CA Small Group Carrier Participation & Specials

 

Carrier Participation (Sole carrier)
United Healthcare 1-100 Eligible: 60% participation
Oscar Health Plans 1-100 Eligible: 70% of eligible W-2 employees are covered by a group health plan. Owners/officers are only counted towards participation if they are enrolling.
Health Net 1-5 Eligible: 66% participation

6+ Eligible: 50% participation

 

EnahancedCare PPO Choice Package (available through 12/15/2018):

1-5 Eligible: 66% participation

6+ Eligible: 35% participation

Salud y Mas (available 07/01/2018 through 12/31/2018):

1-100 eligible: Minimum 2 enrolled, no participation requirements

  • A DE9C is required reconciling only those enrolling
  • Waivers are not required
  • Groups with 100+ employees listed on the DE9C will be required to complete a Group Size Attestation form
Covered CA for Small Business 1-3 Eligible: 100% participation

4+ eligible: 70% participation

Blue Shield of California Relaxed Participation (available through 09/30/2018 for Off Exchange Package)

5+ Enrolled: 25% participation

 

Standard Participation 1-100 Eligible:

Off Exchange Package: 65% Participation

Mirror Package: 70% Participation

 

Trio Participation (Off Exchange Package)

There are no participation requirements for groups with Trio-only membership. One other carrier can be written alongside a Blue Shield of CA plan, no Exchanges.

Anthem Relaxed Participation:

1-4 enrolled: 65% participation (effective 7/1/18 – 12/15/18)

5+ enrolled: 25% participation (effective 7/1/18 – 12/15/18)

 

Standard Participation:

1-14 eligible: 70% participation

15+ eligible: 50% participation

Aetna 1-100 eligible: 60% of eligible employees
California Choice 1-2 eligible: 100% participation; must include at least one W2 employee who is not a business owner/officer or spouse/domestic partner of business owner/officer

3+ eligible: 70% participation