All People, Carrier News

Commission Change Effective January 1, 2018

Each year Covered California for Small Business (CCSB) engages with their carrier partners to ensure that they have competitive products, affordable rates, and that their distribution costs are aligned with current market levels.

After meeting with their carrier partners they are confident that Covered California for Small Business will continue to offer competitive products at rates that are affordable for your customers and provide industry standard commission rates for our agents.

However, achieving this outcome required a change in our agent commission structure that will take effect for all new business written on January 1, 2018 and beyond.

Beginning January 1, 2018, a 5% commission will apply to any new enrollment for groups with 1-50 enrolled employees. All 1-50 groups written from January 1, 2014 through December 1, 2017 will remain on the current 6.5% down-graded commission schedule and will not be affected.  For groups 51-100, no changes are being made.

For further details on the commission schedule changes going into effect January 1, 2018, please review the Agent Commission Structure found here.

As per the terms of the Agency Agreement, Exhibit F, Schedule of Commissions, has been updated and will effectively replace the current Schedule of Commissions found in the Agency Agreement.

Plans & Rates for 2018

Covered California for Small Business has released their portfolio of plans for 2018.


CCSB has offered an average increase of 5.6% in 2018 averaged across all plans and all regions. This is down from 2017 increase of 5.9% and 2016 increase of 7.2%.

Portfolio Changes:

All carriers, with the exception of Western Health Advantage, are returning to the portfolio. In addition to this change, Blue Shield, Chinese Community Health Plan and Health Net are all offering new plans. Health Net is also discontinuing plans for 2018. In addition to these whole plan changes, there are changes to copay, coinsurance, deductibles and OOP maximums, with most changes needing to be made to meet the new Actuarial Value calculations new in 2018.

New Plans:

Blue Shield has filled out their Trio ACO portfolio by now offering a non-Infertility version of their plans, which drops the monthly premium and gives employees more benefit and price point options. And CCHP has included a new HDHP plan that is available in the Bronze Metal Tier. Lastly, Health Net has added 3 new plan designs, two of which are utilizing a new EnhancedCare PPO network.

Discontinued Plans:

All Western Health Advantage plans have been removed for 2018 and members will be migrated to a similar plan with another carrier at their open enrollment. They will have the option to change that selection by submitting a request at open enrollment. In addition to these plan discontinuations, Health Net is also removing their two EPO plans that were tied to the EPO network. These plans are being replaced by the EnhancedCare PPO plans that is now available.

The plans and rates are now available to quote using HealthConnect.

Please contact your LISI Sales Representative for more information.