CalCPA ProtectPlus

If you’re looking ahead toward a big birthday this year—one of those marked by a round number, a party, and jokes about getting older—then among the surprises that may await you is an increase in your health insurance rates.

This unwelcome gift—in addition to the seemingly inevitable yearly rate increase that everyone gets—comes in the form of a higher premium and marks your status in having moved to another age rate band.

You’re probably aware that older people pay more for their health insurance and younger people less, and you may have already experienced such an increase.

Nevertheless, in these lean times, its not something you want to come as a surprise. “Happy birthday! Blow out the candles! Your premium just went up $100 a month!” ProtectPlus uses a range of age bands that are common in health insurance plans:

• under 30
• 30–39
• 40–49
• 50–54
• 55–60
• 60–64
• 65 and older

If you’re with another insurer, you should check to see where the bands fall on your policy. You can’t avoid getting older, of course, but if a higher premium will create a financial burden, you can switch to a less expensive plan during open enrollment (November 2 to December 31). Otherwise, you will have to live with the higher rates for your newly attained age until the next year.

Keep in mind that the rates for your spouse and dependents are dependent on your age band, so their big birthdays don’t count in terms of premiums. You can celebrate as you see fit, and not have to worry about higher rates on their birthdays.

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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.

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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