Individual vs. Group Question

[Franz Kafka]

so there is zero premium risk for very small groups here.

Dave, could you explain what this means?

I have seen this tried so many times, and each time it falls apart for one simple reason, there is inevitably someone currently employed or not yet employed who is uninsurable.

Were you referring to the group policy? I thought any size group in CA was GI? Thank you.

 

[Dave020]

Dave, could you explain what this means?

What I mean is that the maximum premium a small group in CA can be charged is 110% of the standard premium or 10% above the standard cost. Unless the group falls in a rating area that is experiencing severe cost increases, then the group will experience normal rate changes and cannot be charged more that the 10% above standard cost.

Were you referring to the group policy? I thought any size group in CA was GI? Thank you.

No, I was referring to putting individual plans in instead of group plans. All 2-50 in CA are GI regardless of health.

On a side note, you must remember that only the INITIAL enrollment is GI unless you set it up right. Subsequent plan changes can be declined if the risk is too high (claims experience of the group). You can avoid this with Anthem BC by enrolling the group as "employee-elect, all plans" at the initial enrollment. Under that status, the group only needs to send a written request (no applications) for any plan changes it wishes to make.
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Add on...groups 51+ in CA are not GI. They are underwritten and can be declined if the risk is too great. It's is the 2-50 market that is always GI if they qualify.

 

[Franz Kafka]

Very clear. Thanks for your help AS ALWAYS!