Anthem Blue Cross of California
Anthem Blue Cross of California is a popular option for small employers. Blue Cross of California is a for-profit company and the largest subsidiary of Anthem, Inc. which is a publicly traded corporation that is headquartered in Indianapolis, Indiana. Anthem, the parent company, operates in 14 different states and is the second largest health insurance company in the United States.
The most recent data available shows that Anthem Blue Cross provides medical insurance to about 17 percent of small businesses in California (Source, see page 22 of the California Health Care Almanac: California Health Insurers: Staying the Course, by the California Health Care Foundation.)
Strengths
Large Provider Networks: Anthem’s largest PPO network for small group employers (called the “Prudent Buyer PPO” network) includes most of the doctors and hospitals in California and it is a favorite among many business owners and others who desire the greatest freedom to see a specific doctor. Anthem also offers a full/large network HMO plan (called the “California Care HMO” network) that can be offered alongside their smaller/narrow “Select” network HMO plans.
Flexible with Start-Ups: Anthem also seems to be very flexible when qualifying new, start-up companies by requiring only two weeks of payroll records with the understanding that the group will submit four additional weeks of payroll records after the coverage is in force. Many other insurance companies require months of payroll records or follow the state guidelines that require an employer to have “one non-owner W-2 employee for fifty percent of the preceding quarter.” (See California Insurance Code Section 10753(q)(1)(A)) Anthem’s flexibility allows start-ups who have recently hired at least one W2 employee who works a minimum of 30 hours per week to offer coverage right away.
Low Participation Requirements: Anthem recently reduced their underwriting requirements so that employer groups with five or more enrolling employees only need 30 percent of the eligible employees to enroll. Most insurance companies require a minimum of 70 of the eligible employees to enroll. Anthem’s underwriting flexibility means that your company may qualify with Anthem where they may not qualify with other companies. An added plus for Anthem is that they consider individual coverage to be a valid waiver. This is probably more detail that you need, but the result is that Anthem is very lenient when determining who must enroll in your group’s plan. Give us a call and we can help you out 800-746-0045.
Challenges
Anthem has full and narrow (Select) network HMO and PPO plans, however, a small group employer can only offer one PPO network – full (Prudent Buyer) OR narrow (Select), not both. An employer can offer both HMO networks to employees.
Also, Anthem doesn’t offer a Bronze level HMO plan so you’ll need to find a Bronze PPO if you want to offer a bare bones plan.
Anthem Blue Cross of California Small Business Health Insurance FAQ
How many employees do you need for Anthem Blue Cross of California small business health insurance?
A company with at least one non-owner, W-2 employee, but not more than 100 employees qualifies for small business medical insurance with Anthem Blue Cross of California. There must be “a bone fide employer-employer relationship” which means that an owner who works in the company and / or the spouse of an owner doesn’t qualify as the employee. An owner who works 30 hours per week on average can enroll in the small group medical insurance plan but the business must employ at least one non-owner employee to qualify for coverage. The non-owner employee doesn’t have to enroll in his or her company’s plan, which means that the employee can “waive” coverage, and the owner can enroll. Give us a call at BenefitsCafe.com to learn more (800)746-0045.
How do small businesses set up Anthem Blue Cross of California?
To apply for an Anthem Blue Cross of California medical insurance plan, a small employer with 1 – 100 employees must complete an Anthem employer application and the employees must complete employee applications. On the employer application a small business will:
- select the plans the company wants to offer;
- identify the amount the employer will contribute towards employee medical insurance (50% is the minimum contribution); and,
- specify the number of full-time employees who are eligible for the business health plan.
The easiest way to set up Anthem Blue Cross California small business health insurance for your employees is to call the helpful staff at BenefitsCafe.com (800)746-0045. We can help you and your employees enroll. Most importantly, we assist you throughout the life of your coverage. For example, if an employee enrolls in the Prudent Buyer PPO plan, we can help them check if their doctors are part of the Prudent Buyer PPO network. If there are any questions or problems, we’re here to help. Just give us a call. Or, you can contact Anthem directly. The rates and benefits are identical whether you work with a broker / agent like Benefits Cafe, or if you enroll directly with the insurance company.
How do I know which Anthem Blue Cross California small business medical insurance is best for my business and employees?
Everyone wants the best benefits at the lowest cost however, just like with cars, the more you pay, the more you get. Also, like cars, a Lamborghini may be a “better” car but a Volkswagen may fit better. The type of medical insurance plan that is “best” for your business and employees depends on a few factors:
- The nature of your employees You may want to ask yourself: are your employees highly skilled and highly paid and expect great benefits and can get great benefits from your competitors, or, are they formerly independent contractors or low-wage employees and just happy to have coverage? You should match the benefits you offer with the needs and expectations of your employees.
- The budget of your company, if you have high margins, you can likely pay more. Employees evaluate working for your company based on wages and the entire benefits package. If you have skimpy or no medical insurance benefits, expect your employees and prospective employees to know this. California penalizes people who don’t have medical insurance, so this is an important budget item for your employees. Figure that if you offer group medical insurance to your employees that you can pay less in wages. Employer-sponsored medical insurance is highly tax-favored, so it may be wise to offer benefits and reduce wages a bit.
- Deep knowledge of small group plans, benefits, provider networks and other factors There are nearly 400 different medical insurance plans offered to small businesses in California. Platinum, Gold, Silver, Bronze level plans. Full, medium, and small provider network plans. HMO, PPO, EPO plans. Seven state-wide insurance companies, a few regional insurance companies and two exchanges, or bundlers of group medical insurance. If you don’t know the difference between, Vivity, Prudent Buyer, California Care, Select and Priority Select then you should use a knowledgeable broker/agent. (Hint: these are names of provider networks, and some have huge numbers of doctors and hospitals, others have very few.) Admittedly, we’re biased, but we think that BenefitsCafe.com is the best at helping you select your plans, setting everything up and supporting you and your employees and their families throughout the life of your plan. You pay the exact same rate for small group medical insurance if you go direct with an insurance company, through a payroll company or with the high-touch, concierge service of Benefits Cafe. Give us a call at 800-746-0045.
Can an insurance broker advise me on Anthem Blue Cross of California for my business?
Yes, Anthem Blue Cross pays independent, licensed agents to represent them to small businesses. We’re really agents rather than brokers, because we don’t charge a broker fee. Anthem Blue Cross appoints those who must be licensed by the State of California and have Errors and Omissions insurance. That’s the minimum. You want to find an agent that is an expert in the minute details of California small business medical insurance. Some agents try to cover the entire United States; some sell other types of insurance (e.g., property and casualty); some are experts in payroll but not California small business medical insurance. Since you want advice and it doesn’t cost anything extra for accurate, experienced advice, you should select an agent who specializes in this field. Benefits Cafe does. Our number is 800-746-0045.
What is Anthem Blue Cross of California for small businesses PPO plans?
Small businesses medical insurance plans cover companies with 1-100 employees in California. PPO plans enable employees and their dependent family members to select the doctor when they need medical services. This is different from HMO plans where members select their primary care doctor when they enroll in the plan. Call us to compare Anthem’s Prudent Buyer PPO vs Select PPO.
Will Anthem Blue Cross of California save my business health insurance money?
If you offer medical insurance to your employees, then Anthem may be a lower cost option, particularly if you want a very low cost HMO plan, such as Vivity by Anthem Blue Cross. Anthem also offers very competitively priced PPO plans which are frequently less expensive than comparable plans by United Health Care (UHC) and Blue Shield of California. Contact BenefitsCafe.com and we can prepare a proposal for you and compare your current benefits with those from Anthem Blue Cross.
If you don’t offer benefits but are considering offering coverage to your employees, you should know that there are significant tax savings to offering group medical insurance, compared to paying higher wages. Federal law requires employers to pay FICA payroll taxes for Medicare (1.45%) and Social Security (6.2%) (total 7.65%) on wages paid to W-2 Employees. Additionally, every dollar paid to an employee as a wage is included in the calculation for worker’s compensation premium (likely 3% for service businesses and much higher for more hazardous occupations.) This results in a tax penalty to the employer of over 10% when paying a salary bonus. In contrast, employer and employee paid group health insurance is fully tax deductible as a business expense and not subject to FICA taxes or worker’s comp premium.
Also, employees must pay income taxes and payroll taxes on wages vs. receiving non-taxable group health insurance benefits. This is a huge tax penalty. As an example, in 2021 the marginal Federal income tax ratefor a single employee with $100,000 of taxable income is 24%. The marginal California income tax rate is 9.3%. Accordingly, when this employee receives salary, he/she must deduct 7.65% for FICA taxes, 24% for Federal income taxes, and 9.3% for California state income taxes, totaling 40.95%. This results in a tax penalty on paying salary of approximately 45% compared the to cost of paying for an employee’s medical insurance. If an employer pays $100 towards an employee’s medical insurance, it reduces the cost of medical insurance by $100, with no tax consequence. That’s a major reason employers offer medical insurance to employees.
(800) 746-0045
