California members page

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At MNJ Insurance Solutions, our hearts and prayers are with everyone affected by the Southern California wildfires. In these challenging times, the health and safety of the community is the utmost priority. Below, we have provided our carrier partners’ responses and resources to the fires.  We hope that you find this helpful.

 

Aetna: To assist affected members, Aetna created a dedicated disaster resources for California members page where you can find detailed information about the services and support Aetna is offering during this crisis.

  • Aetna’s Resources for Living℠ has published a resource guide with valuable information for all individuals and organizations affected by the Southern California wildfires — regardless of whether they have an Aetna plan. In addition, the following phone lines are available:
  • Individuals without access to Resources for Living may call (833) 327-2386 for resource referrals.
  • Members with access to Resources for Living (Small Group | AFA) should call their assigned RFL number to access services.
  • All Aetna clients, brokers, and members can also access important information on Aetna’s dedicated web page for the wildfires.
  • Members can call (888) 802-3862 for customer service or (800) 238-6279 for pharmacy management.

Anthem Blue Cross:  https://www.anthem.com/ca/blog/cawildfire

  • Anthem Blue Cross is making changes to health plan benefits to provide relief and ensure healthcare access for our members who live in Los Angeles and Ventura counties in California and are impacted by the Palisades wildfire and windstorm conditions. The changes are in effect January 7 through February 5, 2025.
  • Anthem is also offering FREE access to its online health option, LiveHealth Online to anyone living in the impacted area. LiveHealth Online offers video visits with U.S.-based board-certified doctors on a mobile device or computer from anywhere for non-emergency health conditions. The free visit offer will be available through the end of the state of emergency.
  • Anthem’s Employee Assistance Program (EAP) offers mental health support and resources to help with legal and financial concerns, dependent-care needs, and other life challenges. Call the 24/7 EAP crisis line at 877-208-8240.
  • For assistance during this emergency, please call us at 833-285-4030. Anthem is here to help make sure you have access to the healthcare you need. They can help with finding available doctors, refilling prescription drugs, and other health plan questions and are available by phone Monday through Friday, 8 a.m. to 6 p.m. PT.

Blue Shield of California

  • Blue Shield of California is, as always, working hard to ensure the safety and care of all Blue Shield of California members. The following is a centralized resource for how Blue Shield of California members: https://news.blueshieldca.com/2025/01/08/january-8-2025-blue-shield-of-california-offers-assistance-to-members-affected-by-wildfires
  • Here are the key resources available to assist those impacted:
    • Immediate Prescription Refills: Members in mandatory evacuation zones can receive immediate refills of their prescriptions, even if they are not yet due for a refill.
    • Continuity of Care: Blue Shield Medical Care Solutions will proactively reach out to members enrolled in care and disease management programs in mandatory evacuation zones to ensure they continue receiving the care they need.
    • Virtual Care Options: Members can access various telehealth services, including Teladoc and NurseHelp 24/7℠. Visit blueshieldca.com to review the specific virtual care options available under your plan.
    • Mental Health Support: The mental health service administrator provides free access to resources, materials, and counseling services through a dedicated hotline: (800) 327-7451.
    • Vision Plan Assistance: Vision plan members in affected areas who have lost or broken eyewear may be eligible for replacement lenses and/or frames. For assistance, call Vision Customer Service at (855) 492-9028 (TTY: 711) during operating hours, Monday through Saturday, 8 a.m. to 8 p.m. PST.
    • Out-of-Network Provider Access: Displaced members can see an appropriate out-of-network provider at in-network benefit levels and can replace medical equipment and supplies if needed.
    • Member Identification (ID) Card Replacement: If members have lost their ID card, they can view and print a new card by logging into their online account at www.blueshieldca.com/login. Alternatively, the Blue Shield of California mobile app allows access to the ID card on mobile devices.

    If a member needs assistance, please have them call the Customer Service number on the back of their ID card. Blue Shield wants to respond to the urgent needs of all affected members.

 

Additional Special Assistance Information for Members Affected by Palisades Fire and Windstorm Conditions

Cigna

  • Cigna Disaster Resource Center: click here
  • EAP Tools for HR and Managers: https://eapmanager.cigna.com/
  • Mental Health Support line (open to non-members): call (866) 912-1687
  • Veteran Support Line: call (855) 244-6211
  • Coping with loss due to fire: click here

Health Net

  • To ensure members have uninterrupted access to essential prescription medications and healthcare services, Health Net is providing special assistance to members affected by the Los Angeles and Ventura County Fires and windstorm conditions. Click here for up-to-date information.
  • Virtual visits: If members cannot reach their Primary Care Provider, Health Net is providing access to telehealth services at no cost.
  • Serving Those In Need
    • To better serve medically vulnerable members in the evacuation zones, Health Net has proactively reached out to members who may need to the most help, including those identified as experiencing homelessness and members who are wheelchair-bound, oxygen dependent and homebound to check in.
    • Health Net has connected with over 800 members to provide information about:

 

Kaiser Permanente:  https://healthy.kaiserpermanente.org/southern-california/alerts/southern-california-fires

  • News for members impacted in SoCal: click here
  • Appointment and Advice Center: call (833) 574-2273
  • Mental health and wellness support: click here
  • Member Services: call (800) 464-4000; be sure to let the representative know you’ve been affected by the fires

MetLife

Mutual of Omaha

  • Mutual of Omaha Wildfire information: click here
  • Claims assistance: call (800) 877-5176
  • Member Services: call (800) 369-3809
  • 24/7 Employee Assistance Program: call (800) 316-2796

UnitedHealthcare

  • UHC Disaster Relief Info: https://www.uhc.com/disaster-relief-info
  • A free emotional support hotline is available during this time of need at 866-447-3573, Monday through Friday, 8 a.m. to 8 p.m. Central Time.
  • Emotional support resources and information are also available online at www.liveandworkwell.com.
  • If a member needs help seeing a health care provider right now, there are options. They can use the UnitedHealthcare mobile app or website to find a network provider or to schedule a Virtual Visit1.

 

If you have any questions and need additional resources regarding your plan, please reach out to MNJ Insurance Solutions at (714) 716-4303.

May is Mental Health Awareness

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May is Mental Health Awareness Month, a time to raise awareness about the importance of mental health and wellbeing. Taking care of your mental health is just as important as taking care of your physical health.

Here are five tips for better mental health:

  1. Take time to re-group and re-center: Take time to do things that make you happy and relaxed, such as reading a book, taking a bath, or practicing a hobby.
  2. Connect with others: Community is important for good mental health. Spend time with friends and family.
  3. Get 7-8 hours of sleep per night: Adequate sleep is important for good mental health.
  4. Exercise on a regular basis: Physical activity can help reduce stress, improve mood, and boost overall mental health.
  5. Seek help if needed: Don’t hesitate to seek help from a mental health professional if you’re struggling with your mental health.

 

One more tip: If needed, you can call “988,” which is a suicide and crisis hotline number, similar to “911” for emergencies.  When you contact the new mental health crisis hotline number, a trained crisis worker will offer emotional support and connect you with any needed resources.

Your mental health is important and we encourage you to get the help you need.  Let’s all work together to break the stigma surrounding mental health and prioritize our mental wellbeing.

Please contact MNJ Insurance Solutions for more information and how we can help with your Employee Benefits.

COVID-19 National and Public Health Emergencies Will Terminate May 11, 2023

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While California’s COVID-19 state of emergency ended on February 28, 2023, the national COVID-19 Public Health Emergency is still active and will terminate on May 11, 2023. Consumers impacted by the COVID-19 Public Health Emergency may qualify for Special Enrollment using the “Public Health Emergency” Qualifying Life Event to enroll and make changes to their coverage.

The Department of Labor’s Employee Benefits Security Administration (EBSA) is committed to working with employers and other plan sponsors to ensure a smooth transition as the federal government unwinds some of the policies that have been in place during the COVID-19 public health emergency and National Emergency. To partner with you through this process, the Departments of Labor, Health and Human Services, and the Treasury issued guidance today in an effort to ensure that workers and their families are aware of any changes that may be coming their way:

 

As a reminder, states that administer Medicaid, such as Medi-Cal in California, were prohibited from terminating a beneficiary’s enrollment during the national COVID Public Health Emergency unless they moved out of state, became deceased, or the beneficiary requested a voluntary termination of eligibility. Beginning as of April 1, 2023, the Department of Health Care Services will begin to “unwind” this policy and resume its annual eligibility review process for members enrolled in Medi-Cal, which could possible result in a beneficiary being determined no longer eligible for Medi-Cal.  This would allow eligible individuals to enroll in a qualified health plan and possibly gain eligibility for advanced premium tax credits with a July 1, 2023 effective date.  The other option for members who lose eligibility with Medi-Cal is they could enroll in their employer group plan (if they meet the employer’s eligibility requirements), as this is a qualifying life event.  Please reference Covered California’s Public Health Emergency & Medi-Cal to Marketplace Automatic Enrollment Program Toolkit for additional program information and support materials.

 

If you have any questions or would like more information, please reach out to MNJ Insurance Solutions.

 

This summary is provided for informational purposes only and should not be construed as legal or a recommendation of any kind. While we have attempted to provide current, accurate, and clearly expressed information, this information is provided “as is,” and MNJ Insurance Solutions makes no representations or warranties regarding its accuracy and completeness.

CA Bereavement Leave as of January 2023

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Starting Jan 1, 2023, employers with five or more employees must abide by new bereavement leave provisions. This is due to an amendment that was made to California Family Rights Act (CFRA) on September 29, 2022. This modification included the implementation of Assembly Bill No. 1949 (AB-1949). Under this bill, eligible employees may take up to five days of bereavement leave as a result of the death of a family member.

 

Overview

The following information outlines the implications of a bereavement leave:

  • A leave must be completed within three months of the dated death
  • Leave may be unpaid however, employees are entitled to use other leave balances, such as available sick leave
  • Days taken for leave are not required to be taken consecutively
  • The leave must be taken in accordance with any current leave policy, with the assurance that the employee is granted no less than five days of bereavement leave.
  • An employee must provide documentation of the death of a family member within 30 days of the first leave if requested by an employer.
  • A covered employer is required to maintain confidentiality regarding the employee’s request and documentation for bereavement leave.

 

This Bereavement Leave Update is provided for informational purposes only and should not be construed as legal or a recommendation of any kind. While we have attempted to provide current, accurate, and clearly expressed information, this information is provided “as is,” and MNJ Insurance Solutions makes no representations or warranties regarding its accuracy and completeness.

COBRA ARPA Subsidy: What Employers Need to Know

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If you are an employer who offers employee benefits and have terminated individuals, or if you have had employees with a reduction of hours within the last 17 months, it is important to learn more about the COBRA provisions of The American Rescue Plan Act of 2021. President Biden signed ARPA into law on March 11, 2021 and it provides a 100% COBRA subsidy for certain individuals, referred to as “Assistance Eligible Individuals” (AEI) beginning on April 1 through September 30, 2021, and it is important that you are aware on how it may affect your business.

What is COBRA?
Before we dive into the new legislation and how it affects employers and eligible participants (also referred to as “qualified beneficiaries”), it is important to briefly explain “What is COBRA?” COBRA is a federal law that requires employers to offer continuation of their health and welfare benefit plans if the employee has a qualifying event, such as termination or reduction of hours. If the individuals accept COBRA, he/she traditionally will pay 102% of the premium for elected coverages and can have continuation of coverage up to 18-36 months, depending on the situation. COBRA is generally administered by the employer or outsourced to a third-party administrator.

Some states have “mini-COBRA” laws, such as Cal-COBRA, which applies to employers with 2-19 employees. Not all states have mini-COBRA laws. If an eligible participant elects Cal-COBRA, he/she will traditionally pay 110% of the premiums for elected coverages. Cal-COBRA is generally administered by the carrier. We are awaiting further guidance on the implications of ARPA on the mini-COBRA administration.

Who is Eligible for the COBRA Subsidy?
Based on information found on the Department of Labor website and a page created specific to the COBRA subsidy, only certain “Assistance Eligible Individuals,” referred to “AEIs” are eligible for the COBRA subsidy and they may include:

• Individuals who were involuntarily terminated or had a reduction of hours, therefore no longer eligible for coverage during the subsidy period of April 1 through September 30, 2021.
• Individuals who were involuntarily terminated or had a reduction of hours, who previously did not elect COBRA or allowed their COBRA to lapse, and who have not exhausted their maximum 18 months of coverage. These individuals will have a “second chance” to elect COBRA.
• Includes spouse and dependent children, who are qualified beneficiaries.

There are individuals who are NOT eligible for the COBRA subsidy and may include:

• Individuals who voluntarily resigned employment.
• Individuals who are eligible for other group coverage, such as a new employer’s group plan or spouse’s group plan.
• Individuals who are eligible for Medicare.
• Individuals who have used the maximum period of COBRA coverage.
• If an employer cancelled their group plan, there is no COBRA subsidy available.

The COBRA subsidy is NOT automatic. Individuals who are eligible, who previously did not enroll in COBRA or Cal-COBRA must elect within 60 days of the notice from the group’s plan administrator. The group administrator must provide the notice no later than May 31, 2021. If the AEI does not elect COBRA within the 60-day period upon notification, the subsidy is forfeited.

Who is paying for the COBRA subsidy?
• If the employer has 20 or more employees, either fully insured or self-funded, the employer is responsible for the 100% COBRA subsidy and the 2% COBRA administration fees.

Tax credits will be issued to the employer or the insurer, against the quarterly Medicare taxes. If the credit exceeds the premium, a refund will be available. There is a provision of the law that limits the ability to take the tax credit for premium subsidy if the employer is also taking the tax credit for qualified health plan expenses under FFCRA paid leave provisions or Employee Retention Credit under the CARES Act. We are awaiting more guidance from the IRS on the mechanics. There will not be any “double dipping.”

Penalties for non-compliance
The Department of Labor will be monitoring for compliance on The American Rescue Plan Act.

• Employers may be subject to an excise tax under the Internal Revenue Code for failing to satisfy the COBRA continuation coverage requirements. This tax can be as much as $100 per qualified beneficiary, but not more than $200 per family for EACH DAY the employer is in violation of the COBRA rules.
• Individuals who become eligible for other group health plan coverage or Medicare are required to notify their plan administrator. If they do not notify the plan administrator, the penalty can be the greater of $250 or 110% of the amount of the subsidy. However, regulations state that a person will not be subject to a penalty if the failure to notify the employer/health plan is due to reasonable cause and NOT due to willful neglect.

What are the Next Steps for An Employer?

1. Identify individuals who have been terminated or had a reduction in hours since October 2019.

2. Make sure you have employee records and documentation for your voluntary vs. involuntary terminations, as this makes a difference with COBRA subsidy eligibility.

3. New Model Notices and FAQ were released on April 8 for COBRA by the Department of Labor and can be found on the DOL.gov website.
a. General Notice and Election Notice
b. Notice in Connection with Extended Election Period
c. Alternative Notice (special notice for mini-COBRA/Cal-COBRA)
d. Notice of Expiration of Premium Assistance – NEW
e. Summary of the COBRA Premium Assistance Provision

4. If you outsource your COBRA administration, coordinate with the TPA to ensure the notices are sent to qualified beneficiaries.

5. Make sure you properly reinstate the participants electing the COBRA subsidy with the carriers.

6. As of April 15, 2021, it is still unclear how the employers with Cal-COBRA new alternative mini-COBRA notices will be distributed, as Cal-COBRA is generally administered by the carriers. We are awaiting further regulation and details from the carriers. Stay tuned as more information becomes available.

If you are an employer offering group health benefits, it is important to take the time to make sure your group plans are compliant with the new COBRA provisions under the new law, The American Rescue Plan Act of 2021. Make sure the proper, NEW model notices have been updated and distributed, and make sure you document, document, document!

If you have any questions regarding The American Rescue Plan Act and the COBRA subsidy, please contact MNJ Insurance Solutions at (714) 716-4303 for more information.

This content is provided for informational purposes only.  While we have attempted to provide current, accurate and clearly expressed information, this information is provided “as is” and MNJ Insurance Solutions makes no representations or warranties regarding its accuracy  and completeness.  The information provided should not be construed as legal or tax advice or as a recommendation of any kind.  External users should seek professional advice form their own attorneys and tax and benefit plan advisers with respect to their individual circumstances and needs.

California Expands Leave Under the CFRA

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Effective January 1, 2021, there are amendments to expand the leave law requirements of the California Family Rights Act (CFRA) and requires employers with at least five employees to comply, includes new reasons for leave, and adjusted leave limits.

 

What is California Leave Rights Act?

CFRA provides 12 weeks of unpaid, job-protected leave in a 12-month period to eligible employees to bond with a new child, adoption of a child, employee’s own serious health condition, a child, spouse, or parent’s serious health condition.  Prior to January 1, 2021, the law only applied to employers with 50 or more employees within a 75-mile radius of the employee’s worksite. When an employee’s leave is covered under both FMLA and CFRA, employers must apply the provisions of each federal and state law that are most generous to the employees.

To be eligible for family and medical leave under CFRA, an employee must:

  • Have a total of at least 12 months of service with the employer;
  • Have worked at lease 1,250 hours in the 12 months prior to the leave; and
  • Be employed at a work site with five or more employees (effective January 1, 2021)

If an employee is not eligible for CFRA leave at the beginning of their leave because he/she has not met the 12-months of service requirement, the employee may meet this requirement while on leave.

 

California Leave Rights Act Amendments as of January 1, 2021

The amendments to this law increases the employers are covered under the CFRA amendment by:

  • The law applies to employers with five or more employees;
  • Eliminated the 75-mile requirement
  • The amendment also expanded the law to allow for employee leave to care for grandparents, grandchildren, siblings, and domestic partners and their children, and for exigencies related to a family member’s active military duty.
  • Parents who work for the same employer will now EACH be allowed to take 12 weeks of child-related leave.
  • The amendment eliminates the job reinstatement exemption for salaried employees in the highest-paid 10% of the employer’s employees.

During an employee’s CFRA leave period, employers must continue providing group health plan coverage for the employee.  The health coverage must be continued under the same conditions as those provided prior to the leave.  However, employers are not required to pay for retirement benefits for the employee during a leave period.

For more information on employee leave laws in California, please contact your broker at MNJ Insurance Solutions at (714) 716-4303.

 

This content is provided for informational purposes only and is summarizing the CFRA amendments as of January 1, 2021 and not the law in its entirety.  While we have attempted to provide current, accurate and clearly expressed information, this information is provided “as is” and MNJ Insurance Solutions makes no representations or warranties regarding its accuracy  and completeness.  The information provided should not be construed as legal or tax advice or as a recommendation of any kind.  External users should seek professional advice form their own attorneys and tax and benefit plan advisers with respect to their individual circumstances and needs.

CA UPDATE: Commissioner Lara issues Order resulting in workers’ compensation premium savings for California businesses affected by COVID-19

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FOR IMMEDIATE RELEASE:
June 17, 2020
MEDIA INQUIRIES ONLY:
Michael Soller or Byron Tucker: 916-492-3566 916-661-0556 cell
Email inquiries: cdipress@insurance.ca.gov

Commissioner Lara issues Order resulting in workers’ compensation premium savings for California businesses affected by COVID-19
Commissioner’s action mandates workers’ compensation carriers reflect reduced risk of loss in premiums due to “stay-at-home” orders

LOS ANGELES, Calif. — Insurance Commissioner Ricardo Lara today issued an Order adopting emergency workers’ compensation regulations in response to the COVID-19 pandemic. These new regulations will mandate insurance companies to recompute premium charges for policyholders to reflect reduced risk of loss consistent with Commissioner Lara’s April 13 and May 15, 2020 Bulletins, and will result in savings for many policyholders as businesses continue to struggle financially during the COVID-19 pandemic.

“California’s business owners have been hit hard by COVID-19,” said Commissioner Lara. “Workers’ compensation premiums should reflect that many employees are performing less risky duties, and my Order will provide some financial relief for employers when they need it most.”

Under these emergency regulations, employers are permitted to reclassify an employee if the employee’s duties have changed to a clerical classification that has reduced risk than the employee’s previous classification. This reclassification will reduce the employer’s premiums for employees who are a lower risk because they are now working from home even though they may not have previously done so. This change would be retroactive to March 19, 2020, the first day of the Governor’s statewide stay-at-home order, and conclude 60 days after the order is lifted.

“We applaud Commissioner Lara’s efforts to meet the needs of California’s small businesses as they continue to navigate the COVID-19 crisis,” said Mark Herbert, Vice President, California for Small Business Majority. “These new rules will allow small business owners to correctly reclassify their workforce if their duties have changed, helping businesses keep more money in their pockets as they respond to a decline in revenue and adapt their business models. These rules will also ensure small businesses are better positioned for the long-term by protecting them from future increases in workers’ compensation premiums due to COVID-19. This kind of smart action will ensure our state’s job creators and innovators have the tools they need to succeed after this crisis.”

These emergency regulations also exclude from premium calculations the payments made to an employee, including sick or family leave, while the employee is not performing duties of any kind for the employer. Typically, these payments would be used as a basis for the employer’s workers’ compensation premium. This change will lower the employer’s rate by reducing the amount of payroll assessed, and the employer will not pay premium for paid workers who are otherwise being furloughed.

“These changes provide clarity to employers while helping to share any financial costs of work-related COVID-19 cases among all employers—not just those who found themselves at the center of the epidemic,” said Mitch Steiger, Advocate for the California Labor Federation, who is also a member of the Workers’ Compensation Insurance Rating Bureau (WCIRB) Governing Board. “In doing so, both workers and employers most affected by this crisis can more quickly begin the process of recovery.”

This new regulation will also exclude claims related to a COVID-19 diagnosis from being included in future rate calculations so that employers are not penalized with higher rates due to COVID-19 claims.

Insurers will also be required to report injuries involving a diagnosis of COVID-19 which will allow the Commissioner’s statistical agent—the WCIRB—to keep track of COVID-19 injuries, and will aid in the WCIRB’s future analyses of the workplace and market impacts.

The new regulations will go into effect on July 1, 2020.

# # #

Media note:
• Link to Commissioner’s Decision and Order

Insurance Carriers’ Responses to COVID-19

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We recognize this is a challenging time for everyone and MNJ Insurance Solutions remains committed to be a resource to those we serve, our clients, our prospect clients, our business partners, our insurance carriers, and our communities.

We continue to monitor the spread of COVID-19 and the impact around us.  One of the most common questions that we are receiving from our clients is “How are the insurance carriers covering COVID-19?”

Use the links below for Frequently Asked Questions, resources, and more information on how our carriers are covering COVID-19:

Our work does not stop in light of this pandemic and our team is here to answer your questions and help with you and your employees’ insurance needs.  Contact us at (714) 716-4303 if you have any questions regarding your health insurance plans and COVID-19 and we will do our best to help find solutions.

Disclaimer:  Information is subject to change at any time.  For the most current information on COVID-19 and recommendations on how to protect yourself and others during this pandemic, please visit the CDC for more details.

President Trump Announces National Guidelines to Limit Coronavirus Spread

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On Monday, March 16, 2020, President Trump held a news conference to reinforce guidelines intended to slow the spread of COVID-19. He asked Americans to follow the guidelines for the next 15 days:

  • President Trump and his advisors now say to avoid social gatherings and if needed, limit gatherings to under 10 people (down from the “under 50 people” recommendation days earlier).
  • Trump emphasized the importance of self-isolation during this critical time. It was recommended children should be schooled at home, and employees should work from home.
  • Continue to wash your hands, cover your mouth when coughing or sneezing, and create social distancing of 6-feet.

This isolation strategy will hopefully contain individuals who may be carrying the virus and are not aware of it. The administration acknowledged the prevalence of young, healthy individuals without severe symptoms have been unknowingly spreading COVID-19 and want to prevent further spread of the virus.

Unfortunately, no one can be certain how long this pandemic will last. When prompted, Trump suggested the virus may “wash through” the country by July or August, if the administration’s proposed guidelines are followed.

Stay tuned for more updates from MNJ Insurance Solutions about this ongoing pandemic.

Practical Tips for Employers & Employees: Coronavirus Pandemic

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In uncertain times such as these, employees are looking for guidance wherever they can find it. Listed below are practical tips Employers can help calm some of their employees’ fears by taking the following actions:

  • Communicate the future of the business with employees in meetings, on the company intranet site, in newsletters.
  • Educate employees that there are cyber criminals that may prey on individuals during times of panic and hardship.  Be careful of cyber scams.
  • Be empathetic in your communications, as every employee’s situation may be different.

 

In these uncertain times, it’s imperative that you communicate your business’ plans as frequently as possible. While it is impossible to control the pandemic, it is possible for you to help ease the stress your employees are experiencing.

For additional employee communications or resources regarding the COVID-19 pandemic, contact MNJ Insurance Solutions.