CalCPA ProtectPlus Open Enrollment & Plan Changes
Posted Dec.09, 2009 in General, ProtectPlus Plans
The end of the calendar year marks the ProtectPlus annual open enrollment period. It’s also the time to make plan changes. For employees who opted not to enroll in ProtectPlus for whatever reason, this is another chance to join. For current subscribers it’s an opportunity to make changes in their coverage.
Maintaining the longer open enrollment period adopted in 2007, the Group Insurance Trust has announced that open enrollment begins on November 2 and ends December 31.
CalCPA member firms that haven’t offered ProtectPlus plans to their employees can, of course, enroll in Group Insurance Trust plans at any time.
Firms can consider the full range of offerings for 2010 that include;
- 5 copay plans
- 3 HSA-eligible plans
- 2 Anthem Blue Cross HMO plans
This is also the time of year that the Trust announces plan changes and premium adjustments. As always, premium increases are anticipated with concern, but the good news is:
The Trust has been able to maintain its single digit premium increases for the seventh consecutive year.
This is a remarkable achievement when you consider that ProtectPlus also beat industry averages in each of these years.
Several benefit improvements will be implemented in 2010.
- All ProtectPlus copay plans will see a reduction in the copay amount for generic prescription drugs from $15 to $10.
- Improved coverage for mental health and substance abuse services on all copay, HSA-eligible, and Anthem Blue Cross HMO plans.
- Medical plans will now align all mental health and substance abuse member cost-sharing provisions with those offered for in-network and out-of-network medical services and remove any visit limitations (in accordance with the Mental Health Parity and Addiction Equity Act of 2008).
The Trust will also combine several copay plans for 2010.
Last year the Trust offered eight copay plans, including both regular and enhanced versions of:
- Protect 15
- Protect 25
- Protect 35
The enhanced versions of these plans—which waive the deductible for the first six in-network office visits—proved so popular that trustees were persuaded to include the enhanced benefits as standard features in the copay plans at these levels.
For 2010 the Protect 15, Protect 25 and Protect 35 plans will all feature the enhanced benefit of six office visits that are not subject to the plan’s deductible, while the Protect 10 and Protect 45 plans will retain their original structure.
Vision Service Plan and Delta Dental rates will be restructured for 2010.
Going forward, rates for both plans will be based on firm size in much the same way the medical plan rates are structured.
- Effective January 1, 2010, firms with two or more participants will see a reduction in VSP and Delta Dental rates while others will note a small increase.
Changes in Premiums
Some ProtectPlus members will see changes in their premiums next year that reflect altered geographical rate bands. Anthem Blue Cross has re-aligned several zip codes in rate areas one, two, and three, and the Trust has followed its lead in order stay consistent. For some, these changes will mean lower than average premium increases, while for others, unfortunately, it may mean an increase in excess of the average overall premium increase.
December 10th, 2009 on 6:26 pm
Currently our firm of 13 people has Anthem Blue Cross. I personally have a PPO. Would we have to give that up if we moved our insurance to you?
Elizabeth Shwiff
415-291-8600 x232
December 11th, 2009 on 1:54 pm
Can I insure only my one full-time employee, and not include myself?
December 14th, 2009 on 4:22 pm
If a firm owner is covered by another group plan such as a spouse’s plan or Medicare, the owner may decline coverage for themselves, but still provide coverage to the employee. For additional questions, you may contact our sales manager Tom Kowalski at tom.kowalski@calcpa.org. Thank you.
December 14th, 2009 on 4:30 pm
CalCPA ProtectPlus plans utilize the Anthem Blue Cross network, so you would not need to change doctors if you moved to the ProtectPlus plans. However, you could not offer another carrier’s plan (such as the Blue Cross PPO) alongside the ProtectPlus plans. The only other plan that can be offered with ProtectPlus is Kaiser. ProtectPlus offers PPO, HMO and HSA plans and you can mix and match the plans so that your staff members can choose the plan that most suits their needs.
December 22nd, 2009 on 5:28 pm
I’m an unemployed CPA; do I qualify for any plan?
Thank you.
Sincerely yours,
Anne Lagache, CPA, MBA
December 31st, 2009 on 10:42 pm
Good question! The ProtectPlus plans are group plans, which means they can only be sold to firms or employer groups. If you are between jobs and decide to become a consultant in the general financial services arena, then your consulting firm could enroll in the plan and as its owner you would then be eligible to apply.
You should be aware that if you are the only owner/employee you would be subject to underwriting and depending on your health history, could be denied coverage. Firms with two or more owners and/or employees qualify for guaranteed issue.
In short, as a group plan, ProtectPlus cannot be sold to individuals, but can be sold to a firm owned by just one individual.
If you have further questions, you may wish to contact our sales manager Tom Kowalski at tom.kowalski@calcpa.org.