action to help people affected by the wildfires in Lake, Mariposa, Mendocino, Napa, Riverside and Shasta counties by revising medical and pharmacy guidelines that will help ensure members can continue care and access needed prescription medications. The items pertaining to pharmacy apply to Anthem’s relationship with Express Scripts. It’s important that our members know what Anthem is doing for our members in the above mentioned areas during this critical time.

For impacted members, Anthem is:

  • Relaxing time limits for prior authorization, pre-certification and referral requirements – there will be no late penalties.
  • Suspending early refill limits for prescriptions.
  •  Allowing replacement of medical equipment or supplies.
  • Extending filing deadlines for claims.

These medical and pharmacy guidelines are effective from July 26, 2018 until August 25, 2018, unless further extended.

For additional questions, members should call the phone number on the back of their membership card as associates are standing by to help.

Complimentary ID Protection for CalCPA Health Members

All CalCPA Health members have access to identity protection services at no additional cost.

Here at CalCPA Health, we know that your personal information should stay that way – personal. That is why we have taken steps to help keep your information safe.

CalCPA Health, through its partnership with Anthem, is able to provide AllClear ID to all CalCPA Health members at no additional cost. Through this partnership with Anthem and AllClear ID, all CalCPA Health members have access the following services:

  • AllClear Identity Repair– is automatically available to our eligible health plan members with no enrollment required. If you become a victim of identity theft, an AllClear investigator will act as your guide and advocate from start-to-finish until the issue is resolved.
  • AllClear Credit and Identity Theft Monitoring – is an extra layer of protection that helps you stay informed of your credit activity. They’ll send alerts when banks and creditors open new accounts in your name. If something doesn’t sound right, you’ll be able to contact them right away.   

AllClear Identity Repair is currently in place and should members become a victim of identity theft, members need to notify AllClear and if needed, an AllClear investigator will assist to resolve the issue.

CalCPA Health members who would like to enroll in the monitoring service may request a redemption code by entering their information at anthemcares.allclearid.com and a redemption code will be emailed to them once they have been confirmed as a CalCPA Health member. With the redemption code, members would create an account with AllClear at no cost to them.