Offer your clients the greatest access to doctors, hospitals and specialists through EIGHT health plans in a single program.
Q4 CaliforniaChoice Rate Action Summary
Anthem: Rate changes
Health Net: Rate changes
Kaiser Permanente: Rate pass
Landmark Healthplan: Rate changes
Oscar: Rate changes
Sharp: Rate changes
Sutter Health Plus: Rate changes
UnitedHealthcare: Rate changes
Western Health Advantage: Rate pass
Anthem Rx regulatory changes
- Tiered Generic Rx copays (Tier 1a and Tier 1b) will be removed and replaced with a single Generic Rx tier.
- The change will be effective 10/1/19 for all members on any affected plan with a group effective date 1/1/2019 and later.
- The change applies to all CaliforniaChoice Anthem plans, with the exception of the Gold HMO B, Silver HMO B and Silver EPO B plans.
- CaliforniaChoice has sent email communications to groups with Anthem membership and effective dates January 2019 through September 2019.
- Anthem sent mail communication to affected CaliforniaChoice Anthem members on 7/23/2019.
- Updated SBC and EOC documents are pending release.
Anthem Benefit Changes to Q4 plans
- Additional cost sharing benefit changes for Q4 to the Silver HMO A and Silver PPO A plans.
- SBC and EOC documents are pending release.
Ancillary Plan Changes
- Ameritas orthodontic waiting period changed from 24 months to 12 months for the PPO 3500, 4000 and 5000 dental plans.
- Landmark Healthplan pre-authorization requirement removed from both the Chiropractic and Chiropractic/Acupunture plans.
For additional Q4 benefit information see these resources:
- Benefit Summaries Booklet for Groups Beginning 10/1/19
- Summary of Changes for Groups Renewing 10/1/19 – 11/1/19
- Summary of Changes for Groups Renewing 12/1/19
NEW Oscar Broker Bonus
- Earn up to $75 per enrolled employee
- Applies to effective dates from June through December 2019
- Oscar members enrolled through CaliforniaChoice are eligible including new and active CaliforniaChoice members who enroll or move to Oscar at renewal
- Business written through Rogers Benefit Group qualifies for the Bonus
- Oscar Broker Bonus Flyer
CaliforniaChoice Form Updates
For September through December 2019 effective dates:
Employee Enrollment Form 9.19 to 12.19 Effective Dates
Employee Change Request Form 9.19 to 12.19 Effective Dates
For October through December 2019 effective dates:
Employer Application 10.19 to 12.19 Effective Dates
Employer Change Request Form 10.19 to 12.19 Effective Dates
Contact your RBG Team for more information