HELP WITH
THE GROUP HEALTH INSURANCE
APPLICATION
Employer Application FAQ
Now that you’ve chosen a health insurance carrier like Anthem Blue Cross of California or Blue Shield of California comes the fun part - all the group health applications and paperwork you need to put your California health insurance benefits in place. We typically recommend you utilize our services to help you with questions in completing the Employer Group Application, sometimes called the Master Group Contract or Employer Group Service agreement. Here’s a quick walkthrough of frequently asked questions which are universal to Employer Group Applications or contracts.
Plans Offered Depending on your company size the California health insurance carrier will have one to all of the plans available to offer to your employee base. A company which decides to offer ‘All Plans,’ or a plan suite which has a package of health plans where the employee can pick and choose coverage leaves their options open to make enrollment changes at the anniversary month. Number of plans available at the 2-5 employee enrolled level is a strong reason to choose one health carrier over another, as many carriers limit the number of plans allowed to be offered at this group size to one plan.
Employer Contribution Contract will allow for a minimum of 50% of employee premium and down to 0% on dependent premium per State of California regulation AB 1672. Select carriers will allow defined dollar contribution amounts. Watch out for fine print when contributing 100%- this can sometimes force 100% of employee enrollment.
CalCobra/Cobra Enrollees There is always a section questioning if there are COBRA enrollees currently or anyone out there recently terminated who may have rights to the health insurance plan. Simply list applicable terminated employees and sign the section.
Health Questions Typically groups 2-10 in size will have to respond to a limited set of health questions. Each employee responds to the questions for themselves and their dependents and seals the form as the information is considered HIPPA protected health information. The Employer is not allowed to see the health data to prevent invasion of privacy and possible resulting workplace discrimination which could potentially result.
Workers Compensation Most health insurance carriers require the business to carry workers compensation coverage for their employees. The exception to the requirement are companies who are enrolling owners and corporate officers only who are exempt from state requirement to carry the workers compensation plan.
Waiving Coverage Employees waiving coverage will need to sign a waiver or decline for coverage form acknowledging they are refusing the coverage until the open enrollment period next year at anniversary month. This is usually done with a copy of the alternate group insurance plan card for employee waivers to not effect the participation pool. If greater than 25% decline the coverage the group is typically not accepted to prevent adverse selection of the member pool. The number of employees listed on the Employer application is compared by the Underwriting department to the number enrolling and listed on the company payroll.
