Frequently Asked Questions

Announcing a new Viva Health Partnership

Announcing a new Viva Health Partnership

Is this considered a group plan?

With respect to your group/practice, this is considered a group plan, so you have to offer the plan to all employees eligible in your organization (full-time employees working at least 30 hours a week).

What is the minimum number of enrollees per group?

If all employees decline/waive coverage, it is ok if only the employer or one employee enrolls.

Can I take my contribution out of my paycheck pre-tax?
You may make a Section 125 election for your practice in order to allow employees to make plan contributions on a pre-tax basis.
What benefit plans are offered?

There are 3 health benefit plans (Platinum, Gold, Silver) and 1 dental plan offered. The health plans are identical in coverage to the standard Platinum, Gold, and Silver BlueCross BlueShield plans except there is no pediatric dental or vision coverage.

What benefits are in the Dental Plan?

The dental plan is an open network of dentists (meaning you can see any dentist you want). The plan pays usual and customary rates to dentists on a weekly basis. The benefits have no waiting periods.

How many plans can I offer my employees?

Your group can decide to offer all benefit plans and your employees can choose, or you can offer 2 or 1 of the plans. It is up to the employer.

Does the plan offer a Medicare option?

Medicare products are not offered yet. If you are turning 65, you can continue on the plan as long as you are eligible as an active, full-time worker, or you can switch to full Medicare.

When do deductibles start over?

Deductibles reset every calendar year. So on January 1 each year, your deductible starts over.

When can a group start?
  • The plan is starting on 9/1/18 and will renew every year on 1/1.
    • At your current BCBS Group renewal, you can switch to the Benefit Program.  Since the overall Benefit Program renewal will be on 1/1 each year, your initial plan will be a short year plan, but your deductible for that calendar year will be rolled in if you switch to the same plan coverage (gold to gold).
    • If you are starting a group plan for the first time, then you can start on the first of any month. Your deductible for that calendar year will start new at your effective date.
How are contribution rates determined?

Contribution rates are determined on a group/practice basis. Rates are calculated based on the average age of your group’s plan participants. So, the younger the employees you encourage to be on the plan, the cheaper the initial rates usually are.

Are there exclusions for pre-existing conditions?

There are no pre-existing condition exclusions, but rates are not final until after a medical questionnaire is completed during enrollment on all participants, and the underwriting department makes a rate recommendation. Final rates will be approved by the group prior to the effective date.

How are renewal rates determined?

At renewal, rates will be based on the experience of your group. Rates will be transparent and fair! Renewal is optional, of course.

How can a group leave the plan?

You can terminate your contract with the plan with a written notice 90 days in advance of the plan renewal.

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