Medical Plans

Employer Eligibility

CalCPA Health is available to accounting and financial services firms. To be eligible and retain such eligibility, more than 50% of all the Employer’s owners (i.e., principals, proprietors, partners, shareholders or other owners) must be members of CalCPA in good standing. If you are a CPA, financial services professional or firm administrator and not a member of CalCPA, click here to see how you can join. All employers deemed to be part of an affiliated group under Internal Revenue Code Sections 414 (b), (c), or (m) are considered to be a single employer. Solo practitioners (a CPA practicing on his/her own with no other employees) are eligible to apply.

Employee Eligibility

Active, regular full-time employees working at least 20 hours per week are eligible for coverage. If a husband and wife are employed by the same employer, they may both be covered as Employees.

Dependent Eligibility

Eligible dependents include a lawful spouse, Registered Domestic Partner, and dependent children of eligible employees through age 26. Disabled children of eligible employees who, with appropriate medical certification, are eligible for coverage at any age.

Participation Requirements

If the employer pays 100% of the premiums, or if the plan covers three or fewer employees, then 100% of eligible employees must be covered. Otherwise, at least 75% of the individuals eligible for coverage in each firm must apply for that firm’s coverage.

If the employer is paying 100% of the employee premium, then all eligible employees must enroll. If the employee pays part of the premium, a minimum of 75% of the eligible employees must enroll. Employees who waive coverage on the grounds that they have other group coverage are not counted as eligible employees. 1099 employees are not eligible.

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, hospitals and administrators to provide you with valuable benefits. 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 narrow 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.

The Trust is also offering a “Select” Anthem network for firms who seek a discount in return for a smaller network.

Plan Brochure (PDF)

Group Medical: Co-Pay Plans

CalCPA Health offers 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 877-480-7923 or click here to email Banyan Administrators.

Group Medical: Anthem Blue Cross HMO

Because our members value choice, we have partnered with Anthem Blue Cross of California to offer HMO plans. Anthem differs from CalCPA 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. 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 dedicated to CalCPA Health Anthem Blue Cross members

Group Medical: 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.

Group Medical: 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 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.

HSA Guidebook
Contributions to the HSA by employees or employers are tax deductible
Unused contributions roll-over and accumulate
Invested funds grow tax free
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

For details call Banyan Administrators directly at 877.480.7923, CalCPAHealth@CalCPAHealth.com or have your broker contact CalCPA Health at 650.522.3251.

* Dependent on the exact structure of the plan and contribution balance.

Solo: Medical Plans

Enrollment

If you would like an online quote, you may do so by clicking here (please note, you will be leaving the CalCPAHealth.com site).

For other questions, you may contact Banyan Administrators, Managers for the CalCPA Health Programs, at 877.480.7923 or email CalCPAHealth@CalCPAHealth.com.