1. EmployeeChoice Helping employees stay healthy all year long
Designed for businesses with 5 to 50 employees
Added HMO flexibility
Health care plans provided by Anthem Blue Cross. Insurance plans provided by Anthem Blue Cross Life and Health Insurance Company. Anthem Blue Cross is the trade name of Blue Cross of California. Independent licensees of the Blue Cross Association. ® ANTHEM is a registered trademark. ® The Blue Cross name and symbol are registered marks of the Blue Cross Association.

2. Agenda What is EmployeeChoice? Spectacular Savings Opportunities
360° Health®
Dental, Vision & Life
EmployerAccess
Employee Participation
New Business
Existing Groups
Why EmployeeChoice?
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3. What is EmployeeChoice?
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4. What is EmployeeChoice?
A program of EmployeeElect designed for small businesses wanting to offer Anthem Blue Cross plans and another carrier’s HMO side-by-side.
Providing flexibility and access to more options.
Unique ability to offer another carrier’s HMO along with five Anthem Blue Cross plans
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5. What is EmployeeChoice?
Advantages
Five distinct health plans
Four PPOs and one HMO
Employers automatically get to offer all 5 when they purchase the program.
Balanced selection of plan designs
Offering varying price points and plan designs
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6. What is EmployeeChoice?
Advantages
Options for employers to control cash flow
Special savings when employers add specialty products
Guaranteed rates and benefits for first year of coverage
EmployerAccess Tool
360° Health® gives employers a way to help employees be as healthy as they can be.
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7. What is EmployeeChoice?
Overview
Dental, Vision, Life and Workers Compensation available
Prescription drug coverage in all plans
Allowable waivers for employees who enroll in the other carrier’s HMO sponsored by their employer
75% Anthem Blue Cross participation, must include at least 5 medically enrolled employees
Dental, Vision and Life Insurance is provided through Anthem Blue Cross Life and Health Insurance Company.
Workers’ Compensation Coverage is available through Employers Compensation Insurance Company.
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8. What is EmployeeChoice?
Overview
Five Existing Small Group Medical Plans
Plan
Description
Premier PPO $20 Copay
High-end plan features rich benefits and the most comprehensive coverage
PPO $30 Copay
Top selling, mid-range plan offers an ideal balance between cost and comprehensive benefits
PPO $35 Copay GenRx
Simple approach to help with premium cost. Unique, generic-only prescription design allows this plan to provide comprehensive coverage at budget-friendly prices
PPO (HSA-Compatible)
High-deductible plan combines health coverage, financial strategy options and HSA compatibility
Saver HMO
Ideal for employers who want the simplicity and predictability of HMO coverage
The medical plans in the EmployeeChoice program are clones of EmployeeElect plans. This means that they mirror exactly the same benefits and rates, they are just combined together in a new program.
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9. Spectacular Savings Opportunities
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10. Spectacular Savings Opportunities… Complete Benefits Packages
1% Medical savings
– Employers purchasing $25,000 or more in Life along with Medical will qualify for 1% savings on medical premium.
(.90 RAF is the best RAF available)
6% Life savings plus 6% Dental savings
– Employers purchasing both $25,000 or more in Life and any of our insured Dental plans at the same time, will receive 6% savings on their Life and Dental premium.
Automatic 10% Workers’ Compensation discount
Employers integrating coverage from Employers Compensation Insurance Company* with any of our medical plans (integrated MediComp) get an automatic 10% discount on the Workers’ Comp portion of the bill.
Possible Medical savings with Integrated MediComp
In addition to the Workers’ Comp discount through Employers Compensation Insurance Company, employers may qualify for savings on their Medical premium with Integrated MediComp.
* Employers Compensation Insurance Company is a separate entity that does not offer blue branded products or services.
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11. Spectacular Savings Opportunities… Employer Tax Advantages
Because health insurance premiums are treated as a general business expense, employers can deduct premiums and health benefit costs.
Maximize tax savings with Premium Only Plan (P.O.P) from Ceridian Benefits Services. This option lets employers take advantage of IRS Section 125 provisions to help cut payroll taxes and increase employees’ take-home pay.
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12. Spectacular Savings Opportunities… Premium Only Plans (P.O.P.s)
Allows employers to use pre-tax salary dollars to pay employees’ share of benefit premiums
Employees reduce their taxable income.
Employers cut payroll taxes by decreasing total taxable payroll.
With Ceridian Benefits Services*, the cost of a P.O.P. is only $125 per year!
1st year can be free with 10 or more medical and life enrolling employees!
* Administrative services for the Premium Only Plan (P.O.P.) are provided by Ceridian Benefit Services, Inc., an independent company that is not affiliated with Anthem Blue Cross, its affiliates or parent organization.
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13. 360o Health®
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14. 360° Health®
Gives employers a way to help their employees be as healthy as they can be!
Comprehensive suite of programs and services
- Online resources, including helpful decision-making tools
- Interactive health programs
- Discounts on health-related programs
- Personalized programs to help manage and coordinate care for chronic conditions
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15. Dental, Vision & Life
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16. Dental, Vision & Life Coverage
Employers can obtain all of their health benefit products from one source – the most trusted source in the industry.
When employers include Dental, Vision and Life insurance from Anthem Blue Cross Life and Health Insurance Company with their Medical coverage to create the ultimate health benefit package, employers also have the opportunity to get the biggest savings possible and simplify benefits administration at the same time.
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17. Dental Coverage Choices
PPO Plans
Dental Blue Metallic
Ultimate in flexibility, employees can choose comprehensive plan and network that work best for their needs and budget.
Access to one of the largest PPO dental networks in CA
Traditional Metallic
5 of the same plan designs as Dental Blue with a smaller PPO network
Basic, Standard & High Option
Traditional designs with a smaller PPO dental network
100% in-network coverage for preventive and diagnostic screenings
Cover both minor and major restorative services
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18. Dental Coverage Choices
HMO Plans
Dental Net & Select HMO
Employees choose a participating dentist from our California dental networks.
Voluntary Plans
Dental Saver SelectHMO
Employees can pay up to 100% of the cost.
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19. Vision Plans Blue View VisionSM Blue View and Blue View Plus
Extensive network of participating providers across the United States.
44,000 in the U.S. and 4,000 in California
Additional savings of up to 40% on unlimited purchases of most extra pairs of eyewear, contact lenses, lens treatments, specialized lenses and various accessories.
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20. Life Options
2 or more employees enrolled in our medical plan(s): Life coverage is guaranteed issue.
11 or more employees in Anthem Blue Cross life coverage: Employers automatically receive a single (composite) life rate per $1,000 in life coverage.
Life coverage of $25,000: Our LifeConnectionsSM member assistance program included at no additional cost.
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21. EmployerAccess
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22. EmployerAccess
An easy way for employers to manage their company’s health benefits all year long.
Online benefit administration tool
- View employees’ coverage
- Enroll employees and add dependents
- Change and cancel coverage for employees and dependents
- Request ID cards
- And more!
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23. Employee Participation
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24. Employee Participation
Here’s how participation will be calculated: 1
Start with the total number of employees, including owner(s) 15 2
Subtract allowable waivers:
Covered under MediCal / Military, or as dependents under a spouse’s or parent’s employer-sponsored plan
Enrolled or enrolling in the other carrier’s HMO sponsored by the employer (this is an allowable waiver only for the EmployeeChoice Program)
- 2
- 6 3
Remainder = Eligible Employees 7
75% of 7 = 5.25 therefore 6 employee’s need to enroll
75% Blue Cross participation must include at least 5 medically enrolling employees
At least 75% of eligible employees must participate in Anthem Blue Cross coverage (cannot be less than 5 subscribers).
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25. Employee Participation
What if there is a group of 5 enrolling, and two employees are married to each other and want to enroll under one certificate, is this OK?
Yes, if husband and wife both work for the same employer, they may apply separately as employees or one may enroll as a dependent on the other’s coverage.
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26. New Business
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27. New Business 12-month rate guarantee
“All Plans” – Groups automatically underwritten for all five plans in the package
Employer decides which to offer
Enrollment Verification
We will require employees enrolling in the other carrier’s HMO to complete Section 4 of the Employee Application declining coverage through Anthem Blue Cross.
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28. Existing Groups
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29. Existing Groups
Will existing groups be able to switch to the EmployeeChoice Program?
Yes, existing groups will be allowed to apply for the EmployeeChoice program of products at their anniversary date, subject to full underwriting.
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30. Existing Groups
What documents are needed for EmployeeChoice benefit modifications?
Letter from an officer/owner on letterhead
Completed Employer Application
Completed Employee Application's
Most recent DE-6
Statement for owners not appearing on the DE-6
Cal-Cobra/Cobra/FMLA Questionnaire if applicable.
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31. Why EmployeeChoice?
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32. Why EmployeeChoice? Increase your sales
Deliver more value and flexibility
Reach more California Small Businesses
Remove a barrier
Increase your sales – Employee Elect is great with all its options for All Plans, we have added another option to reach diverse groups who wish to have another HMO option
Deliver more value and flexibility: This is great in areas where the traditional HMO network is not ideal or for groups who have employees who have a preference for a specific HMO model.
Reach more California Small Businesses: Who want Anthem Blue Cross and another option
Remove a barrier: Agents who were worried about showing our plans and meeting 75% participation don’t have to be as concerned since we will now allow the other carrier as a valid waiver.
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33. EmployeeChoice Helping employees stay healthy all year long
Questions?
Health care plans provided by Anthem Blue Cross. Insurance plans provided by Anthem Blue Cross Life and Health Insurance Company. Anthem Blue Cross is the trade name of Blue Cross of California. Independent licensees of the Blue Cross Association. ® ANTHEM is a registered trademark. ® The Blue Cross name and symbol are registered marks of the Blue Cross Association.