There has been a change that affects how long a newborn can stay covered under the parent’s group insurance. In the past, a newborn was covered for the first 30 days but only until the end of the month. So, a baby born on the 28th is covered for only 2-3 days, until the 30th or 31st of that month.

Effective 1/1/2010, newborns will be covered for the first 30 days, without the end of the month rule. So, a baby born on January 28th will remain covered until February 28th.

Coverage will be free the first 30 days, but if they enroll the baby with Kaiser, coverage will be backdated to the first of the month. This means they’ll pay for the coverage- just like they would have done before the rule changed. This helps improve KP sales, but also lifts the pressure off of parents from having to make a snap decision, which is often the case when the baby is born at the end of the month.

Tip: When enrolling in a California group health insurance plan due to a pregnancy, especially for your first child, call 1-877-752-4737 after the baby is born. Then, we can look into enrolling the child under the cheaper IFP plan. If you have other children, then, keeping all the kids on the group plan tends to be more cost-effective because there are no extra charges for additional children.

Posted: January 19th, 2010 under California Group.
Comments: none

When a group is renewing their California Business Health Insurance, often the group will need to be recertified. In this case, Kaiser Permanente will send the business a letter that asks for four documents.  The letter is generic, so the documents requested may not all apply to that particular group. Some groups have been confused by this.  Hopefully the following information will be helpful for such groups.

Below are the forms Kaiser Permanente will ask for:
1. DE6 or Payroll
2. Business License
3. Employers’ Confirmation of Workers’ Compensation Form
4. Proprietor Form

Not all of these documents apply to every group. For example, a group without employees does not need to provide a DE6. Kaiser Permanente will always require two of the forms:
1. The Proprietor Form needs to have current signatures.
2. The Employers’ Confirmation of Workers’ Compensation Form must always be submitted. If Workers’ Compensation is not required for that business, then the form just needs to be marked ‘exempt’.

Posted: June 9th, 2009 under California Group.
Comments: none

When changing from one group deductible plan to another group deductible plan, customers often ask, “Will the money I’ve paid out toward my deductible be carried over to my new plan?” The answer to this question depends on whether or not you are switching between like plans or not. If you are switching from an HSA Deductible Plan to another HSA Deductible Plan, then yes, your payments toward the deductible will carry over. The same applies if you are switching from on Regular (non-HSA) Deductible Plan to another Regular Deductible Plan. If you are switching from an HSA to a Regular Deductible Plan or visa versa, then there is no carry over.  

Here are a couple examples:

Example A:  ABC Group has an anniversary date of 7/1/09.They are switching from the $0/1500 HSA to the $0/2700 HSA. Member, John Smith, already spent $500 before the 7/1/09 anniversary. In this case:
A. The $500 John spent will carry over to the 7/1/09 renewal because the plan ‘category’ is the same.  (HSA to HSA.)
B. Come January 2010, the group’s deductible will reset to 0. 

Example B: Same scenario as above, except the group is switching from the $0/1500 HSA to the $30/1500 Deductible Plan. In this case:
A. The $500 John spent will not carry over- because the group switched to a different category.
B. Come January, the group’s deductible will reset again.

In both scenarios, the deductible will reset in January.

Posted: June 8th, 2009 under California Group.
Comments: none

When a Kaiser Permanente California group wants to add dental at open enrollment, there are several things to be aware of. First, you will need to wait approximately five weeks before new members can use the dental plan. Also, it takes about 2 months before the invoice will reflect the additional premium. If there’s an emergency, the dentist will need to file a claim, and the member will need to pay the dentist. The dentist can later reimburse the member. Be aware that there are no “Temporary Membership ID’s” for group dental like there are for group medical. 

When applying for group health insurance in California, social security numbers are not required unless you are adding dental to the group medical plan. However, if a small business enrolls in a dental plan, Delta Dental requires social security numbers to verify membership.

Posted: April 28th, 2009 under California Group.
Comments: none

Customer Questions:

I have an existing Kaiser health insurance 30/1000 Deductible Plan at work. I just want to add a maternity coverage on my existing policy, would that be possible? How long is the waiting period before the maternity coverage takes effect? I want to see different plans for this. I want the good maternity coverage with low monthly premium and deductible. What will happen to my coverage if in case the company will close down, can I still pay for the same premium?

Answer:

You may not need to change plans. The $30/$1,000 Deductible Plan includes coverage for maternity. Also, with small group plans there is no waiting period for maternity or any other benefits. Regarding changing plans, you can do that each year at open enrollment. Contact your companies HR person for details regarding open enrollment and the plans your company is offering.

If your insurance is lost because the business closes before you deliver the baby, it would be a good idea to consider Kaiser’s conversion plan. 

Posted: April 16th, 2009 under California Group.
Comments: none

Customer Questions:

I have an existing Kaiser health insurance 30/1000 Deductible Plan at work. I just want to add a maternity coverage on my existing policy, would that be possible? How long is the waiting period before the maternity coverage takes effect? I want to see different plans for this. I want the good maternity coverage with low monthly premium and deductible. What will happen to my coverage if in case the company will close down, can I still pay for the same premium?

Answer:

You may not need to change plans. The $30/$1,000 Deductible Plan includes coverage for maternity. Also, with small group plans there is no waiting period for maternity or any other benefits. Regarding changing plans, you can do that each year at open enrollment. Contact your companies HR person for details regarding open enrollment and the plans your company is offering.

If your insurance is lost because the business closes before you deliver the baby, it would be a good idea to consider Kaiser’s conversion plan. 

Posted: April 16th, 2009 under California Group.
Comments: none

Kaiser Permanente no longer does retro changes for small business plans.  Formerly, Kaiser would backdate plan changes up to 2 months back. Now, they will only go back to the first of the current month. For example, if on 3/2/09 a group asks to backdate a plan change, we can only go back to 3/1/09.  Basically, Kaiser Permanente will need to receive the request by the end of the month in order to backdate a change to the 1^st of that month.

Posted: April 14th, 2009 under California Group.
Comments: none

We recently suggested group health insurance coverage for an applicant who was waiting on her status on a private insurance application from underwriting. Her status was not yet available and she needed to get coverage in place quickly. In January of 2009, Kaiser received a high volume of applications and the process has been taking longer than anticipated.  We anticipate processing times on individual and family applications to improve in the near future, but in the meantime group coverage may be the best option for some. There are a couple advantages to small business medical insurance.   

1. You can get coverage in place more quickly

Recently, underwriting has been taking six to eight weeks to process private health insurance applications. Group medical applications are processed more quickly. Small businesses and self-employed individuals can often get coverage in place in a week or less. 

2. Pre-existing Conditions are OK

The small group medical insurance forms do not include any medical questions. Preexisting health conditions that would be cause for automatic denial on a private health insurance application are not a problem when applying for a small business plan. To qualify for group medical benefits, you simply need two people on the plan. Husband-wife businesses are OK if spouses file taxes jointly. We have even qualified one person groups in some cases. In one instance, one spouse was on medicare and the other was too young. Since medicare is counted as group coverage, we were able to qualify them. The younger spouse we put on the Kaiser group plan and the older spouse signed the declination of coverage saying that he had group insurance through medicare.

Posted: February 3rd, 2009 under California Group.
Comments: none

Kaiser Permanente offers nine dental health insurance plans through Delta Dental. Small businesses who enroll in a Kaiser group health insurance plan may add dental coverage. The two DeltaCare plans, the DeltaCare 10A and the DeltaCare 13B, tend to be the most popular. These plans offer the lowest monthly premiums, two free teeth cleanings a year, orthodontic coverage and more. Members enrolled on these plans have a smaller pool of dentists to choose from, but many employers and employees feel the lower monthly premiums more than makes up for the limited selection.

There are six rate areas for the Delta Dental Plans. Northern California rate areas include North Valley and the Bay Area. Southern California rate areas include Coachella Valley, Kern County, San Diego and Southern California. The Southern California rate area includes Los Angeles County, Orange County, Riverside County (excluding Coachella Valley), San Bernardino County and Ventura County.

The group DeltaCare plans are broken up into two rate areas: Northern California and Southern California.

Posted: December 15th, 2008 under California Group.
Comments: none

Durable Medical Equipment: All small group health insurance plans from Kaiser California cover base equipment like canes, crutches, and wheelchairs. However, only the $5, $15, and $20 Copayment Plans cover formulary equipment like C-Pap machines and other breathing apparatus.   

Prosthetic and Orthotic Devices: By law, all California small business medical plans cover prosthetic and orthotic devices. 

Note: For more information click here: http://kaiserquotes.com/california-health-insurance/group.php

Posted: December 9th, 2008 under California Group.
Comments: none