| Criteria |
Information |
| Underwriting Guide |
No information yet |
| Small Group Definition |
No information yet |
| Employer Contribution |
No information yet |
| Carve-Outs / Varied Offerings |
No information yet |
| Participation Requirements |
No information yet |
| NPNC Groups |
No information yet |
| Valid Waivers |
- Other Group Coverage
- Individual Coverage
- Enrolling as dependent in the group health plan
- Medicare
- Medi-Cal
- TRICARE
- Indian Health Service (Native American Tribal Coverage)
|
| Residency Requirements |
No information yet |
| W-2 Enrollment Requirements |
W2 common law employee may waive as long as group meets all participation requirements. W2 cannot be spouse/domestic partner of the owner/officer. |
| Owner Only Groups |
Anthem will accept Owner Only groups as long as the groups’ business entity is a type of Corporation such as LLC, S-Corp or C-Corp. At least 2 eligible owners are required. |
| Husband & Wife Only Groups |
Spouses Only / Domestic Partner Only Groups are not eligible for coverage. |
| One-Person Groups |
No information yet |
| Slice Business |
No information yet |
| Employers Replacing Coverage |
No information yet |
| Start-Up Group Requirements |
- A signed and completed Conditions of Enrollment form is required.
- The company’s first 30 days of payroll records must be submitted within the first 45 days of the requested effective date.
- Business Documentation required (example: business license/SOI).
- An existing group that just hired their first W2 qualifies as a Start-Up.
|
| Common Ownership Guidelines |
Companies that are affiliated and eligible to file a combined tax return for purposes of state taxation shall be considered one employer. Common ownership groups must meet the definition of a small employer when combined. All companies in the common ownership group must appear as Active on the California Business Portal. |
| Spin-Off Groups |
No information yet |
| Employers with Union Employees |
No information yet |
| Employers Leaving a PEO |
No information yet |