Now that you’re offering health insurance to your employees get ready for questions about:
- signing up for the first time
- how to make changes to coverage (adding spouse or dependent coverage, ending coverage for a spouse or child)
- how to update contact information
Read on for answers and details on the forms you’ll want to keep handy.
New Hire Enrollment Quote Request
If you hire a new employee, you’ll need to complete and return a New Hire Enrollment Quote Request to get a customized enrollment quote for that employee. Your new employee’s quote will be returned by our team within a few days, along with a Member Enrollment Guide and enrollment application (see below) to share with each employee.
Visit calchoice.com, log in, and select “Employees” and “New Hire Quote” for the quote request form.
Employee Enrollment Application
Any of your eligible employees who want to get coverage through CaliforniaChoice must complete a Medical/Dental/Life/Vision Enrollment Application. Be sure you give your new hire your group number, so the employee can include it in the top section of the application’s first page. The employee should complete all applicable sections: personal information, enrollment information, selected benefits, and acknowledgment.
Page 5 of this form summarizes Family Coverage Eligibility Requirements.
Late enrollment or involuntary loss of coverage: If an employee waived coverage in the past, he/she/they may be able to enroll late and/or change benefits. This can happen when other coverage ends due to death of a spouse (who maintained it). Or when there is a loss of benefits eligibility due to reduced work hours or job loss.
CaliforniaChoice Medical/Dental Waiver
New employees who want to waive Medical and/or Dental coverage must complete page 4 of the Employee Enrollment Application, which specifically relates to waiving Medical and Dental.
Employers are required to maintain a valid waiver for employees who decline coverage.
Waivers should also be submitted to CaliforniaChoice via mail, email, or fax (714-558-8000). Refer to your Employer Administrative Guide for more information.
Change Request Form
If your employees go through any significant life changes or events, they’ll need to fill out a Change Request Form.
This form can be used in a wide variety of situations., including:
- Marriage or domestic partnership: A change in an employee’s marital status (e.g., marriage, divorce, or separation) or domestic partnership.
- New family member: Adding a dependent child through adoption or birth.
- Remove coverage or dependents: Employees can remove existing insurance coverage or dependents from current inclusion in their plan(s). For example, when a dependent child reaches age 26 (and is no longer eligible for insurance through a parent).
- Moving: If an employee moves to a new residence (and outside of their existing health plan’s service area), they may have only an address change or they may need to change plans.
Section A must be completed in its entirety. Section B applies only in situations where employees are canceling or adding dependent coverage. Section C specifies the coverage modification. Section D applies only the adding or changing optional benefits, such as Dental, Vision, or a Life Beneficiary change.
Limited Time to Make Changes: Generally, individuals have up to 60 days from a qualifying/triggering event to make coverage changes. Tell your employees they can log in at calchoice.com for details about different kinds of changes. They can also call Customer Service at 800.558.8003 or 714.558.8000 or send an email to CustomerService@calchoice.com.
Employee Termination Notification Form
All employees who become ineligible for your group coverage must be terminated from the group plan. You (as the employer) must complete an Employee Termination Notification Form and submit it to CaliforniaChoice within 30 days of the last day the worker is employed.
Help When You Need It
These forms are all available on the CalChoice website. Log in and download the forms you need and check back regularly for updates. If you have any questions, or if you are unable to locate what you need, contact Customer Service at 800-558-8003, via fax at 714-558-8000, or by email (CustomerService@calchoice.com).