Oct 23, 2018
Kaiser Permanente® revised their policy, and is now offering coverage to small groups with a professional employer organization (PEO) agreement — effective November 2018. Who Qualifies Employers must meet all small group underwriting guidelines for Kaiser Permanente®, including:
- A group must satisfy the small group size requirement (1-100 eligible employees) by combining directly employed individuals and co-employees (leased employees).
- A group may not allow co-employees to choose between coverage through the group or coverage through the PEO. However, the group can offer Kaiser Permanente® alongside another carrier that isn’t available through the PEO.
Co-employees must be employed full-time to be eligible. Required Documentation Enrollees may be listed on the group’s DE 9C (for direct employees). Co-employees must be listed on the PEO’s DE 9C, and the group must provide one of these documents in addition to the standard required documents:
- A copy of the group’s PEO payroll subgroup or 3 months of recent invoices showing the PEO, subgroup name, and co-employed individuals
- For start-up groups, a copy of the group’s PEO payroll subgroup or 4 weeks of recent invoices showing the PEO, subgroup name, and co-employed individuals
Why It’s Easy to Do Business With Kaiser Permanente® Enjoy lenient underwriting this peak season. The small group participation requirement is 50% instead of the normal 70% for all group sizes (The promo ends January 1, 2019). A DE-9C is not required for groups with 6+ subscribers enrolling, and only 4 weeks of payroll is required for startup groups (The promo ends December 1, 2018). There are also opportunities to earn more:
- Get $50 per enrolled member when you sell a group with 50 full-time employees or more
- Get $50 per member when you enroll a new group with members in Santa Cruz County
- Get $30 per enrolled member when you sell a group with 6-49 employees through CaliforniaChoice or Covered California for Small Business.
Contact your LISI Regional Sales Manager for Kaiser Permanente® selling strategies. “Kaiser,” “Kaiser Permanente,” “Kaiser Foundation Health Plan” and the Kaiser Permanente Logo are registered trademarks or service marks of Kaiser Foundation Health Plan, Inc., in the United States.
