Broker Resources - CA | Amwins Connect

Most commonly asked questions:

Are Extended Grace Period Options Available?

Insurance Commissioner Ricardo Lara issued a Notice requesting that all insurance companies provide their policyholders with at least a 60-day grace period to pay insurance premiums. An additional Notice was issued May 15th to extend the 60-day grace period through July 14, 2020. The Commissioner's request was to ensure policies are not cancelled for nonpayment of premium due to the Coronavirus (COVID-19) public health emergency. It was recommended carriers comply but it was not a requirement. The chart below shows the current standard grace periods as well as any options the carriers have made available.

Group are required to submit payment by the due date shown on their bill. If a group misses their due date, they have up until the standard grace period to make a payment before coverage is cancelled. The standard grace period begins the day after the missed due date. Carriers are reviewing their policies to determine if/how they can assist their employer groups with making payments during this difficult time.

CARRIER	STANDARD GRACE PERIOD	EXTENDED GRACE PERIOD OPTIONS
Aetna	31 days	Per the Insurance Commission notice, will support a 60-day grace period for small groups.
Anthem Blue Cross	31 days	Grace period extensions are not available. If a group is having trouble paying their bill have them contact the Enrollment & Billing team for assistance at (855) 854-1429.
Blue Shield of California	30 days	A general policy has not been put into place but requests will be reviewed on a case-by-case basis. If a group has determined they will not be able to pay on time they should contact the Billing Team (800-325-5166).
CaliforniaChoice	30 days	Requests will be reviewed on a case-by-case basis. Contact the group Account Manager or Customer Service for assistance.
Choice Builder	30 days	Requests will be reviewed on a case-by-case basis. Contact the group Account Manager or Customer Service for assistance
CoPower	30 days	Grace period extensions are not available.
CCSB	30 days	Grace period extensions are not available.
Cypress Ancillary Benefits	30 days	Supported a 60-day grace period through May 31, 2020. After this date grace period extensions are no longer available. FAQ
Guardian	30 days	Allowing a 60-day grace period.
Health Net	30 days	Grace period extensions are not available.
Humana	30 days	Grace period extensions are not available.
Kaiser Permanente^®	30 days	For large and small groups, Kaiser has extended their payment grace period and will not terminate group coverage for unpaid monthly membership premium dues through June 2020.Groups that have missed payments will start receiving delinquency and termination notices in mid-June and will be terminated by August 1, 2020.
MediExcel Health Plan	60 days	Grace period extensions are not available.
MetLife	30 days	MetLife is extending premium grace periods for Group Products to the lesser of 90 days from premium due date or July 31, 2020, for all premiums due March 1, 2020 and forward.
Oscar Health	30 days	Grace period extensions are not available.
Premier Access / Avesis	30 days	Supported a 60-day grace period through May 31, 2020. After this date grace period extensions are no longer available
Principal	30 days	Supported a 60-day grace period through July 2020 billing statements. In addition, the 60-day extension has now expired for policies whose contractual grace period ended in March. These policies will terminate if premiums due haven’t been paid (certain state exceptions apply).
Sharp Health Plan	30 days	Grace period extensions are not available.
Sutter Health Plus	30 days	Grace period extensions are not available.
UnitedHealthcare	30 days	Grace period extensions are not available.
Unum	30 days	If an employer anticipates having any issues with being able to remit premiums due to the circumstances surrounding COVID-19, please contact AskUnum at askunum@unum.com or connect with the groups Billing Coordinator.
Western Health Advantage	30 days	A general policy has not been put into place but requests will be reviewed on a case-by-case basis. If a group has determined they will not be able to pay on time they should contact the Premium Billing department.

Are Payment Deferrals or Refunds Available?

Some carriers are offering payment deferral programs to those in need, while others may be refunding a portion of premiums. For groups that receive a refund, broker compensation may be affected.

CARRIER	PAYMENT DEFERRAL	PREMIUM REFUNDS
Aetna	Not available.	Not available.
Anthem Blue Cross	Not available. If a group has trouble paying their bill have them contact the Enrollment & Billing team for assistance at (855) 854-1429.	Premium credits will be issued to fully-insured employer groups based on their April 2020 invoices. This is a one-time credit. The credit will appear on the employers August 2020 invoices (issued in July): 15% of the April premium for small group medical plans 50% of the April premium for dental plans Broker compensation will not be impacted.
Blue Shield of California	For April - July 2020 premium payment, Blue Shield offers a Premium Payment Plan Program. Available to those whose premium is delinquent, but current as of the prior month, and who are from the following segments: IFP on-exchange and off-exchange members Medicare Supplement members Small Group employers Read the FAQ for eligibility and requirements. Broker compensation will be paid based on the premium paid by the group.	Not available.
CaliforniaChoice	Deferral requests will be reviewed on a case-by-case basis. Broker compensation will be reduced by the deferred amount.	The following premium credits will be applied to August 2020 invoices: For members enrolled in UnitedHealthcare, a one-time 10% credit For members enrolled in MetLife, a one-time 50% credit Note for all: Does not apply to new business effective 8/1/20 and later. Broker compensation will be reduced by the credited amount.
Choice Builder	If an employer is having trouble making payments they should reach out to their account manager or customer service. Payment extension requests will be evaluated on a case-by-case basis.	Not available.
CoPower	Not available.	Not available.
CCSB	For April and May 2020 premium payment, CCSB offers a Premium Deferral Program. Employer pays a minimum 25% of the premium due for April and/or May. The deferred amounts will be spread across the remaining months of 2020.	Not available.
Cypress Ancillary Benefits	Not available.	Not available.
Guardian	Not available.	1-month premium credit will be applied for fully-insured dental and vision plans. Pandemic Support Program Flyer For existing groups: The premium credit will be applied to the 2nd bill after the group renewal, beginning with September 2020 renewals through August 2021. For new business: the premium credit will be applied to the 1st bill for dental and vision cases with July 2020 effective dates through March 2021. Employers may elect a rate guarantee instead of the premium credit. For existing groups: employer may choose a 2 year rate guarantee on both products. For new business: employer may choose a 2 year rate guarantee for dental and a 2 or 3 year rate guarantee for vision.
Health Net	Not available.	Not available.
Humana	Premium payment flexibility option may be available to employers facing financial hardship. Contact Humana at 1-800-592-3005.	Not available.
Kaiser Permanente^®	Not available.	Not available.
MediExcel Health Plan	Not available.	Not available.
MetLife	Not available.	Fully-insured Dental PPO customers will receive a 25% premium credit on a future bill for the months of April and May 2020. Flyer
Oscar Health	Not available.	Not available.
Premier Access / Avesis	Not available.	Not available.
Principal	Not available.	10% premium credit will be applied for May-September bills, these will show on the June-October invoices.
Sharp Health Plan	Not available.	Not available.
Sutter Health Plus	Not available.	Not available.
UnitedHealthcare	Premium extension options available on a case-by-case basis. Broker compensation will be paid based on the premium paid by the group.	UnitedHealthcare will give premium credits on medical coverage, estimated to range 5%-20% based on enrolled plans, to be applied to June billing statements. Applies to all California small and large employers. For all dental plans, UHC will give a one-time 50% premium credit in the month of July, which will be reflected on June invoices. Broker compensation will be reduced by the credited amount.
Unum	If an employer anticipates having any issues with being able to remit premiums due to the circumstances surrounding COVID-19, please contact AskUnum at askunum@unum.com or connect with the groups Billing Coordinator.	Not available.
Western Health Advantage	If a group has determined they will not be able to pay on time they should contact the Premium Billing department.	Not available.

Can Employers Cover Furloughed Employees or Those With Reduced Hours?

Carriers are easing guidelines so employers can keep their employees covered, even if the employees no longer meet eligibility due to reduced hours. For carriers who have made this option available, review the chart to find out how long these employees may be covered. Unless otherwise indicated, these rules apply to small and large group fully-insured plans.

Keep in mind that employees who are permanently terminated are no longer eligible and should be offered COBRA/Cal-COBRA as usual.

CARRIER	COVID-19 GUIDELINE	REFERENCE
Aetna	Members can remain on the plan, through June 30, 2021, as long as premiums are paid.	COVID-19 FAQ
Anthem Blue Cross	Members can remain on the plan, through June 30, 2021, as long as premiums are paid.	-
Blue Shield of California	Members can remain on the plan as long as premiums are paid.	Blue Shield Notification Article
CaliforniaChoice	Members can remain on the plan, at the employers discretion, as long as premiums are paid.	-
CCSB	Members can remain on the plan, at the employers discretion, as long as premiums are paid.	-
Cypress Ancillary Benefits	Members were allowed to remain on the plan, through April 30, 2020, as long as premiums were paid. There is no extension to this guideline.	FAQ
Delta Dental	Members can remain on the plan, at the employers discretion, as long as premiums are paid.	-
Guardian	Not available, ended June 2020.	-
Health Net	Not available, ended July 2020.	-
Humana	Members can remain on the plan, through March 31, 2021, as long as premiums are paid.	-
Kaiser Permanente^®	Members can remain on the plan as long as premiums are paid.	-
MediExcel Health Plan	Members can remain on the plan, at the employers discretion, as long as premiums are paid. Approved groups will be allowed to remain active for a 6 month period, even if their last member terminates, keep their contract honored. Groups renewing during this period will be required to accept their renewal with new rates.	Temporary Billing Options
MetLife	Group Life, Dental, AD&D, Vision, Accident & Health and Legal Will allow employees who are furloughed, temporarily laid-off or have reduced hours/salary to continue their coverage for 12 months from the date of the furlough, temporary lay-off or reduced hours/salary. Group Life Will allow employees who are furloughed, temporarily laid-off or have reduced hours/salary to continue their coverage for 12 months from the date of the furlough, temporary lay-off or reduced hours/salary. Coverage amounts will not be reduced as a result of temporary salary reductions and will remain in effect just as they were prior to the furlough, temporary lay-off or reduced hours/salary. Accordingly, premium needs to be remitted based on the volume for the regular (non-reduced) coverage amounts. Group Disability Will allow employees who experience a furlough, temporary lay-off or have reduced hours/salary between March 1, 2020 and May 31, 2020, to continue their coverage for 60 days from the date of the furlough, temporary lay-off, or reduced hours/salary. Coverage amounts will not be reduced as a result of temporary salary reductions and will remain in effect just as they were prior to the furlough, temporary lay-off or reduced hours/salary. Accordingly, premium needs to be remitted based on the volume for the regular (non-reduced) coverage amounts.	-
Premier Access / Avesis	Members can remain on the plan, through April 1, 2021, as long as premiums are paid.	COVID-19 FAQ - Brokers
Principal	Not available, ended June 2020.	Insurance Coverage and COVID-19
Oscar Health	Members can remain on the plan as long as premiums are paid.	-
Sharp Health Plan	Members can remain on the plan, through December 31, 2020, as long as premiums are paid.	-
Sutter Health Plus	pending	-
UnitedHealthcare	Members can remain on the plan as long as premiums are paid. Coverage will remain in force the later of the public health emergency, or no longer than 20 consecutive weeks after the public health emergency for non-medical leaves (i.e., temporarily laid off) or no longer than 26 consecutive weeks for a medical leave. Applies to medical, dental and vision.	COVID-19 FAQ
VSP	Members can remain on the plan as long as premiums are paid.	-
Western Health Advantage	Members can remain on the plan as long as premiums are paid. Employers also have the option of paying premium for terminated employees who elect to enroll in COBRA/Cal-COBRA; with this option employers can set a specific amount of time they are committing to pay the premium (e.g. 1, 2, or 3 months).	-

Can an Employer Self-Adjust their Bill and Pay Only True Premiums?

Employers may want to adjust their own billing statement to pay only for employees still covered, taking into account any recent terminations. This is referred to as paying true premium. Avoid cancellation by understanding each carriers position on true premium.

CARRIER	GUIDELINE
Aetna	Employers may pay true premium. Employers should indicate terminated employees on the billing statement and review the next months bill to ensure members are removed.
Anthem Blue Cross	Employers should pay billed premium to avoid cancellation.
Blue Shield of California	Employers may be able to pay true premium. Employers should contact the Billing Team (800-325-5166) to request support.
CaliforniaChoice	Employers should pay billed premium to avoid cancellation.
CCSB	Employers should pay billed premium to avoid cancellation.
Health Net	Employers may pay true premium. Employers must not terminate employees retroactively and must clearly identify on the remittance who will remain active on the plan.
Kaiser Permanente^®	Employers should pay billed premium to avoid cancellation.
MediExcel Health Plan	Employers may be able to pay true premium. Employers should contact their account manager first to discuss.
Oscar Health	Employers should pay billed premium to avoid cancellation. If given advance notification, Oscar can cancel members and regenerate the bill to reflect new employee counts.
Sharp Health Plan	Employers should pay billed premium to avoid cancellation.
Sutter Health Plus	Employers should pay billed premium to avoid cancellation.
UnitedHealthcare	Employers should pay billed premium to avoid cancellation.
Western Health Advantage	Employers should pay billed premium to avoid cancellation.

Do Carriers Have Special Rules for Renewals and Re-certifications?

Some carriers will not be re-certifying groups during this difficult time. Carrier systems may still auto generate letters to employer groups so it's important to know what you can expect.

CARRIER	GUIDELINE
Aetna	Will continue to re-certify 1 and 2 life groups at renewal.
Anthem Blue Cross	Groups will NOT be re-certified, they will auto renew. Groups that have temporarily shut down due to COVID-19, that are in the middle of or have an upcoming open enrollment period, will be allowed 60 days after the renewal date to make policy changes. For specialty lines, groups with July-December renewals will auto-renew with no rate action.
Blue Shield of California	Groups will NOT be re-certified, they will auto renew. If a group receives a decline notice, this should be disregarded.
CaliforniaChoice	Business as usual.
CCSB	Business as usual, groups are not re-certified under normal procedures.
Cypress Ancillary Benefits	All renewals for May through August will auto renew with no increase.
Guardian	Groups with 2-499 lives: All renewals for May 1, 2020 through August 31, 2020 will receive a rate pass. The next renewal rate review will be set to the plan anniversary in 2021. Groups with 500+ lives: All renewals for May 1, 2020 through August 31, 2020 will be deferred for 3 months from the original renewal date. After this, the original renewal date will apply for 2021 and future renewals.
Health Net	Business as usual.
Humana	Business as usual for renewal distribution. Employers will be allowed an additional 30 days from their effective date to complete open enrollment activities.
Kaiser Permanente^®	Groups will NOT be re-certified, they will auto renew. If a group receives a re-certification letter, this should be disregarded (it is auto generated). In addition, Kaiser will allow a delayed open enrollment window when it was not offered prior to the contract effective date, so long as it's offered to all eligible employees and all carriers offered.
MediExcel Health Plan	Groups will NOT be re-certified, they will auto renew.
MetLife	All renewals for May through September, with under 500 lives, will auto renew with no increase. (excludes business written through a trust, association, or PEO)
Premier Access	Under 500 Lives: All renewals for May through August will auto renew with no increase. 500 or More Lives: All renewals for May through August will be deferred 3 months from the original renewal date. After this, the original renewal date will apply for 2021 and any future renewals.
Principal	Dental and Vision renewals for May 2020 through April 2021, with under 500 lives, will auto renew with no increase. Life and Disability renewal for May through October 2020, with under 500 lives, will auto renew with no increase. These policies will resume normal renewal practices as of November 2020.
Oscar Health	Business as usual.
Sharp Health Plan	Business as usual.
Sutter Health Plus	Groups will NOT be re-certified, they will auto renew.
UnitedHealthcare	Will continue to re-certify at renewal, however UHC is allowing employers more time to submit their information. Specialty lines renewal guidelines (Dental, Vision, Life, Disability & Supplemental Health): Specialty lines with 2-499 employees, renewing May-December 2020, will auto-renew with no rate action. Includes UnitedHealthcare and All Savers business. Specialty lines with 500-3,000 employees, renewing May-September 2020, will have their renewal deferred until October 1, 2020. The original renewal rate will be applied October 1 for the remaining contract period. Includes UnitedHealthcare and fully-insured products tied to UMR medical self-funded (ASO) products.
Western Health Advantage	Business as usual.

Can Employers Make Off-Anniversary Eligibility Changes?

With the unique circumstances facing employer today, some may be looking to change their contract. This could mean changes like adjusting eligibility to include part-time employees as eligible or shortening the waiting periods so new hires can join the plan sooner. Most carriers require these changes be made only at the anniversary date. Read below to see which carriers may be loosening their guidelines.

Related: To see what carriers have opened a special enrollment opportunity allowing employers to make a plan downgrade, view the Member Access to Care tab above.

CARRIER	GUIDELINE
Aetna	Not allowed, changes may only be requested at open enrollment.
Anthem Blue Cross	Small Group ACA: Window to make changes closed May 31, 2020. Large Group: Employer may be able to make off-cycle changes. It is subject to underwriting approval. Please review page 29 of Anthem's FAQ for further details.
Blue Shield of California	Underwriting will review as an exception request. Employer must submit a completed Request for Contract Change Form along with the groups most recent reconciled DE-9C. If part-time employee must submit an application. All items can be send to SGUW@blueshieldca.com.
CaliforniaChoice	Employers may make a one-time "mid-plan year" change to adjust contribution.
CCSB	Not allowed, changes may only be requested at open enrollment. However, when it comes to FT/PT eligibility, CCSB does not monitor this and relies on the employer to determine when employees are added to the plan.
Guardian	Not allowed, changes may only be requested at open enrollment.
Health Net	Not allowed, changes may only be requested at open enrollment.
Humana	Requests will be reviewed by underwriting on a case-by-case basis.
Kaiser Permanente^®	Members can remain on the plan as long as premiums are paid.
MediExcel Health Plan	Not allowed, changes may only be requested at open enrollment. However, when it comes to FT/PT eligibility, MediExcel does not monitor this and relies on the employer to determine when employees are added to the plan.
Oscar Health	Not allowed, changes may only be requested at open enrollment.
Sharp Health Plan	Through Dec. 31, 2020, groups can downgrade their medical benefits to a single benefit plan (one time only). The group’s effective date will not change.
Sutter Health Plus	pending
UnitedHealthcare	Not allowed, changes may only be requested at open enrollment.
Western Health Advantage	Employers may make a one-time "mid-plan year" change to add part-time eligibility. Employers should submit a request in writing and specify a single effective date for the change and all members to be added.

Can Employers Waive the Waiting Period for Re-Hires?

Many employees who have been laid off will be re-hired once the pandemic is over. Read below to learn how each carrier handles this and whether your employer group will be able to waive the group waiting period for these individuals.

CARRIER	GUIDELINE
Aetna	The waiting period is waived for employees rehired within 1 year.
Anthem Blue Cross	If employee is rehired within 60 days* Coverage will resume with no lapse and back-premium must be paid. If an employer’s eligibility rules prohibit the employee from being reinstated as of the original effective date, the employer must notify Anthem of the requested effective date (no back premium will be owed). . If employee is rehired more than 60 days* but not more than 91 days after the termination date Coverage shall restart effective on the rehire date. The rehired employee will not be subject to any applicable group-imposed waiting period and must complete a new Employee Enrollment Application. If employee is rehired more than 91 days (13 weeks) after the termination date The employee is considered a new employee, subject to any applicable group-imposed waiting period and must complete a new Employee Enrollment Application. * deadline is normally 30 days; it is extended to 60 days for enrollment received through 12/31/20.
Blue Shield of California	The waiting period is waived for employees rehired within 6 months.
CaliforniaChoice	Will allow the employer to define the waiting period when the employee returns to work.
CCSB	Does not monitor and will allow the employer to make the determination.
Cypress Ancillary Benefits	Standard guidelines apply.
Guardian	Employees who lost eligibility between March 1, 2020 and June 30, 2020 due to COVID-19, and are re-hired within 6 months of their termination date, will not be subject to a waiting period.
Health Net	Standard re-rules apply.
Humana	Waiting period is waived for re-hired employees who were terminated due to COVID-19. If a different provision is requested by the employer, Humana grants first of the month following.
Kaiser Permanente^®	Large Group: will allow the group to define the waiting period, as long as the waiting period and employer contribution are consistent for all employees. Small Group: will allow the group to define the waiting period when the employee returns to work, with no minimum, but no greater than 90 days.
MediExcel Health Plan	Does not monitor and will allow the employer to make the determination.
Oscar Health	Employees rehired by May 31, 2020 will not be subject to a waiting period. Must specify employee is a "rehire who was previously covered by Oscar."
Premier Access	Will waive the waiting period of rehires through April 1, 2021.
Principal	Will waive the waiting period if rehired within 6 months of termination date.
Sharp Health Plan	Does not monitor and will allow the employer to make the determination.
Sutter Health Plus	Does not monitor and will allow the employer to make the determination.
UnitedHealthcare	Waiting period is waived for re-hired employees who were terminated due to COVID-19.
Western Health Advantage	WHA will rely on employer instruction to notify them of employee eligibility, even if the time differs from their waiting period, so long as it does not exceed first of the month following 60 days.

Is Deductible Credit Available for Re-Hires?

For the many employees that have been terminated and offered COBRA/Cal-COBRA, understand what will happen when they are re-hired and brought back onto the group plan. Some carriers will allow the members deductible credit to roll over, while others will reset the member at re-enrollment under the group plan.

CARRIER	GUIDELINE
Aetna	Deductible credit available. Will be applied as long as the member's ID number has not changed, and in most cases the ID number does not change for re-hires.
Anthem Blue Cross	Deductible credit not available. The deductible will reset to $0 at re-hire enrollment.
Blue Shield of California	Deductible credit is available for employees re-hired by the same employer in the same calendar year.
CaliforniaChoice	Refer to enrolled carrier for guideline.
CCSB	Refer to enrolled carrier for guideline.
Health Net	Deductible credit available. Will be applied as long as the member remains on the same plan with the same member ID, in the same calendar year.
Kaiser Permanente^®	Deductible credit is available for employees re-hired by the same employer in the same calendar year.
MediExcel Health Plan	Deductible credit not available. The deductible will reset to $0 at re-hire enrollment.
Oscar Health	Deductible credit is available for employees re-hired in the same state and on the same metal tier.
Sharp Health Plan	Deductible credit available. Member should keep track of their deductible and maintain EOB records to provide proof.
Sutter Health Plus	Deductible credit not available. The deductible will reset to $0 at re-hire enrollment.
UnitedHealthcare	Deductible credit not available. The deductible will reset to $0 at re-hire enrollment.
Western Health Advantage	Deductible credit is available for employees re-hired by the same employer in the same calendar year.

How Do We Submit Employee Applications If We Can't Obtain Signatures?

For new business submissions, some employees may not have access to printers/scanners/smart phones or may not have internet at home. This poses a concern for carriers that require employees sign applications. Read below to identify which carriers are more flexible on this requirement, and those that require a signature due to legal requirements.

CARRIER	SIGNATURE GUIDELINE	ELECTRONIC SIGNATURES ACCEPTED
Aetna	Signatures will not be required when submitting enrollment via the eTool spreadsheet. During the pandemic: will accept font signatures when accompanied by the email trail as documentation of the signature date.	Yes, must link to a reputable eSignature company. May also use signature with digital certificate.
Anthem Blue Cross	Signatures will not be required when submitting enrollment via the census spreadsheet.	Yes, must link to a reputable eSignature company.
Blue Shield of California	Signatures are required. Electronic signatures are accepted so long as they are time and date stamped by the service being used.	Yes, must link to a reputable eSignature company and have date/time stamp.
CaliforniaChoice	Signatures are required. Online enrollment available through the CalChoice system.	Yes, must link to a reputable eSignature company.
CCSB	Signatures are required. Electronic signatures are accepted.	Yes, must link to a reputable eSignature company and have date/time stamp.
Health Net	Signatures are required. Electronic signatures are accepted.	Yes, may sign with digital ID or link to a reputable eSignature company.
Kaiser Permanente^®	Any type of signature will be accepted, including font/brush scripts.	Yes, must link to a reputable eSignature company.
MediExcel Health Plan	Signatures required if submitting applications. If signatures can't be obtained, submit census enrollment instead.	Not allowed.
Oscar Health	All enrollment is done online.	Yes.
Sharp Health Plan	Signatures are required.	Yes, must link to a reputable eSignature company.
Sutter Health Plus	Until further notice, will process the enrollment application with/without Subscriber/Employee signature as long as form is being submitted directly to SHP Enrollment/Sales by an authorized representative of the employer group such as an HR, Benefits Admin, COBRA TPA or Broker contact.	Yes, fillable forms allow for electronic signature.
UnitedHealthcare	Signatures not required, all enrollment processed through SAM.	Yes, must link to a reputable eSignature company.
Western Health Advantage	Signatures are required. Electronic signatures are accepted.	Yes, must link to a reputable eSignature company.

Brokers: How Does Partial Group Payment Affect Commissions?

Some employers may be unable to make their full monthly premium payment. Learn which carriers will pay you commission based only on premium paid (even if partial) versus those that require full payment in order to release commission.

CARRIER	GUIDELINE
Aetna	Commission will be paid based on the premium paid by the group.
Anthem Blue Cross	Group must be paid to date for the month in which commission will be paid.
Blue Shield of California	Commission will be paid based on the premium paid by the group.
CaliforniaChoice	Group must be paid to date for the month in which commission will be paid.
CCSB	Commission will be paid based on the premium paid by the group.
Health Net	Commission will be paid based on the premium paid by the group.
Kaiser Permanente^®	Commission will be paid based on the premium paid by the group.
MediExcel Health Plan	Commission will be paid based on the premium paid by the group.
Oscar Health	Commission will be paid based on the premium paid by the group.
Sharp Health Plan	Commission will be paid based on the premium paid by the group.
Sutter Health Plus	Commission will be paid based on the premium paid by the group.
UnitedHealthcare	Commission will be paid based on the premium paid by the group.
Western Health Advantage	Commission will be paid based on the premium paid by the group.

Are Dental Personal Protective Equipment (PPE) Charges Covered?

Some dental offices are charging a new fee to cover protective equipment, such as gloves and masks. There is no legislation that requires coverage for these materials and therefore they may be excluded under the plan. This list will be updated as confirmation becomes available from each dental carrier.

CARRIER	PPE CHARGE GUIDELINE
Ameritas	This is not a covered benefit; the member will be responsible for the full cost of the PPE fee when receiving services. Ameritas is reviewing this practice due to recent changes in the industry.
Choice Builder	This is not a covered benefit; the member will be responsible for the full cost of the PPE fee when receiving services.
Cypress Ancillary Benefits	This is not a covered benefit; the member will be responsible for the full cost of the PPE fee when receiving services.
MetLife	This is not a covered benefit; the member will be responsible for the full cost of the PPE fee when receiving services. MetLife is reviewing this practice due to recent changes in the industry.
Premier Access	This is not a covered benefit; the member will be responsible for the full cost of the PPE fee when receiving services. Premier Access is reviewing this practice due to recent changes in the industry.
Principal	When a member sees an in-network provider, from June-December 2020, Principal will automatically pay $7 toward the cost of PPE. This is paid regardless of whether the provider is charging a PPE fee. Any PPE fee charge beyond this amount will be the members responsibility.

Get Answers

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