Skip main navigational links

Our plans

For small business—1 to 50 employees

Health care reform and your business

On March 23, 2010, the Affordable Care Act (ACA) — also known as health care reform — became federal law. To comply with the ACA, for plan years beginning on or after January 1, 2014, all insurers must offer small group plans that meet new standards for coverage. This excludes grandfathered plans, which may be renewed for 2014 as is.

Whether your group is offering a grandfathered plan or a new 2014 metal tier plan, your employees still get the quality services and support they need to stay healthy and productive every day — top doctors, a focus on prevention, innovative health management tools, and high-quality, personalized care.

More information on health care reform.

Essential health benefits

Starting with plan years beginning on or after January 1, 2014, the ACA requires all small group commercial plans1 (with some exceptions, such as retiree and dental-only plans) to cover 10 categories of essential health benefits, as defined by ACA regulations:

  1. Ambulatory patient services
  2. Emergency services
  3. Hospitalization
  4. Maternity and newborn care
  5. Mental health and substance use disorder services, including behavioral health treatment
  6. Prescription drugs
  7. Rehabilitative and habilitative services and devices
  8. Laboratory services
  9. Preventive and wellness services and chronic disease management
  10. Pediatric services, including oral and vision care2

Pediatric dental information

Pediatric dental services is one of the essential health benefits required to be provided in conjunction with your ACA metal-tier medical plan(s). When employees and their dependents enroll in the medical plan(s) you've chosen, we will also enroll them in a separate pediatric dental plan underwritten by Delta Dental of California. Pediatric dental plans are paired with medical plans based on metal tier, except for embedded PPO plans.

For more information visit pediatric dental.

New "metal tiers" of coverage

For 2014, plans fit into four main categories of coverage, known as "metal tiers." Each tier has a different actuarial value — the percent that the health plan will pay for covered essential health benefits based on the claims of a standard population:3

  • Platinum — 90% actuarial value
  • Gold — 80% actuarial value
  • Silver — 70% actuarial value
  • Bronze — 60% actuarial value

These four categories offer different levels of copayments, coinsurance, and deductibles. For example, bronze plans have lower premiums with higher out-of-pocket costs, while other metal tier plans have higher premiums and lower out-of-pocket costs.

Navigate healthcare reform with our new resource guide

From exchanges to employer responsibilities to new taxes and fees, understanding the many aspects of the Affordable Care Act can be challenging. To help you make sense of impending changes and make the right decisions for your business, take a look at our brand-new health care reform resource guide.

More information on renewals.

1 Excludes grandfathered plans.

2. Pediatric vision is a new benefit and is embedded in the medical plan.

3 The ACA allows a difference of +/- two points for actuarial value percentage.

You will need the free Adobe Acrobat Reader to read this file.

Covered ZIP Codes

Is your ZIP code in our service areas?

Contact us: Small business

Manage your account, renew, or change coverage

Or call 800-790-4661 (toll free), Monday through Friday, 8:30 a.m. to 5 p.m.

To learn about your quote and applying for coverage, request information online. You will receive a response within 48 hours (excludes weekends and Holidays).

Contact a sales representative

Or call 800-730-4661 (toll free), Monday through Friday, 8:30 a.m. to 5 p.m.