Infographic for 51-100 Moving to Small Group

In an effort to help your clients make the transition from Large Group (51-100) to Small Group, as mandated by the ACA (effective January 1, 2016 upon renewal), Anthem has developed some key highlights and a ​marketing infographic to help groups understand what to expect when transitioning to the Small Group segment.  

• Rating Areas – in Small Group, there are 19 rating areas in CA, divided mainly by county.
• Small Group Rates 
  • Rates are based on a group location (rating region), employee and dependent ages, and plan choice. The rates are filed as standard rates and no adjustments can be made. Where the group’s rates were in Large Group in relation to the standard rate (above or below it), this will impact their renewal increase.
  • Rates are filed quarterly, but once a group joins or renews, rates are guaranteed for 12 months – until a group’s renewal effective date.
  • 3:1 Rate Ratio (highest cost point cannot be greater than 3x lowest cost point for members age 21+)
  • Rates are based on exact age, and not age-banded rate increments.
  • The new family rate is determined by the individual age rate for the employee, spouse, and all dependents age 21 and older, and up to 3 dependents who are age 20 or younger, combined.

• Products and Networks 
  • The Small Group portfolio offers several HMO & PPO product choices, pharmacy, and specialty options to meet your budget & benefit needs.

• Enrollment and Waiting Periods
  • For Small Group a date of hire waiting period is equal to the first of the month following the employee date of hire, and a group can no longer offer different waiting periods by employee classification.

• Plan Choices (Mapping) 
  • The Small Group renewal will include suggested Small Group plan options that are based on each group’s current plan and network offerings.