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Claremont Insurance Services Claremont Insurance Services is a leading General Agency serving employee benefits brokers and agent

Claremont helps clients increase revenue, reduce operational costs and reduce risk by truly understanding the California market, then sharing that insight with brokers and agents to ensure they can best serve their clients. Claremont focuses on building their clients’ businesses through market analysis, product education, and a comprehensive portfolio of competitive health, dental, and ancillary insurance plans.

CMS has finalized new Part D creditable coverage requirements for plan years beginning January 1, 2027:• The existing ...
10/13/2026

CMS has finalized new Part D creditable coverage requirements for plan years beginning January 1, 2027:

• The existing Simplified Determination Method will be retired.
• The Revised Simplified Determination Method will require plans to cover an average of at least 73% of participants’ prescription drug expenses.
• Plans may instead use a full actuarial determination.

The threshold change from 72% in 2026 to 73% in 2027 may appear small. But the determination should not be treated as automatic, especially for groups with lean prescription drug benefits.

If a plan loses creditable status, Medicare-eligible members will need accurate, timely information. Delaying Part D enrollment without creditable coverage can result in late-enrollment penalties.

For brokers, the next step is to identify potentially affected groups before renewal decisions are finalized. Confirm the plan’s status, understand which determination method is being used, and give the employer time to communicate with affected members.

Read the full update https://ow.ly/szhk50ZSWuL

Which clients or plan designs are most likely to need an early review?

Contact The Answer Team at [email protected] or 800.696.4543 for more information.

Medicare

10/08/2026

A difficult Health Net renewal may have more Blue Shield of California options than it did before.

Blue Shield’s latest changes may give brokers more ways to address smaller groups, participation challenges, and split-carrier situations.

The opportunity includes:
• A lower minimum of three enrolling subscribers.
• No 25% participation minimum for groups moving directly from Health Net.
• Acceptance of a Health Net billing statement instead of a DE 9C.
• A one-time option to coordinate a new 2027 renewal date for groups splitting carriers.
• An uncapped broker bonus based on cumulative qualifying membership.

These provisions apply to October 1, 2026, through March 1, 2027 effective dates.

The added flexibility could help with smaller cases, split-carrier strategies, and groups that have been difficult to place https://ow.ly/u8kJ50ZSWna

Start identifying potential cases before renewal discussions begin. The Answer Team can help you evaluate the available options.

10/07/2026

Your next Health Net client conversation can start with two reassuring answers.

Employees may be able to keep their Health Net coverage longer, and the employer may not need to complete another group application next year.

For eligible groups moving by January 1, 2027:
• Participating members can keep Health Net HMO through December 31, 2027.
• Other employees can choose from several HMO carriers or an Anthem PPO.
• The current reconciled Health Net invoice may replace the DE 9C.
• Employees can select a different carrier at the next open enrollment without a new group application.
• You can earn $100 bonus per Health Net member who enrolls in California Choice coverage.

CaliforniaChoice gives you a clear way to discuss continuity, employee choice, and the group’s longer-term plan https://ow.ly/lNit50ZSWr5

Contact The Answer Team at 800.696.4543 or [email protected] to see whether your client qualifies.

10/06/2026

That small group you previously labeled “not a fit” may now be worth another look.

Recent Covered California for Small Business changes include:

• Easier documentation for qualifying Health Net transitions.
• Deadlines extended to the 15th through March 2027 effective dates.
• A 70% creditable-coverage participation requirement.
• No administration fees.
• An active new-business broker bonus.

The added flexibility could open the door for more groups, but early submission is still recommended.

Learn more (https://ow.ly/7XXe50ZSWk9) and contact us today at 800.696.4543 or [email protected] for a quote.

10/01/2026

Smaller Health Net groups just became easier to place with Blue Shield.

Blue Shield is temporarily relaxing several underwriting requirements for groups moving directly from Health Net.

For October 1, 2026, through March 1, 2027 effective dates:
• The minimum number of enrolling subscribers drops from 5 to 3.
• The 25% participation requirement is waived.
• A Health Net billing statement can replace the DE 9C.
• Groups splitting carriers may qualify for a one-time 2027 renewal-date alignment.

Blue Shield of California is also offering an uncapped, cumulative broker bonus of $100 to $200 per member, depending on total qualifying membership.

Cases that did not fit before may fit now https://ow.ly/u8kJ50ZSWna

Review your Health Net groups and contact us at 800.696.4543 or [email protected] for help confirming eligibility.

09/30/2026

One piece of missing payroll documentation no longer has to stop a qualifying Health Net transition.

Moving a small group off Health Net now requires less documentation.

Covered California for Small Business has added a more flexible option for qualifying Health Net transitions:
• A prior Health Net bill showing at least one enrolling subscriber may replace the DE-9 or payroll report.
• Employees who are enrolling but do not appear on the bill may be verified with a pay stub or offer letter.
• The change can help brokers keep a case moving when standard payroll documentation is difficult to obtain.

CCSB has also extended submission deadlines to the 15th of the month for all new groups with October 2026 through March 2027 effective dates.

That extra time is useful, but early submission is still recommended because CCSB expects heavy volume through March.

If a Health Net group previously looked difficult to move, it may be worth reviewing the case again.

Get the details (https://ow.ly/7XXe50ZSWk9) and contact us today for a CCSB quote.

09/15/2026

Blue Shield of California has shared several 2027 updates that may affect Small and Large Group planning. What brokers should know:

• 2027 HSA-compatible plan deductibles.
The IRS minimum deductible will increase to $1,750 for individual coverage and $3,500 for family coverage. These changes apply to both Small and Large Group HSA-compatible plans.
• Small Business Broker Roadshow.
Learn about Q1-2027 Small Business updates during Blue Shield’s annual Broker Roadshow on September 22, 1:00 to 2:00 p.m.
• Large Group MCO tax update.
Blue Shield will exclude the anticipated $8.85 per member per month California MCO tax from January 1, 2027, fully insured and flex-funded Large Group renewal and new business rates.

Get all the updates and register for the Small Business Broker Roadshow: https://ow.ly/3zZ050ZI1jq

09/09/2026

Three Blue Shield of California updates for 2027:
• HSA-compatible minimum deductibles will increase to $1,750 for individuals and $3,500 for families.
• The Q1-2027 Small Business Broker Roadshow will take place on September 22 from 1:00 to 2:00 p.m.
• The anticipated $8.85 PMPM MCO tax will be excluded from January 1, 2027, Large Group rates for now.

Get the details and register for the Roadshow https://ow.ly/3zZ050ZI1jq

09/08/2026

Join the Statewide Covered California for Small Business Q1-2027 Update Webinar to learn about:

• The new carrier announcement.
• 2027 plan designs.
• Broker bonus opportunities.
• Q1-2027 rates.

To get prepared for your client conversations, register today to attend the webinar on Tuesday, September 22 at 11:00 am https://ow.ly/4a4c50ZI12Z

09/03/2026

When employers ask why ancillary benefits matter, having the right information can make the conversation easier.

Humana has several new broker resources:
• A new Dental Wellness Center that helps members understand benefits, networks, claims, oral health, and potential dental costs.
• A September 1 webinar exploring dental and vision benefits for children.
• An on-demand webinar with research about employee views of life and disability coverage.

These resources can help shift the discussion from simply offering another benefit to explaining how employees may actually use and value the coverage.

Take a look at the latest Humana resources (https://ow.ly/2lbW50ZI0Rc) before your next benefits discussion, and contact our Answer Team at 800.696.4543 or [email protected] for a quote.

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1000 Burnett Avenue, Suite 330
Concord, CA
94520

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