CSURMA AORMA BENEFITS PROGRAM OVERVIEW
Content: Established in 1979, 29 California Counties formed CSAC Excess Insurance Authority (EIA), a Joint Powers Authority (JPA). The sole purpose of this new JPA was to find cost-effective insurance solutions and risk management services for members. In 2020, EIA became Public Risk Innovation Solutions and Management (PRISM).
PRISM is a risk sharing pool dedicated to controlling losses and providing effective risk management solutions serving California public agencies. Membership has expended to include 95% of counties, 70% of cities, as well as educational organizations, special districts, housing authorities, fire districts, and other Joint Powers Authorities. In 2019, the Board of Directors approved expanding outside of California. Growing nationally is one example of the innovative spirit PRISM embodies.
The CSURMA AORMA Benefits Program accesses PRISM Programs through the CSURMA JPA. The Employee Benefit Coverages Offered to AOA members through PRISM are below:
Medical (PRISM Health - Anthem and Kaiser)
Kaiser Medicare (KPSA)
Dental (Delta Dental)
Vision (VSP)
Hartford (Life & Disability)
Talkspace Digital Therapy
Mass Mutual Voluntary Life
Metlife Pet Insurance
Chubb Voluntary Long-Term Care
PRISM – PRISM Health
PRISM Health is a self-funded Medical Purchasing Program offered to Counties, Cities and Special Districts since 2003
PRISM now covers more than 41,500 employee/retiree primary subscribers.
To maximize savings for the PRISM Health Pool, in 2006, PRISM entered into a risk sharing contract with SISC (Self Insured Schools of California)
PRISM Health has a risk sharing agreement with another JPA, Self-Insured Schools of California, offering a combined risk pool of over 407,000 members and is the second largest purchasing coalition in the state of CA after CalPERS
Today, 55 of the 58 counties in California participate
Both Kaiser and Anthem are offered with HMO and PPO offerings
This partnership has created:
Greater volume for wholesale pricing on administrative costs
Financial stability through balanced renewals, with less year-to-year rate volatility
Plans Available through CSURMA AORMA Benefits Program:
Anthem Medical– HMO (Full/Limited Networks, PPO (High / Low), High Deductible Plan (HDHP), Medicare Retiree PPO, Medicare Retiree HMO
Kaiser Medical– HMO High / Low options + Medicare Retiree HMO
Delta Dental– 3 DHMO + 3 PPO Plan Options
VSP– 4 plan Options
Hartford (Life & Disability) - Custom plans available with simple quoting process. Disability program includes EAP and Travel Assist benefits. Life & Disability program is not through PRISM and self-billed.
Talkspace Digital Therapy: Offers employees a network of thousands of licensed clinicians. Talkspace is an online therapy service that connects users to a dedicated therapist by text, voice or video messages anytime, anywhere, including from the comfort of their home. Plan is not through PRISM and is self-billed.
Mass Mutual Voluntary Whole Life: – Voluntary Group Whole Life insurance includes guaranteed issue up to $100,000 with an express issue option up to $250,000. Plan offers permanent portable coverage.
Getting Started:
Each Auxiliary selects from the set menu of plan designs with each carrier.
Health
Plan Selection
(2-100) enrolled lives: 2 plans + 1 Kaiser plan
(101+) enrolled lives: Standard is 3 plans + 1 Kaiser plan
Plan Combinations
(2-100) Only one HMO or HDHP plan may be offered (excludes Kaiser)
(101+) Two or more HMO or HDHP plans require Underwriting approval (excludes Kaiser)
Current plan structure will be reviewed and approved via the underwriting and renewal process.
Dental
(2-50) enrolled lives: Employers can select 1 DPPO plan and 1 DHMO plan to offer their employees and dependents.
(50+) enrolled lives: Employers can offer more than 1 DPPO plan, subject to AUS review.
Vision, Life/Disability/EAP
(2—50) enrolled lives: Employers can select only 1 plan to offer their employees and dependents.
(50+) enrolled lives: Employers can offer more than 1 plan subject to AUS review.
Basic Life and AD&D (only): Employer must select a plan for each class of employee.
Other Benefits: Talkspace and Digital Therapy
Rates for new Auxiliaries wishing to enter the pool will be fixed for one year periods, so no auxiliary-level marketing will be required (fast quotes + easy implementation).
Book rates are based on geography (Northern/Southern CA).
Exceptions
Existing Kaiser groups will be subject to Kaiser's first year "break-in/break-out" policy
Hartford plans and rates are custom, no book rates.
Entry/Exit: Plan Participants (Participating Auxiliaries) who enter the pool are committing to remaining in the pool for 3 full plan years (January - December). Plan Participants who exit the pool will not be able to rejoin for one full plan year.
Value Adds & Resources Available through CSURMA AORMA Benefits Program:
Financial Wellness: Sage Financial Wellness program available to all employees of auxiliaries who participate in one or more benefit plans through the CSURMA AORMA program.
Anthem: ConditionCare heelness program, discounts on ProClear Aligners, Telehealth (including mental health) with LiveHealth online.
Carrum Health: Available to Anthem PPO members is a surgical concierge benefit, provides fixed cost, bundled pricing for common surgeries, hip/knee replacement, cervical / lumbar Spinal Fusion, coronary Bypass Surgery, bariatric surgery, spine surgery and orthopedic surgeries (i.e. shoulder, elbow, wrist, hand, ankle, and foot).
Online Benefits Administration(BCC) services for groups participating in medical (employee self-service available).
COBRA & FSA Administration included for groups participating in medical.
How to learn more:
Alliant can provide an analysis and comparison to current offerings. Schedule a call with the Alliant team to walk through considerations.
