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Over the last five years employers has been faced with the dilemma of double-digit rate increases on health plans. Until now, the choices have been limited to:
- Reducing your benefits so the premium reduces
- Passing the extra cost to employees in the form of their payroll deductions
- Eliminate the health plan completely
Well, none of these choices are acceptable...
So, take on the risk and responsibility of providing your benefits in a new way, which helps control cost but maintains great benefits.
Get a High Deductible Health Plan (HDHP) from an insurance carrier. California Department of Insurance mandates that all Insurance Companies must allow "Wraps," unless they file actuarial proof otherwise. (12/15/2010 Notice) Ben-e-lect will provide the benefits for you under the HDHP so that your plan works the way you want with the benefits you need. By wrapping around the HDHP.
This will maintain or improve your benefits while at the same time getting cost under control. .
While the plan works pretty much the way all plans do, there are a couple procedures to follow to assure that your benefits are paid correctly. Steve Shorr Insurance or a Ben-e-lect representative will review these with you.
Ben-e-lect has been helping employers and employees get the most from their premium dollar since 1996. If you have any questions about your benefits, how a claim was paid, PPO network, or just a "what if" then give Ben-e-lect a call. We will steer you to the right member of our staff to help.
Why it works!
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| Get Started with a Proposal for a High Deductible Plan
We will then fill in with a Ben E Lect Self Funded Proposal to give you the benefits that your Employees WANT.
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Consumer Links
                
NOTICE - DOI Letter on Self Funded Plans (Wraps)
To: All Health Insurers Selling Insurance to Small Employers in California
Date: December 15, 2010
On October 1, 2008, the General Counsel of the California Department of Insurance issued a legal opinion letter (“Letter”) stating that insurers may prohibit small employers from “wrapping” a Health Reimbursement Account or other employer deductible payment mechanism with a high-deductible insurance policy. The Letter also permits insurers to charge more for policies that allow wrapping. The Letter interprets and applies the Small Employer Insurance chapter of the Insurance Code, Ins. Code §§ 10700-10718.7 (“Act”).
The Letter states that if an insurer seeks to prohibit wrapping, the insurer must set forth that restriction in the benefit plan design (“BPD”). Insurers must file all BPDs with the Department. Ins. Code § 10717.
The purpose of this Notice is to alert all health insurers selling insurance to small employers in California to the following:
1. The Department will undertake enforcement action against any insurer that prohibits wrapping and does not have on file with the Department a BPD setting forth a restriction on wrapping. Ins. Code § 10718, 10718.5, 10717(e) & 10700(v).
2. Insurers that prohibit wrapping should provide actuarial documentation to the Department establishing by clear evidence that wrapping materially and significantly increases utilization of medical services by employees of small employers.
3. Insurers that permit wrapping but charge more for policies that may be wrapped should provide actuarial documentation to the Department establishing by clear evidence (a) the extent of increased utilization of medical services by employees of small employers that wrap and (b) that the increased premium accurately reflects the extent of increased utilization.
4. The Department will review all actuarial documentation. If the Department concludes that documentation does not establish by clear evidence the facts described in Nos. 2 and 3 above, the Department will notify the insurer that the BPD may not be sold with restrictions on wrapping or based on higher pricing for wrapping. Ins. Code § 10717(e); id. § 10700(v); id. § 10700(b).
Adam M. Cole
General Counsel
(scharnweber.blog.com)
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