Firms With 2 or More: Medical Plans
Why Choose CalCPA Health
CalCPA Health is a self-funded medical plan offered through the Group Insurance Trust of the California Society of CPAs. Because we operate our own plans, we design the benefits, rates and options. To provide outstanding service and value to our members, we have contracted with Anthem Blue Cross use its comprehensive provider network and to process our claims. In effect, we’ve chosen what we believe are the best doctors and hospitals and the best administrators to provide the best benefits for you. You and your employees will have the freedom to choose virtually any health care provider and no physician referral is required. It’s up to you whether you go in-network and receive a higher benefit or go out-of-network and pay more. However, when you choose participating network providers, you will take advantage of negotiated rates, which lowers out-of-pocket expenses.
When evaluating your plan choices please note that many insurance plans have begun to utilize narrower provider networks sometimes referred to as “skinny” networks. If you see a plan from another carrier that seems to have a lower than expected premium, as a first step you should evaluate or verify the doctors and hospitals included in the provider network for your individual or firm’s needs.
CalCPA Health continues to offer the full Anthem Blue Cross doctor and hospital network, the largest provider network in California. With all the changes brought about by the Affordable Care Act, the full Anthem network can minimize the disruption. The Trust is also offering a “Select” Anthem network for firms who seek a discount in return for a smaller network.
Group Medical Plans: Co-Pay Plans
CalCPA Health offers seven PPO/Copay plan options. PPO plans allow you to see any physician or other eligible provider without a referral. However, if you use out-of-network providers you should expect to pay a significantly greater portion of the eligible charges. For questions call Banyan Administrators at 1-877-480-7923 or click here to email Banyan Administrators.
Group Medical Plans: HSA Eligible Plans
Why Choose a Health Savings Account (HSA)
CalCPA Health’s HSA plans are self-funded High Deductible Healthcare Policies (HDHPs) offered through the Group Insurance Trust of the California Society of CPAs. Our HSA plans, when paired with a Health Savings Account offered through a bank, brokerage or other financial institution, provides security against catastrophic medical expenses, while allowing you to set aside pre-tax dollars to pay for qualified medical expenses.
Fully integrated HSA plan
If your firm currently has employees enrolled in the CalCPA Health HSA plan, CalCPA Health now offers these members a unique – fully integrated HSA that offers low High Deductible Health Plan (HDHP) premiums, combined with integrated banking and health claims administration.
CPA Firms use HSA plans at 10x’s the rate of the commercial market.* An HSA is a tax advantaged savings account combined with a HDHP. The HSA funds can be used for health expenses under the HDHP deducible or for other health care expenses allowed under IRS Code.
- HSA Guidebook
- Contributions to the HSA by employees or employers are tax deductible
- Unused contributions roll-over and accumulate
- Invested funds grow tax free
- All health care premiums and out-of-pocket costs can be tax deductible**
- Key advantages – lower cost premiums now and in retirement years – paying Medicare premiums and deductibles with funds that were never taxed
- No risk of losing money – post age 65 non-health related withdrawals similar to an IRA or 401k.
For details call Banyan Administrators directly at 877.480.7923, CalCPAHealth@key.insurance or have your broker contact CalCPA Health at 650.522.3251.
* Based on data from CalCPA Health and AHIP Center for Policy and Research.
** Dependent on the exact structure of the plan and contribution balance.
Fully Integrated HRA Plan
CalCPA Health offers firms a unique fully integrated Health Reimbursement Arrangement program (HRA) which allows firms of any size, except for solo practitioners, to seamlessly self-fund a portion of the employee’s deductible.
CalCPA Health’s HRA program is designed to offer cost savings for employers, with increased sharing responsibility for medical expenses between employers and employees. The HRA plan combined with integrated HRA administration services allows firms to self-fund a portion of their employee’s deductible under a high deductible fully-insured plan. In simplest terms, the high deductible HRA lowers overall premiums by allowing the employer to assume a portion of the risk and self-fund the lower end of the deductible.
- Contributions to the HRA are tax deductible
- The employer is totally in control of their funds unlike HRA contributions which the employee controls once made
- Unlike HSAs, unused HRA funds belong to the employer at the end of the year
- The fully integrated model provides a user friendly platform that offers cost savings for employers
- Key advantages
- Self-funding without the administrative burden and undue risk
For details call Banyan Administrators directly at 877.480.7923, email or have your broker contact CalCPA Health at 650.522.3251.
Anthem Blue Cross HMO
Because our members value choice, we have partnered with Anthem Blue Cross of California to offer two of its Anthem Blue Cross HMO plans. Anthem Blue Cross differs from Health in that it is a fully-insured plan through Anthem Blue Cross of California. Anthem Blue Cross determines the rates and benefits and sets underwriting and administration policy. Some plan features offered by the CalCPA Health plans are not available to participants in the Anthem Blue Cross HMO plans, including rights of survivorship, availability to Solo Practitioners, and multiple plan selection. Your firm may offer only one of the HMO plans; however, you can pair a Anthem Blue Cross HMO plan with any, or all, of the CalCPA Health copay and HSA plans.
All Anthem Blue Cross HMO Plans Provide:
- Access to quality healthcare through the Anthem Blue Cross network of Anthem Blue Cross HMO healthcare providers
- Coverage for mental health and substance abuse services
- Comprehensive coverage for a wide range of healthcare services
- Emergency care coverage worldwide, 24 hours a day
- Simplified procedures – no claim forms to fill out
- Customer services exclusively dedicate to CalCPA Anthem Blue Cross members
Choose Multiple Plans
You May Mix and Match Your Health Plans
Although most employers will elect to offer a single plan, your firm may elect to enroll in and offer any combination of CalCPA Health’s copay, HSA and Anthem Blue Cross HMO plans. However, if the firm wishes to include an HMO option, only one of the Anthem Blue Cross HMO plans may be offered.
CalCPA Health utilizes the Anthem Blue Cross provider (standard Prudent Buyer) network with more than 60,000 doctors and more than 400 hospitals throughout California. CalCPA Health also offers Anthem’s Select network (both for PPO and HMO plans) which provides premium savings to members.
Choosing an Anthem network provider lowers your out-of-pocket medical costs. You may choose any provider but benefits levels are significantly lower when using a non-network provider and non-network providers may seek additional payments directly from you for amounts not covered by your health plan.
Please note: When you click to search for Anthem Blue Cross providers, you will be taken to a Anthem Blue Cross of California web site. Once you are on the Anthem Blue Cross page, please select “Anthem Blue Cross PPO-Prudent Buyer Plan” from the drop down menu to access the appropriate provider listings. HMO participants please select Blue Cross HMO (CaliforniaCare)