NORTH CAROLINA EDITION
Small Group Benefit Plans – for
50 or fewer eligible employees
The CIGNA HealthCare Small Group Business
in California and American Insurance Brokers
(AIB) joined forces to offer state-of-the-art
benefit solutions for your clients.
CIGNA has teamed up with AIB to provide
your customers both medical and dental plans
for groups of 2-50 employees.
HMO, POS and Open Access Plus (a national,
seamless network with a PCP-optional feature)
options are available to California employers
with features such as coverage for out-of-state
employees, comprehensive infertility benefits,
and a no-deductible, three-tier prescription
benefit.
Group quotes can be obtained immediately
by contacting AIB at 1.800.669.8700 or
by going online to www.aib4insurance.com.
Quotes can also be requested by sending
an e-mail to info@aib4insurance.com.
Why choose CIGNA HealthCare of California
for your Small Group Solutions?
- National Scope, Local Presence
- We're A Leader in Quality
- Award-winning Disease Management
- Service Excellence
- A Better Member Experience
- Toll-free access to a registered nurse
- 24/7
- Discounts on health and well-being products
and services
- Member education, online and in print
- Care away from home
- Integrated behavioral and employee assistance
program
So, tell us your plans. If your small group
clients want high quality benefits with competitive
rates, contact AIB at 1.800.669.8700.
Legislative Update
The California legislature returned from
recess on August 7 and they must adjourn
the regular session by August 31. Two of
the four universal coverage bills remain
alive:
SB 840 - Single Payer Bill – The
bill establishes the California Health Insurance
System (CHIS) a new state program to provide
health insurance to all California residents
on a single payer basis. The
system is to be administered by the newly
created California Health Care Agency under
the control of an elected Health Insurance
Commissioner (newly created position). The
bill prohibits any HMO or insurance policy
from being sold except for CHIS plans by
CHIS. The system is to be operational within
two years of enactment of the legislation.
Benefits and other details of the program
are to be developed by several boards and
committees.
SB 1414 – Wal-Mart Bill – The
California Fair Share Health Care Act requires
employers with 10,000 or more employees:
- Designated as nonprofits that do not
pay 6% of their payroll on employee health
care coverage, to pay to an amount equal
to the difference between what the employer
spends on health care and the 6%, and
- Designated as for-profits that do not
pay 8% of their payroll on employee health
care coverage, to pay an amount equal to
the difference between what the employer
spends on health care and the 8%.
The bill imposes a $250 civil penalty for
each day a required report is late and subjects
an employer that fails to make a required
payment to a civil penalty of $250,000. The
program would be administered by the Director
of Industrial Relations.
It creates the California Fair Share Health
Care Fund which, when appropriated by the
Legislature, would be expended by the Department
of Health Services and the Managed Risk Medical
Insurance Board (MRMIB) to fund Medi-Cal,
Healthy Families and AIM Programs.
The following bills have been defeated:
AB 2281 would have placed
restrictions on health care coverage and
deductibles by limiting annual out-of-pocket
expenses to $5,000 for an individual and
$10,000 for a family. The bill would not
have allowed the following services to be
subject to a deductible: periodic health
evaluations, including annual physical; routine
prenatal and well child care; child and adult
immunizations; tobacco cessation programs;
obesity weight loss programs; and, screening
services for cancer, heart and vascular diseases,
infectious diseases, mental health conditions,
substance abuse, metabolic, nutritional and
endocrine conditions, musculoskeletal disorders,
OB/GYN conditions, pediatric conditions and
vision and hearing disorders. Additionally,
the bill would limit enrollee costs for co-pays
and co-insurance to not more than 30% of
the negotiated rate for par providers and
not more than 40% of the health plan’s
allowable rate or 50% of the rate charge,
whichever is less for non-par providers.
AB 977 would have required
the Department of Managed Health Care (DMHC)
and the Department of Insurance to develop
standardized health plans in the individual,
small group, and large group market, and
would have prohibited the sale of any products
that would differ without a public hearing.
SB 1591 would have expanded
the Commissioner of Insurance's authority
over group products to allow him to determine
whether the benefits under any policy are
of real economic benefit to the insured.
LOCAL SPOTLIGHT
Where We Are
Charlotte
11016 Rushmore Drive, Suite 300
Charlotte, NC 28277
Toll-free: 800.880.4973
Who to Contact
Michael Foresman
704-540-2125 or toll free 800.880.4973, ext 5482125
Michael.Foresman@cigna.com
Where We Are
Raleigh
701 Corporate Center Drive
Raleigh, NC 27607
Toll-free: 800.849.9300
Who to Contact
Susan Murray
919.854.8122 or toll free 800.849.9300, ext 8122
Susan.Murray@cigna.com
Where We Are
Winston-Salem
CIGNA HealthCare Triad Sales Office
1590 Westbrook Plaza Drive, Suite 103
Winston-Salem, NC 27103-2965
Who to Contact
Susan Murray
919.854.8122 or toll free 800.849.9300, ext 8122
Susan.Murray@cigna.com
Experienced Local Leadership
Charles C. Pitts, President and General Manager – CIGNA
HealthCare of the Carolinas
Charles Pitts has over 20 years experience
in the health care industry. Prior to joining
CIGNA in 2006, Charles led the development and growth
of multiple health plans for UnitedHealthcare. His
responsibilities included financial, operational and
leadership performance of health plans in North Carolina,
South Carolina, Alabama, Louisiana and Mississippi. Charles
earned his Bachelor of Arts degree from Washington
and Lee University, and his MBA in Finance from the
University of Alabama. He currently resides
in Charlotte, North Carolina.
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