Anthem Blue Cross provides complete health plans for small groups in California. Employers must comprehend the underwriting guidelines and submission criteria to ensure a hassle-free enrollment process and maximum employee coverage.

At Skyline Benefit, we are a 5-star Broker specializing in small business insurance in California. We understand that selecting the best health insurance plans can be overwhelming. Therefore, our mission is to simplify the process and assist our clients every step of the way. Today, we delve into Anthem Blue Cross underwriting guidelines to facilitate a seamless enrollment process and ensure maximum coverage for your employees.

What are the group eligibility requirements for Anthem Blue Cross small group plans?

Anthem Blue Cross defines a small employer as one employing an average of at least one but no more than 100 full-time (including full-time-equivalent) employees during the preceding calendar year. Employers must also meet eligibility requirements under the Affordable Care Act (ACA) and California Small Group regulations. Additionally, employers must have a bona fide employer-employee relationship and maintain appropriate state filings allowing them to conduct business in California.

Anthem evaluates submissions based on various criteria, including California headquarters, business or legal documentation, employee and dependent eligibility, employee participation, and employer contribution. Evidence of insurability may be required for certain benefits, and long-term disability for groups of 2–5 eligible employees is medically underwritten.

What is the timeline for submitting new group applications to Anthem?

Anthem accepts new group submissions for specific effective dates. Furthermore, it requires additional information to be provided within ten days of the original request.

What are the different medical plan options offered by Anthem Blue Cross?

Anthem Blue Cross offers various medical plan options, including Platinum, Gold, Silver, and Bronze plans, each with different benefits and premiums. The metal structure represents actuarial values (AVs) and can be used to compare overall cost sharing across plans.

What network options are available for Anthem Blue Cross small group plans?

Anthem Blue Cross provides Preferred Provider Organization (PPO) and Health Maintenance Organization (HMO) network options. Each network offers access to a different number of doctors, specialists, and hospitals, allowing employers to choose the option that best fits their employees’ needs.

Orientation/Waiting Periods

Anthem Blue Cross underwriting guidelines does not impose a waiting period but allows employers to impose an orientation period of up to 30 days. Employers may also impose a waiting period beginning after the orientation period, not to exceed 90 days.

What can employers and employees expect upon approval of the group health insurance plan?

Upon approval, Anthem completes enrollments and issues the group’s documents. Employers receive EmployerAccess login credentials, and employees receive ID cards and a welcome packet with enrollment instructions.

Takeaway

Understanding Anthem Blue Cross underwriting guidelines and submission criteria is paramount for navigating small-group health plans effectively. By addressing key questions and considerations, employers can ensure a smooth enrollment process and optimal coverage for their employees.

As an employer seeking the best health insurance for your team, partnering with Skyline Benefit can streamline the process and provide personalized attention to your group health insurance needs. Let our licensed brokers guide you through the complexities and find the perfect plan tailored to your business requirements.

Need Help with a Group Health Insurance Broker in California?

Skyline Benefit is an independent group health insurance broker in Fullerton, CA that offers affordable and flexible health insurance options. Selecting the best health insurance plans can be overwhelming; our mission is to simplify the process and help our clients every step of the way.

Schedule a consultation today. Call us now at (714) 888-5112

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