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

Benefit Changes

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:

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

EMPLOYEE FORMS

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


EMPLOYER FORMS

For September 2019 effective dates only:
Employer Application 9.19 Effective Dates
Employer Change Request Form 9.19 Effective Dates

EMPLOYER FORMS
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