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How Carriers Handle Companies Working 100% from Home

Aug 18, 2020

With many companies moving to a work-from-home arrangement, we’ve asked our carriers how they will handle an employer with 100% of their workforce working remote. See the specific carrier responses below for more information. In general, our medical carriers will look at the address on the company’s legal documents to determine the address they’ll use for rating purposes, even it’s the owner’s residential address.

 

Aetna

Aetna will accept business that is residential based. They may look for it to make sense that the business can be performed from the home. Generally, the business files with the state and the group provides their business location. If a business has not updated their address or the tax documents provided list the old address, please have them provide an explanation of this change so Aetna is able to connect the dots and rate appropriately.

 

The rating is based on employer’s business address and that would be the rating area used, which in this scenario would be the owner’s residential address. Aetna will still apply the guidelines for employer eligibility and require the majority (51%) of the employees to reside in CA.

 

Anthem

Anthem will write businesses that are run out of the CEO's, Officer's, or Owner’s home address. They would need to be based in CA and are rated based off that home address.

 

CaliforniaChoice

We are pending information from CaliforniaChoice.

 

Covered CA for Small Business

CCSB would use the corporate address for rating purposes. If the corporate office goes away, and everybody works remotely, then they would need to amend their documents to show the new address which most likely would be the Owner’s, which CCSB would then go by. If the paperwork has not been filed yet, then CCSB would have to go with the current address per the filed documents until the file the address change and submit a ER Change Form to update CCSB’s systems.

 

Health Net

Health Net would use whatever address is on the legal docs (DE-9C, SOI, etc), which would most likely be the Owner’s address.

 

Kaiser Permanente

The rates are based on the filed address; for a Corp/LLC that would be the address the group registered with SOS as their location in CA. If they end up going to a fully remote model, they should update their filed address. (Same would apply for sole props/partnerships filing business licenses or FBNs.)

 

The only time something like this may pose an issue is if the updated address is outside a CA service area. In that case, only employees who live in a service area would be eligible to enroll, and the owner/officer might not be eligible in that scenario.

 

UnitedHealthcare

UnitedHealthcare only needs to know the address of the company. If the company changes their address, they may get re-rated if they move to a different rating region.

 

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

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