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ASKCCSB: Contributions with Group Reference Plan

Jun 22, 2021

Covered California for Small Business (CCSB) sent the below ASKCCSB newsletter to Employer Groups on Tuesday, June 22, 2021 at 2:00 PM.

 

ASKCCSB answers some of the most frequently asked questions that their Call Center receives and this issue covers questions on contributions to group reference plans.

 

For questions, please contact a member of your B&P Sales Team - 888.722.3373.

How Do Contributions Work With A Group Reference Plan?

Covered California for Small Business (CCSB) is committed to providing employers with the tools and resources to simplify managing your employees' benefits. We created ASKCCSB to answer your frequently asked questions.  

 

What is a Group Reference Plan?

A Group Reference Plan is a plan chosen by the employer that their contribution will be based on. Your employee's premium contribution and out-of-pocket costs will depend on your reference plan and total contribution, your selected level(s) of coverage and the plan(s) your employee selects.

  

Can my employee choose a different plan from the reference plan that I have selected for contribution?

Yes. If the employee selected the same plan as a reference plan, then the contribution will be 50/50, if the employer only selected to contribute 50% towards the employee premiums. If the employee selected a more expensive plan, the employer only pays 50% of the reference plan rate and the employee pays more than the employer. If the employee selected a less expensive plan, then the employee pays less than the employer.

  

What if my employer invoice does not reflect the contribution amount on the reference plan that I chose?

With CCSB plans, employers are required to contribute at least 50% of the cost towards the lowest premium available for employee-only coverage. Your invoice may show a different contribution percentage if your employee chooses a different health plan coverage than your reference plan.

 

For example, an employer selects 50% contribution, but the employee chooses a lower or higher health plan which means the invoice will not reflect a 50/50 split on the contribution for the employee’s premium. This difference is often more apparent when an employee selects a plan that is either a different metal tier than the reference plan, or a different plan type (HMO vs. PPO).

  

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