CalCPA ProtectPlus

The Group Insurance Trust of the California Society of CPAs is pleased to announce that it has selected a new administrator for the CalCPA ProtectPlus programs. Effective later this fall, program administrator responsibilities will transition from Seabury and Smith Insurance Program Management to Banyan Administrators, LLC. Banyan is a firm with extensive experience in administering multiple employer health plan arrangements.

What’s Next?

• Additional Web Features on CPAProtectPlus.com
• Brainshark Multimedia Online Presentation
• Detailed Administrative Guide Released
• Annual Enrollment Communications

The Trust is committed to continually improving the ProtectPlus member experience and the quality of the CalCPA ProtectPlus programs. The administrator transition will allow ProtectPlus program members to take advantage of a host of new and enhanced services, including:

• Simplified enrollment processes
• Improved program invoice design
• Enhanced communication capabilities – new web features; dynamic, multi-media presentations
• Streamlined administration leveraging web-based technology
• Online HR and Benefits reference materials

ProtectPlus Members
Your Annual Enrollment materials will be mailed to you on November 2, 2009 and will include new plan contact information.

In an effort to reduce Medicare costs, Congress passed the Medicare, Medicaid and SCHIP Extension Act of 2007 (MMSEA) on December 29, 2007. Because Medicare has been unable to identify primary payers consistently, Section 111 of the new Act (MMSEA) imposes mandatory reporting requirements for fully insured and self-funded group health plans.

These requirements impose an obligation on primary payers to identify claimants entitled to Medicare and to report those claims to Medicare electronically.

As of July 1, 2009. Health plans are required to report specific member eligibility data for members who meet certain age or disability criteria. The reporting rules apply to covered individuals age 45 and older for groups with 20 or more full or part-time active employees. (continue reading…)

It’s as easy as 1,2,3.

1. Provide a written request including; the employee’s name, the plan(s) from which the employee should be terminated, the reason why, and the effective date.
2. Sign, date and include your title.
3. Fax your written request to Seabury & Smith @ 800-682-8787

(Originally published by Anthem Blue Cross April 24,2009)

The new CalCOBRA legislation, California Assembly Bill 23, is expected to be signed by the Governor by the end of this week. This bill will align the current CalCOBRA legislation with the Federal Subsidy as defined by ARRA (American Recovery and Reinvestment Act). The following are high-level details you should be aware of:

• This bill states that health plans and health insurers have 14 days from the date of enactment to provide proper notification to those individuals who may qualify for the Cal-COBRA subsidy. The Department of Labor (“DOL”) has agreed that the timeliness within which the state mini-COBRA programs must comply is to be determined by the states themselves. The DOL held a call with the California Department of Insurance (“CDI”) and the Department of Managed Health Care (“DMHC”) to assure this is understood by all three regulators.
• The mailing will go out to all individuals who had a qualifying event between Sept. 1, 2008, to the present, regardless of whether or not they had already elected CalCOBRA.
• The bill (AB23) currently states that California residents who were involuntarily terminated from their jobs between Sept. 1, 2008, and the present will qualify for the Cal-COBRA special election period.
• There is a notice letter being developed by Anthem in conjunction with the California Association of Health Plans (“CAHP”) and other health plans in this state. Once finalized, this notice will be deemed approved by both the CDI and DMHC. Anthem will send the notice as soon as possible following the enactment of AB 23.
• Once the bill is finalized and signed into law, Anthem will share a more detailed summary of the specific provisions of this law.

To continue reading “In the Interim“