CalCPA ProtectPlus

If you are vacationing just over the state line, across the country, or elsewhere in the world and experience a medical problem, you will be glad to know that ProtectPlus has you covered. The Anthem Blue Cross card that identifies you as a ProtectPlus subscriber is not only good for network coverage in California, it also represents your membership in BlueCard®, a national program through the BlueCross BlueShield Association that enables members of one Blue company to obtain healthcare services while traveling in another Blue company’s service area.

Boasting an impressive reach, this coverage extends to all 50 states and Puerto Rico, plus more than 200 countries and territories worldwide. So, you can enjoy your vacation at ease knowing that covered healthcare is within easy reach. Here are a few guidelines for making use of your coverage with the least hassle.

Always carry your ID card wherever you are traveling, and in any emergency go to the nearest hospital. If you don’t need emergency care but do need to see a doctor or visit a hospital before you return home, call the “Coverage while traveling” number on the back of your Anthem Blue Cross ID card for help in locating the provider nearest to you, or referral authorization. For travel in the US, Puerto Rico and US Virgin Islands, you can also find participating provider information online (provider.bcbs.com).

Once at the hospital or doctor’s office, present your Anthem Blue Cross card. For services provided in the US, you shouldn’t have to complete claims forms or pay up-front for medical care other than your usual out-of-pocket expenses such as deductibles and copays. Anthem will send you a complete explanation of benefits.

If you are traveling out of the country and need emergency medical care, call, or have a family member or friend call the BlueCard Worldwide Service Center collect (1-804-673-1177) as soon as you are admitted to a hospital. If you need nonemergency care, the service center will help you make an appointment with a doctor or facilitate your hospitalization at a network hospital. The center can help obtain cash-less access for inpatient care except for your usual out-of-pocket expenses. For outpatient care and/or services from a non-network hospital you may have to pay the provider and submit a claim form.

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The old idiom with the words, “two is company,” was reinforced at a recent CalCPA member event. A ProtectPlus staff member was chatting with an accountant who described himself as a sole practitioner while mentioning that he had an assistant. He subscribed to ProtectPlus as a sole practitioner, he said, because the person who helped him already had medical coverage through her spouse’s employer, and she wanted to keep that coverage.

Alerted to a possible misunderstanding, the ProtectPlus representative responded by pointing out that under ProtectPlus rules even if his employee waived coverage, the accountant qualified for the lower premiums of firms with 2 to 14 employees. In addition, if the firm ever moved to another carrier, it would not be subject to underwriting to qualify for coverage. Moreover, simply having that employee on staff is enough to qualify for the lower rates as long as the employee is working a minimum of 20 or 30 hours a week. Even if the employee waives the benefit—whether because he or she has other group insurance coverage or a Kaiser plan—the CPA still qualifies for coverage at the two-member firm rate.

ProtectPlus subscribers should keep in mind that the same rules apply to a CPA sole practitioner who employs his or her spouse. As long as the spouse works at least 20 hours per week and is compensated as an employee, the CPA firm is defined as a group of two. The CPA can purchase a ProtectPlus policy at the lower rate, forego underwriting, and choose whether to include the spouse as a dependent on his or her policy, or cover the spouse as an employee under their own policy. However, in firms where the only other employee is the spouse, the Trust requires documentation (W-2, payroll records, income tax returns, etc.).

For CalCPA members—especially sole practitioners and small firms—one of the greatest benefits of the Group Insurance Plans is access to high quality medical insurance at prices that are competitive to those usually offered to large firms. While true sole practitioners are subject to underwriting, the ProtectPlus policies available to them will for the most part be miles ahead of anything they can purchase on the individual market. And even those who don’t qualify for coverage due to their medical history may qualify for a ProtectPlus HIPAA option. For more information please contact Banyan Administrators (877) 480-7923.

The following information if from Anthem Blue Cross and is quite helpful in guiding you to a healthier lifestyle.

Are you or a family member living with a chronic condition such as asthma, diabetes or heart disease? If so, we can help. 360˚ Health provides you with support to help you achieve your health goals. We’ll work with you, your doctor and other health care professionals to help you improve your health.

ConditionCare enhances your doctor’s plan of care through the use of a dedicated nurse plus a team of health professionals including dietitians, exercise physiologists, pharmacists and more. You can gain a better understanding of your health, receive help in following your doctor’s care plan and learn how to better manage your health. This program is designed to help members with chronic conditions such as asthma, diabetes, coronary artery disease (CAD), chronic obstructive pulmonary disease (COPD) and heart failure.

ConditionCare Support Programs complement our core ConditionCare programs. They assist members who are not managing a core chronic condition, such as asthma or diabetes, but need help with other conditions ranging from arthritis pain to high blood pressure. These programs include help with vascular at-risk conditions, low back pain, musculoskeletal conditions, and various types of cancer.

ConditionCare Kidney Disease is a program specifically designed to support members with chronic kidney disease. Nurses that specialize in renal care and the treatment of kidney disease provide education and support to help members manage their health.

ComplexCare provides help to those with multiple health concerns who may require high levels of collaborative care. Personalized nurses who specialize in treating multiple health conditions work with members to help improve their health.

Comprehensive Medical Management provides one-on-one expert assistance to help members find and receive the right services and care. The program includes a personal advocate to see that benefits are utilized effectively and that necessary medical interventions are appropriate and safe.

360° Health program offerings vary by state. Specific programs are included in your health plan and others are available for additional cost. Contact your human resources department or benefits administrator as appropriate for eligibility and further details.

Take your next step to better health. Choose a link:

• 360° Health Overview
• Improve Your Health
• Get Guidance

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Open enrollment is going on now through December 31st. See why so many CalCPA member firms choose CalCPA ProtectPlus. Each of our plans have been developed through research, member feedback, and collaboration with leading national service providers to deliver an attractive balance of benefits and savings. And because these are proprietary plans, we can provide them to our member firms at highly competitive group rates.

You may choose to offer your employees almost any combination of the CalCPA ProtectPlus plans. This exclusive coverage is a great enticement for attracting and retaining top-level talent to your firm.

Here is a quick look at our plans.

To find the plan that be fits your needs, please use our Plan Selector Tool.

• Protect 10 $10 copay, 10% coinsurance, 
individual deductible $250/Family $500. More details

• Protect 15 $15 copay, 20% coinsurance, Individual deductible $250/Family $500, the first 6 in-network office visits per calendar year are exempt from annual deductible. More details

• Protect 25 $25 copay, 30% coinsurance, Individual deductible $500/Family $1,000,the first 6 in-network office visits per calendar year are exempt from annual deductible. More details

• Protect 35 $35 copay, 40% coinsurance, Individual deductible $500/Family $1,000, the first 6 in-network office visits per calendar year are exempt from annual deductible. More details

• Protect 45 $45 copay, 50% coinsurance, no in-network deductible. More details

• Protect HSA 1500 $1,500 Individual deductible $1,500/Family $3,000, 30% coinsurance, $4,500 Individual out-of-pocket maximum. More details

• Protect HSA 2500 $2,500 Individual deductible $2,500/Family $5,000, -0- coinsurance, $2,500 Individual out-of-pocket maximum. More details

• Protect HSA 2850 $2,850 Individual deductible $2850/Family $5,650, 30% coinsurance, $5,500 Individual/ out-of-pocket maximum. More details

• HMO Value 80 $15 copay, no deductible, 20% coinsurance for most covered expenses. More details

• HMO Advantage 100 $10 copay, no deductible, no additional charge for most covered expenses. More details

Did you know that although most employers will elect to have partners and employees covered under a single plan, firms may chose to offer one or more, or all of CalCPA ProtectPlus plans to their owners and employees. However, if the firm wishes to include an HMO plan, only one the the Anthem Blue Cross plans may be offered.

Learn more about CPA ProtectPlus healthcare plans

Tax-Savings Can Really Add Up To Lower Healthcare Costs

Times are tough. Medical costs are on the rise. But there’s something you can do right now to get more for your healthcare dollars. Simply sign up for a CalCPA ProtectPlus Health Savings Account (HSA) plan and save big on the services you already use. HSA plans are available to any CalCPA ProtectPlus member whose employer is offering any of our three High Deductible Health Plans (HDHP).

With these accounts, you deposit pre-tax dollars into your Health Savings Account and then use your HSA debit card to pay for eligible medical expenses for you and your dependents. You can use your HSA for expenses like office visits, prescriptions, and emergency services, plus eligible expenses NOT covered by your plan such as dental, vision, many over-the-counter drugs and long-term care.

Get full details on HSA plans. See HSA eligible plans.

Comprehensive healthcare, with simple administration.  We know that your time is limited and you have enough to do just keeping your firm running smoothly. The last thing you need standing between you and billable hours is more work shopping for healthcare options and then investing even more time administering a plan. But, there’s an easier way to provide your firm with quality healthcare at affordable rates.

ProtectPlus, makes it simple for small firms to provide comprehensive healthcare to their employees with easy one-stop shopping for plans that include medical, dental, vision, disability and life insurance. And, we make it even easier by providing back office assistance–so administration of your benefits is a breeze.

With ProtectPlus, your CalCPA firm can get exclusive programs and coverage ordinarily available only to larger firms. Our group plans include the best doctors, hospitals and administrators available at competitive rates. Additionally, our staff is responsive and delivers personalized service you won’t get anywhere else.

Since we offer programs only to CalCPA member firms, we understand the unique needs of your business. Our plans are specifically designed just for CPAs, so you’ll find the perfect program for your business.

And if you thought you needed more staff to administer a healthcare plan, think again. So you can stay focused on your core business, ProtectPlus provides back office services that include:

• CalCobra administration and billing
• Employee eligibility assistance
• Help with completing forms
• Billing and collection of premiums
• Answering employee’s questions about plan benefits
• Facilitating claims resolution

Get comprehensive coverage for your firm from the people that know your needs and understand your business. Click here to receive an instant, no-obligation quote now.

As a solo practitioner, you’re in great company. When it comes to healthcare, being a solo practitioner doesn’t mean going it alone.

With ProtectPlus, you can take advantage of the comprehensive coverage and competitive rates of a group plan. We make it simple for solo practitioners to get superior healthcare with the ease of one-stop shopping for plans that include medical, dental, vision, disability and life insurance.

With ProtectPlus, your one-person firm can get exclusive programs and coverage ordinarily available only to large firms, with group plans that include the best doctors, hospitals and administrators available. Additionally, our staff is responsive and delivers personalized service you won’t get anywhere else. Since we offer programs only to CalCPA member firms, we understand the unique needs of your business. Our plans are specifically designed for CPAs, by CPAs, so you’ll find the perfect program that fits you. (continue reading…)

Responding to the growing popularity of Health Savings Account eligible medical insurance plans (commonly referred to as HSAs), the Group Insurance Trust (CPA ProtectPlus) has expanded its current offerings with a third such plan, Protect HSA $2,500.

With premiums approaching the lower end of ProtectPlus co-pay plans, the new plan offers significantly greater benefits than the two already established Protect HSA plans.

As with all HSA-eligible plans, Protect HSA$2,500 features a high annual deductible that must be satisfied before benefits are paid by the plan. For the new plan the deductible is $2,500 per individual and $5,000 per family.

Though not greatly different from HSA $2,850 in respect to the deductible, the difference in benefits is large indeed.

After the deductible is met HSA $2,500 provides 100 percent coverage for all in-network office visits, professional services, emergency and in-patient hospitalization, hospital and outpatient surgery, lab costs and more.

It also pays 70 percent of the negotiated fee for all these services when provided out-of-network. In contrast, HSA $1,500 and $2,850 pay 70 percent of negotiated fees for in-network services and 50 percent of negotiated fees out-of-network. (continue reading…)

Widely publicized before they were available, Health Savings Accounts (HSAs) are quickly becoming an accepted health insurance option.

We recently introduced a new HSA, Protect 2500, once you meet the plan deductible, the plan pays 100% of in-network, eligible expenses.

Consider these guidelines whether you’re interested in an HSA for yourself, an alternative plan for employees, or when consulting clients on how an HSA might serve them.

1. You can’t open an HSA without subscribing to a high deductible healthcare plan (HDHP), but you can subscribe to an HDHP without opening an HSA.

The Medicare Prescription Drug, Improvement and Modernization Act of 2003 stipulated that HSAs were created to allow individuals to pay for qualified medical expenses with pre-tax dollars in conjunction with specially designed HDHPs. Getting HDHP coverage without opening an HSA is possible. However, keep in mind that this option fails to take advantage of HSA tax benefits while exposing subscribers to the risk of paying the very high deductibles out of ordinary savings should they need expensive medical treatment. (continue reading…)

Protect HSA plans are self-funded High Deductible Healthcare Policies (HDHPs) offered through the Group Insurance Trust of the California Society of CPAs. The Protect 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. Detailed information on HSAs: official government site.

As with the ProtectPlus copay plans, the Protect HSA plans have contracted with Anthem Blue Cross of California to use its comprehensive provider network and to process our claims. You 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 (after your deductible is satisfied) 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.

For more on CPA ProtectPlus HSA Plans