Underwriting Requirements At A Glance

2006 Renewal

 

The Participation Requirements are Simple.

All you need to participate in the program is the following:

 

 

·        City of San Diego Business License.

·        2 or more eligible, full-time employees working more than 30 hours per week (5 for PPO Dental).

·        50% contribution of the Employee Only premium.

·        100% contribution of the premium for Term Life plans

·        In-force Group Medical Plan to participate in the Voluntary, Chiropractic, Acupuncture or Term Life plans

·        Both HMO and PPO Dental / Vision plans can be offered to the same employer group.

·        Multiple medical plans can be offered to the same employer group.

 

 

Complete Requirements

 

Sharp Health Plan HMO

 

  • Employer must have a minimum of two eligible full-time employees in order to participate.  Standard waivers will apply.
  • Requires minimum 50% employer contribution of employee only rate.
  • Minimum of 70% of eligible employees must participate.

 

Golden West PPO Dental Plan(s)

 

  • Employer must have a minimum of five eligible full-time employees in order to participate.  Standard waivers will apply.
  • Requires minimum 50% employer contribution of employee only rate.
  • Minimum of 75% of eligible employees must participate.

 

Golden West HMO Dental Plan(s)

 

  • Employer must have a minimum of two eligible full-time employees in order to participate.  Standard waivers will apply.
  • Requires minimum 50% employer contribution of employee only rate.
  • Minimum of 75% eligible employees must participate.

 

Safeguard Vision Plan(s)

 

  • Employer must have a minimum of two eligible full-time employees in order to participate.  Standard waivers will apply.
  • Requires minimum 50% employer contribution of employee only rate.
  • Minimum of 75% of eligible employees must participate.

 

American Specialty Health Chiropractic / Chiropractic & Acupuncture Plan(s)

 

·        Employer must have a minimum of two eligible full-time employees participate.  Standard waivers will apply.

·        Requires 50% employer contribution of employee only rate.

·        Must have a Group Medical Plan

 

Golden West Voluntary Dental / Vision Plan(s)

 

  • Employer must have a minimum of two Full-time employees to participate in the Voluntary HMO Dental & Vision Plans.  Standard waivers will apply.
  • Employer must have a minimum of five full-time employees enrolled in the Voluntary PPO plan.
  • 100% employee paid.

 

The Hartford Employee Term Life / Dependent Life Plan(s)

 

·        Employer must have all eligible full-time employees participate.  Standard waivers will apply.

·        Requires 100% employer contribution

 

Additional Underwriting Requirements

 

  • Employer must have a City of San Diego business license.
  • Sharp Health Plan will no longer allow a rollover Sharp HMO group into City Care Benefits Trust Plan until a period of 12 months after the date of termination has elapsed.  Groups rolling over from California Choice or Pac Advantage are not subject to this provision and can roll over at any time.
  • Eligible employees of the employer must work a minimum of 30 hours per week.  Eligible dependents are the employee’s legally married spouse, domestic partner and dependent children to age 19 if unmarried; and to age 25 if unmarried and full time students (certification required).
  • Domestic Partner participation requires an affidavit from the plan member.
  • Partnership Agreements must be Notarized.