Depending on the average age of your group, rating factor, and renewal cycle, it may be financially beneficial to change your renewal date.  This particularly applies if you have a January 1, 2014 effective date. Most of the carriers have agreed to an early renewal and have become flexible with the date changes but they all have very specific rules. 

Kaiser's deadline is almost upon us, so if you are considering changing your renewal date, we need to submit the change request before the end of August.

We are contacting all of our groups personally to discuss this option. Your team at Benefits Done Right is working quickly however, as always, we welcome your calls and questions.

A new California law, effective January 1, 2014, prohibits insured plans from imposing waiting periods in excess of 60 days on covered employees and their dependents. Note that this provision is narrower than the federal requirement prohibiting waiting periods in excess of 90 days.

The California law was originally thought to apply only to small, non-grandfathered plans; however, recent guidance has clarified that all insured plans (regardless of size or grandfathered status) are subject to this provision. The law means an insured plan in California cannot have more than a 60-day waiting period; the first of the month following 60 days will not work. It is unclear whether it can be phased in with plan year renewals or will require an across-the-board change on January 1, 2014.

Who Does the Law Apply To?

The law is written to apply to any insured plan that provides benefits to residents in California regardless of the status of the contract or the policyholder. It is important to note that if an employer has an insured plan written outside of California that covers California employees, the plan may not be able to impose a waiting period over 60 days.

The law does not apply to self-insured plans; however, self-insured plans remain subject to the federal prohibition on waiting periods in excess of 90 days beginning with plan years in 2014. The law also does not apply to dental or vision coverage when provided under a separate insurance contract; however, plans may prefer to align waiting periods for administrative ease.

Has your primary care doctor directed you to your pharmacy to obtain vaccinations ?

Be sure to check with your insurance carrier requirements prior to obtaining vaccinations at your local pharmacy. Many insurance carriers require that members be referred to another doctor or obtain a pre-authorization before obtaining vaccinations from their pharmacy or other medical professional.