2017 Kaiser Permanente Covered California Plans and Rates

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2017 Kaiser Permanente Covered California health insurance plans for individuals and families will be available for viewing November 1.

Anyone can get Kaiser coverage as long as you live in a Kaiser service area.  You can no longer be denied coverage because of a medical condition, and you don’t have to pass a medical exam to qualify for a Kaiser health insurance plan.

2017 Qualifying Events – Situations which allow you to enroll in a Kaiser plan “outside” the Open-Enrollment period:

  • Divorce, termination of domestic partnership or civil union.
  • Change in full time employment status.
  • Loss of employer sponsored insurance.
  • Voluntary or involuntary termination of employment.
  • Death of parent or spouse.
  • Change in dependent status – i.e. dependent child turning 26.
  • Existing coverage is being changed to a qualified health plan.
  • Marriage.
  • Domestic Partnership (in states which allow).
  • Birth of child.
  • Adoption of child.
  • Placement for adoption of child.
  • Guardianship or court order dependent.
  • Permanent move to a new state.

Be sure to enroll by December 31 to receive a January 1, 2015 effective date. After that, the next available effective dates are: February 1st and March 1st.  The only way to enroll in a plan after March 1 is if you have a “qualifying event” such as, you are coming off of an employer health insurance plan, or you move to an area where your current plan is not available or if you are moving on or off of MediCal.  There are a few other situations but typically if you miss the Open Enrollment period you will not be able to enroll for the balance of the year.

4 Levels of Coverage …  With all companies including Kaiser you will see four levels of coverage; Bronze, Silver, Gold and Platinum.  Each level provides a different level of coverage to meet your needs.  Bronze offering the lowest level, while Platinum is the highest.

All plans will offer the “essential health benefits” which are; doctor visits, hospital care, prescription coverage and maternity care, and will include certain preventive care for no charge.

Enrolling “On and Off the Covered California Exchange .. Enrolling “On” the Covered California Exchange is typically for the individual or family who qualify for a subsidy due to their income level.  Individuals and families who do not qualify for a state subsidy, will usually enroll “Off” Covered California (the plans are the same) although the premium amounts are quite different.

Health Care ... Almost everyone gets sick or hurt, or needs some sort of medical help.  To get better you usually need care, like seeing a doctor or staying in a hospital or taking prescription medications.  Health Care includes many different services such as; Doctors office visits, hospital stays, emergency room visits, X-Ray and Lab, prescription drugs, preventive care, well baby visits, well woman visits, immunizations and screenings.

Health Coverage Health Insurance is a lot like the insurance people get on their car or home.  Some people get their health insurance through their jobs, while others buy it themselves.  Without insurance, high medical bills can wipe out savings and even lead to bankruptcy.  Insurance helps protect you financially, if you have a serious illness or injury that requires extensive care.

How you Benefit … Peace of mind .. You shouldn’t have to worry how you are going to pay if you get sick, injured or pregnant.  Life is unpredictable, but when you have Kaiser, you have more control and you can rest easy knowing you are going to get the care you need.

Care when you need it .. You can see a doctor when you are sick or just need preventive care like a check up or screening.  You don’t need to ignore symptoms, or hope they’ll go away.  You can get treated before they get worse.

Quick Quote:   Anthem   –   Blue Shield   –   Kaiser 

Stay on a Healthy Course .. Preventive care helps you catch minor symptoms before they become problems.  Screenings like mammograms and cholesterol level tests can catch problems early, when they are easier to treat.

Quick Quote     Enroll Online

Questions?  Call or email anytime.

John Conner

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Sacramento Group Health and Employee Benefits

Group Health Insurance and Employee benefits in Sacramento County for the employer with 1 to 100 employees.  Flexible benefits and payment options for the employer who provides medical coverage for their employees.

Sacramento Businesses with 1-100 employees are able to provide small group health insurance plans to their employees.  If you have questions about your current plan or would like information on a new company plan, call anytime at 916-682-1117.

Can the Employer reimburse employees for “individual or family health insurance plans?

Reimbursement for individual plans is no longer allowed. This arrangement is is subject to a $100 daily excise tax, or fine per employee ($36,500 per year, per employee). Yikes.

I provide help with …

  • Open-Enrollment
  • Rate Comparison
  • COBRA Administration
  • Change Plan or Company
  • Anthem, Aetna, Kaiser, United Health Care, Blue Shield.

4 Common Group Health plans employers choose:

PPO (Preferred Provider Organization) This is one of the two most popular Group Plans.  With a PPO the true benefit is the ability to have freedom of choice with doctors and hospitals.  Although there is a network of contracted providers with a PPO, the member has the freedom to choose. You will always pay less out of pocket costs when you see a provider who is in the PPO network.

HMO (Health Maintenance Organization) This is the other most popular plan.  The benefit of an HMO is you have much lower out of pocket costs compared to a PPO style plan.  An HMO typically has a very low or no annual deductible, and copay amounts. The big difference is when you enroll in an HMO you need to choose a Primary Care Physician (PCP) who is typically a general practitioner or internist from a list of contracted doctors.  This PCP organizes you health care, meaning when you need see a specialist or have a medical procedure, your PCP will refer you to the appropriate doctor or facility within the same medial group.  With an HMO you do NOT have freedom to choose different doctors, your PCP will refer you to different specialists.

EPO (Exclusive Provider Network) An EPO looks and feel a lot like a PPO plan, but the big difference is you must stay within the contracted network of providers.  There is no coverage outside of the companies EPO network except for emergencies.  Be very careful with an EPO, because you may be referred or have a medical procedure and one of the doctors may not be an “contracted” doctor, which means you will be paying that doctor for their services.

HSA (Health Savings Account)  This is a 2-part plan.  Fist you have a high deductible health insurance plan which must be HSA qualified.  The second part is the Health Savings Account, which is a special bank account which allows you to deposit money pre-tax, and use these funds for medical expenses tax free.  If used properly, this is a very good way of saving on you premiums and paying for care.  The HSA bank accounts can be opened at most financial institutions; banks, mutual funds, brokerages, etc.

Sacramento employers who offer group health to their employees know that health insurance is one of the most important employer-provided benefits currently offered in the workforce. If you are thinking about offering this benefit, or are reevaluating your insurance needs, consider which group insurance benefits are right for you. Call today for a free comparison 916-682-1117.

Optional Employee Benefits …

  • Dental … PPO and HMO dental plans are available, with many plan benefit options.
  • Vision … Several popular vision companies and plans for your company employees.
  • Life Insurance … Group life is also a widely used employee benefit.  Low premiums and high life insurance benefits are the attraction.
  • Disability … Short and Long-term group disability plan provide this much needed benefit.
  • Long Term Care … Many companies take advantage of the “guarantee-issue” LTC policies available to employees, management and ownership.

Looking for a new Group Health policy or a free comparison, call today. I’ll be happy to help.

John Conner

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Group Health for your California Company

Starting or changing your group health insurance policy for your California Company can be done at anytime of the year.

To start a new plan you only need two people.  An employer and one employee, or a partnership.  It doesn’t matter if you are a sole proprietor, incorporated or other.

Anthem  –  Blue Shield  –  Kaiser  –  Aetna

Changing plans or company .. If you simply wish to change plans within the same insurance company, it’s best to make the desired changes during your policy anniversary month.  If you wish to switch companies, that can be done at anytime throughout the year.

Health  –  Dental  –  Vision  –  Life  –  Disability

The product features are going to be the same.  All companies offer the 4 metalic tier levels; Bronze, Silver, Gold and Platinum, along with the traditional plan types; PPO, HMO and HSA qualified plans.

When requesting a proposal, typically all you need are the ages of the employees and their dependents.

Participation Requirement …

The participation requirements for a Group health plans are:  70% for groups with 1-14 eligible employees.  50% for groups with 15 or more eligible employees.

Remember, group policies have a “participation” requirement.  Meaning, in order for a company to qualify for a group health policy there must be at least 50% – 70% of all eligible employees on the plan. If an employee is covered on their spouse’ group health plan, they do not count towards the participation requirement.

Also, employees must be on traditional payroll, independent contractors are not eligible for coverage on the group plan.

Advantages of a Group Health Policy …

  • Access to the largest networks of doctors, hospitals and other providers. Individual plan policies have seen their networks slashed. And many doctors are no longer contracting with Individual insurance providers.
  • Better prescription services.  Group plans typically provide better access to more prescriptions, and the costs can be significantly lower.
  • Optional Benefits … Dental, vision, life and disability plans with better coverage and flexible benefit options.
  • Mix and match plans with your employees.  You have the options to offer 1 or several plans to your employees. Some may want a ppo others may choose an HMO.  Flexibility!

Pediatric vision and dental coverage is included …

All small business medical plans PPO, HMO and HSA medical plans include PPO pediatric dental and vision coverage for age-eligible members.

Many Group Plans Include Wellness Programs …

Wellness discount programs offer a variety of member discounts on massage sessions, gym memberships, LASIK eye surgery, and even a popular weight management program. Online discounts of up to 40% off retail items (many with free shipping) include vitamins and supplements, yoga and fitness equipment, and much more. •

  • Discount Provider Network – Take 20% off the published retail prices when you use a participating provider in the Discount Vision Program network for exams, frames, lenses and more.
  • Alternative Care Discount Program – Get 25% off usual and customary fees for acupuncture, massage therapy, and chiropractic services, plus get discounts on health and wellness products, with free shipping on most items.
  • MESVision Optics – Take advantage of competitive prices on contact lenses,3 sunglasses, readers, and eyecare accessories, with free shipping on orders over $50.
  • QualSight LASIK – Save on LASIK surgery at more than 45 surgery centers in California. Services include pre-screening, a pre-operative exam, and postoperative visits.
  • NVISION Laser Eye Centers – Receive a 15% discount on LASIK surgery from experienced surgeons with offices in Southern California and Sacramento.
  • Hearing-aid discount – Save 30% to 60% off manufacturers’ suggested retail prices on major brands through EPIC Hearing Service. • Weight Watchers – Get discounts on three- and 12-month subscriptions, monthly passes, and at-home kits.
  • 24 Hour Fitness – Enjoy waived enrollment, processing, and initiation fees and discounts on monthly membership dues.
  • ClubSport and Renaissance ClubSport – Obtain a 60% discount on enrollments when joining with a month-to-month agreement. Enrollment fees are waived when joining with a 12-month agreement. There is a onetime $25 processing fee when you enroll.
  • NurseHelp 24/7 – Speak with registered nurses anytime, day or night, and get answers to your health-related questions, or go online to have a oneon-one chat. The NurseHelp 24/7SM phone number is conveniently located on the back of the Blue Shield member ID card.

Changing plans, switching companies, even changing brokers is easy. Please contact me anytime with questions.

John Conner

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Anthem Group Health Insurance Plans and Rates in California

Anthem Blue Cross of California Small Group health insurance plans for 2 to 100 employees offers a tremendous amount of plan, rate and benefit options for 2017.

You can offer 1 plan or several to your employees.  Each employee can choose from a portfolio which you decide on.  PPO’s, HMO’s, HSA’s (Health Savings Accounts), etc.

  • If you wish to switch companies, a plan change, need help with administration, such as COBRA, adding or removing employees or dependents, finding a lower premium plan.  Please call or email anytime for help.
  • Print the Census form for a Company Quote.

Switching plans within the same company is typically done during your anniversary policy date.  A request to change plans, within the same company, outside of your anniversary month, will need to be approved before the change is available or not.

Changing companies can be done throughout the year, simply by submitting the appropriate forms and application to the new health insurance company.

Provider Network …

Our access to providers that employees can find easily online or through our mobile app. They can even get directions. And if they live, work or play across the country, or abroad, they’ll have access to doctors and hospitals through one single electronic network: BlueCard.

The BlueCard program lets them use providers almost everywhere in the U.S. (in urban and rural areas alike).

  • 92% of doctors in the U.S.
  • 96% of hospitals in the U.S.
  • 87% of doctors in California.
  • 89% of hospitals in California.

Now you have even more ways to save with new pharmacy benefits Did you know that employees use their pharmacy benefit more frequently than any other health benefit? And, that the average person fills 12 prescriptions per year and only goes to the doctor three times a year?2 Because pharmacy costs make up about 20% of employer health care costs, we created the following benefits to help you save on your health care premiums. Take a look:

Employees have quick access to care with LiveHealth Online

All it takes is an internet connection – When using LiveHealth Online, your employees can have face-to-face video visits with board-certified doctors (in English and Spanish) or licensed psychologists and therapists right from their computer or mobile device. In just minutes, they can connect to a doctor to address common health issues. And psychologists and therapists are available by appointment in four days or less.

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LifeHealth …

Benefits when seeing a doctor using LiveHealth Online

  • No appointments
  • Easy to use
  • Board-certified doctors
  • Available for nonmembers
  • Doctors diagnose health issues and may prescribe medicine

Cost effective: $49 or less per visit depending on the health plan Benefits when seeing a psychologist or therapist using LiveHealth Online

  • Appointments available in four days or less
  • Easy to use
  • Licensed psychologists and therapists
  • Cost effective: cost is similar to an office therapy visit

Members must be at least 10 years old to see a therapist online. Psychologists and therapists using LiveHealth Online do not prescribe medications.

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Anthem Small Group Health Plans …

Here’s a brief explanation of the types of health plans we offer.

PPO … A preferred provider organization allows members to see providers in network or out of network.

HMO … A health maintenance organization only covers services from providers in the HMO plan network. Members must choose a PCP in the network. If a specialist is needed, the PCP provides a referral.

CDHP … Consumer-driven health plans feature higher deductibles than traditional insurance plans. They can be paired with a health savings account allowing members to pay for qualified out-of-pocket medical expenses.

PPO A preferred provider organization allows members to see providers in network or out of network. Members pay substantially less out of pocket when they use a provider in the PPO network. There’s no need to get a referral to see a specialist.

HMO A health maintenance organization only covers services from providers in the HMO plan network. Members must choose a PCP in the network. If a specialist is needed, the PCP provides a referral.

CDHP health plans feature higher deductibles than traditional insurance plans. They can be paired with a allowing members to pay for qualified out-of-pocket medical expenses.  HSA Health savings account is a member-owned savings account that you and your employees can fund with pretax dollars to help pay for qualified health care expenses, including prescriptions.

Let’s get technical with pharmacy

It’s easy to fill prescriptions, check copays or coinsurance and more by going to anthem.com/ca or downloading our mobile app. We are closing the gap between giving members information and getting them to act on it.

For all your health care needs, Anthem Small Group is your one solution: Anthem Whole Health ConnectionSM. See how our medical, dental, vision, life and disability plans work together for your employees’ health and your bottom line.

We believe health care should serve the whole person — head to toe — at each stage of life. It should also be easy to administer, so you don’t get bogged down in paperwork. That’s the Anthem Whole Health Connection. Through electronic health records, we get claims and clinical data from network dentists, eye doctors, primary care physicians and care coordinators, which allows us to create more complete health profiles for our members.

Print Census for Small Group Quote.

Individual & Family Plans:

Everyone in the U.S. is eligible for an individual and family health insurance policy of their choice regardless of health status.

Question?  Call or email anytime.

John Conner

Information Request:

California Group Health Insurance Rates for 2017

skylineCalifornia Group Health Insurance rates for companies with two or more employees looking for more plans to choose from, a different company to compare and larger or different network of doctors and hospitals.

Anthem  –  Aetna  –  Blue Shield  –  Kaiser.

Group Health Coverage for every size of small business 2017 packages for small business, 1-100 employees

Most companies are entering their annual open enrollment and are experiencing significant group health rate increases and wish to see what other companies have to offer to keep premiums in control.

For a group health quote and comparison call or, print the Census and fax it to 916-258-0296.  I’ll be happy to forward the quote information.

PPO and HMO plan options with the different metallic benefit levels. Platinum, Gold, Silver and Bronze, all offering a different level of coverage and price point.

Solutions that grow right along with you…

No matter what size business, we offer a full range of health insurance options for small group employers that provide affordability for you and flexibility for your employees. Enter your company size to learn more about Anthem Blue Cross’s coverage options. We’ll match your business needs with high-quality plans that are comprehensive and budget minded.

PPO network options:
  • Statewide PPO (Prudent Buyer): This network provides access to nearly 60,000 California doctors and specialists, and more than 330 hospitals.
  • Select PPO: This network gives access to more than 40,000 California doctors and specialists, and more than 300 hospitals.
HMO Health maintenance organization network options:
  • Traditional HMO Network (CaliforniaCare): This network provides access to more than 40,000 California doctors and specialists, and more than 330 hospitals.
  • SELECT HMO Network: This network offers access to more than 23,000 California doctors and specialists, and nearly 250 hospitals.
  • Priority SELECT HMO Network: This network offers access to more than 7,500 California doctors and specialists, and more than 150 hospitals.
Group Health Participation Requirements:

Typically you must have 65% of the total number of eligible employees enrolled in a Blue Shield healthcare plan(s). If an employee has “group” coverage through a spouse, they do not count towards the participation requirements.

Pediatric vision & dental coverage is included with all Small Group medical plans.

To comply with the ACA, every plan must include the following 10 essential benefits:

  • Preventive, wellness and chronic disease management services
  • Outpatient (ambulatory) care
  • Emergency services, including emergency room or urgent care
  • Inpatient care (hospital stays)
  • Laboratory services
  • Prescription drugs
  • Mental health and substance abuse services
  • Maternity (pregnancy) and newborn care
  • Pediatric services, including dental and vision care*
  • Rehabilitative and habilitative services and devices (habilitative services help people learn, keep or improve skills that they may not be developing normally) These are just the basics. Many of our new plans also cover family dental care and much more.
Dental Coverage … 


Our dental plans give employers the best of all possible worlds. With access to one of the largest dental networks in the nation, we offer more providers and deep discounts, along with ways to customize our plans for total flexibility. And the administrative simplicity of having one carrier for medical and dental means you spend less time managing your benefits.

We’ve designed our dental plans to provide the right mix of choices and value that can lead to a healthier bottom line, in more ways than one.

Vision Coverage … 


From network to pricing to service, our vision plan leads the industry. We have the largest vision network in the country, including convenient retail locations with extended hours. Simplified administration, from enrollment through claims processing, takes the hassle out of managing your benefits.

And our connected vision and health coverage leads to early detection, prevention and management of chronic conditions so we can help keep your employees healthy and productive.

Better for you … Better for your employees.

With medical, dental, vision, life and disability benefits for your business has the convenience of combined enrollment and implementation plus one bill for all plans. Your employees will appreciate having only one ID card for their benefits plus one web site to check details about their coverage and claims.

Request a Group Health Quote – Print the Census Form

Questions?  Call or email anytime.

John Conner

Information Request:

Medicare and Health Insurance typically provides NO Coverage Outside the U.S.

Are you or someone you know traveling outside the U.S. on a vacation, cruise, study or work?

As we all know, Medicare provides no coverage while traveling or living outside the U.S., and our individual and group health insurance plans typically provide NO Coverage as well while abroad.

So what do individuals, families, students and employees do to make sure they are properly covered while, vacationing, working, traveling, studying or living outside the U.S.?

Cross your fingers and hope nothing happens?

Either, do nothing, cross your fingers and hope nothing serious happens, or, enroll in a short or long-term Travel Insurance plan offering comprehensive medical coverage for hospital, outpatient, Rx, office visits and emergency evacuation anywhere in the world.

During an emergency or crisis situation, who do you call?  Will your health insurance company help you find the best available hospital near you, will they provide a translator, or pay the hospital direct so you don’t have to?  Will they answer the phone on a weekend or holiday?  Not a chance.  In other words, you are left stranded and left to work it out yourself?

Emergency Medical Evacuation

Car accident, heart attack, slip and fall, stroke … there are so many situations that need an emergency medical evacuation.  If an emergency strikes and you do not have adequate medical services near you, a Travel Insurance policy will provide emergency air transport to the nearest hospital that can properly care for your condition. Transport can take you nearby, to another country or even back to your home for care.  Health Insurance and Medicare do NOT provide Emergency Medical Evacuation coverage.

If you are on a cruise and you experience an emergency which cannot be properly cared for on the ship, you will be off loaded at the next port, either an island or country. At this point it is your responsibility to care for yourself, coordinate care and find medical services on the island or the country you are now in.  In most cases the ship will notify the port town or province and request an ambulance.  Once transferred to the ambulance for transportation, you will need to make the remaining decision for your care.

If you location does not provide adequate care you may need to pay for your own Emergency Evacuation and transportation.  Costs can easily exceed $50,000 to $100,000, depending on the severity of your illness or injury, where you are located and if medical personnel must accompany you on the flight.

Remember these are privately chartered helicopters and jets specifically designed for medical transport.  In most cases commercial airlines do not allow someone to fly with critical conditions.

Types of Travel Insurance Plans

A few days or several years, a Travel Medical Insurance policy provides comprehensive medical coverage, access to a global network of doctors, specialists and hospitals, emergency medical evacuation coverage and a crisis management team available 24/7 to help you in your time of need.

Travel Insurance PLAN TYPES ..

Don’t be stranded during an emergency while in a far away country.


John Conner

Information Request:

2017 Anthem Health Insurance

Anthem Blue Cross Medicare Supplement2017 Anthem health plans and rates for Individuals, Families and children.

All plans are guaranteed-issue basis, regardless of your current or past health status, as long as you enroll during an open-enrollment period.

2 Ways to Enroll …

Enroll “On or Off” the Covered California Exchange .. Enrolling Inside the Covered California Exchange is typically for the individual or family who qualify for a subsidy due to their income (see the chart below).  Individuals and families who do not qualify for a state subsidy, will usually enroll outside of Covered California (the plans are the same) although the application process is much quicker because you don’t have to state your income totals.

Anthem of California offers 4 levels of coverage both inside Covered California and out.  The plans are categorized into four metal levels of coverage based on the percentage of costs covered for an average population:

  • Platinum:  You pay 10% of health costs, Anthem plan covers 90%
  • Gold:  You pay 20% of health costs, Anthem plan covers 80%
  • Silver:  You pay 30% of health costs, Anthem plan covers 70%
  • Bronze:  you pay 40% of health costs, Anthem plan covers 60%

All plans will offer the “essential health benefits” such as; doctor visits, hospital care, prescription coverage and maternity care, and will include certain preventive care for no charge.

What is a Health Insurance Marketplace?  It’s a website that is set up to allow the government to regulate health insurance plans.  People can buy health insurance from the marketplace (Covered California) with government aid called subsidies.  All Health Insurance Marketplaces like Covered California must be fully certified and running by January 1, 2015, by federal law.  Also known as an “Exchange.”

Do I have to buy from the Health Insurance Marketplace Covered California Exchange?  You can choose to buy insurance from an insurer like Anthem from the state Insurance Marketplace (Covered California).  If you are eligible to get a subsidy and want to use one, you must buy your plan from a Health Insurance Marketplace like Covered California.

What are my Health Care Reform plan choices in 2017?  Under the new health care law, all new plans fit in one of four levels: bronze, silver, gold or platinum.  These levels make it easier to compare costs and benefits so you can choose the right plan for your needs.

Questions or more information.

John Conner

Quote & Information Request:

Group Health Employer Mandate (50 plus employees)

aca logo January 1, 2016 ObamaCare’s “employer mandate” is a requirement that all businesses with 50 or more full-time equivalent employees (FTA) provide health insurance to at least 95% of their full-time employees and dependents up to age 26, or pay a fee.

Is your company part of the “Employer Mandate” … To be subject to the Employer Shared Responsibility provisions for a calendar year, an employer must have employed during the previous calendar year at least 50 full-time employees or a combination of full-time and part-time employees that equals at least 50.  For example, an employer that employs 40 full-time employees (that is, employees employed 30 or more hours per week on average) and 20 employees employed 15 hours per week on average has the equivalent of 50 full-time employees, and would be an applicable large employer.

What’s the fine … If an employer owes the fee because they didn’t cover workers, it’s a flat $2,000 per full-time employee, excluding the first 30 employees.  If only a few end up with unaffordable coverage or if that coverage doesn’t meet minimum value standards, it’s $3,000 per full-time employee who received premium assistance through an exchange.  The fee is always per month, so it’s always 1/12 of those annual totals for each month.

Are all full-time employees counted, even if they are eligible for Medicare or covered under their spouses group health plan … Yes.

Are Companies with employees working outside the U.S. subject to the Employer Shared Responsibility provisions?  For purposes of determining whether an employer is an applicable large employer, an employer generally takes into account only work performed in the United States.  For example, if an employer has employees who are permanently living and working outside the U.S., they would not be counted towards the Employer Shared Responsibility.

Advice for Employees with Unaffordable Options .. If employer-sponsored coverage is unaffordable (costs more than 9.5% of employee-only income) or doesn’t provide minimum value, you may be eligible for marketplace subsides. If employer-sponsored health insurance (for self-only coverage for you or a family member) costs more than 8% of your household Modified Adjusted Gross Income, you may be exempt from the fee as well. You are not required to take the coverage that your employer offers.

  • The employer mandate is based on full-time equivalent employees, not just full-time employees.
  • Employers have to offer coverage to 95% of their full-time employees.
  • Coverage must be offered to dependents up to age 26.
  • Spouses do not count as dependents; coverage does not have to be offered to spouses.
  • Coverage to employees must be considered affordable and can’t cost more than 9.5% of employee household income.
  • Employers who don’t provide coverage the fee is; $2,000 per full-time employee or $3,000 per full-time employee who is receiving a subsidy through an exchange.
  • Employers must offer at least a 30 day “Special Enrollment Period” for employees or qualifying employee family members losing coverage from another source.

The employer mandate is starting for all employers with more than 50 full-time employees on January 1, 2016.  Employers that employ fewer than 50 full-time employees (including full-time equivalents) in their businesses are not subject to the Employer Shared Responsibility provisions. The vast majority of businesses fall below this threshold.

What the Employer Reports to the IRS … All large group employers (ALE – Applicable Large Employer) must file a “Form 1095-C. Employer Provided Health Insurance Offer and Coverage, and Form 1094-C, the transmittal form. The ALE must also furnish a similar statement to each of its full-time employees.

Be sure you have all the appropriate info before January 1.  Some groups may be able to keep their current plan for the 2016 plan year.  If you have questions or would like more information, please contact me anytime.

John Conner

Information Request:


Health Insurance

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Individual & Family Health insurance …

Open-Enrollment Starts November 1.

Everyone in the U.S. is eligible for an individual and family health insurance policy of their choice regardless of health status.

Enroll Today … Choose one of the companies; Anthem and Blue Shield.  Find the plan of your choice and simply enroll online.  It as simple as that!  Your new ID and policy will be mailed within a couple weeks and you can start using your policy right away.

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Group Health ..

No matter what size business, we offer a full range of health insurance options for small group employers that provide affordability for you and flexibility for your employees.  Learn about our coverage options, we’ll match your business needs with high quality plans that are comprehensive and budget minded.

Anthem   –   Blue Shield   –   Kaiser

Your employees will also appreciate the personalized programs that help manage and coordinate care for more than 40 chronic conditions. 360° Health can help your employees at all stages of their lives, and wherever they are along the health spectrum.

Call for a custom group health quote today … 916-682-1117

No Broker Fees … My advice and services are free of charge, and the premium you pay should you buy a policy through us will never be higher than going direct to the insurer.

John Conner

Quote and Information Request: