As I  see it, the main advantages to CCSB:

Participating Companies:

Blue Shield,

Chinese Community Health Plan,

Kaiser

Health Net

Sharp

Western Health Advantage

Ask about the “Employee only” plan
Which Allows  Subsidies for Dependents in Covered CA

  • Employees who have dependents seeking subsidy assistance through the individual exchange cannot qualify.
  • Spouse/parents enrolled in an employer group ACA qualified plan in most cases disqualifies the subsidy eligibility – Family Glitch –  9.66% Rule
  • Most employers do not contribute to the dependent portion of the premium, but because the offer the coverage the dependents technically have “Access” to a ACA qualified plan.
  • Dependent coverage is perceived as “unaffordable” to the employee; result = low to no dependent participation
  • Why have an employer offer a benefit that is not utilized and unintentionally penalizes??

 

Solution

 

  • Implement an “employee only” plan; dependents do NOT have “Access” thereby receiving subsidies. 9.17.2015  Covered CA Email 
    • Covered California for small business filed their contract to support this feature.
    • If  the dependents of your employees qualify for Covered CA subsidiesFREE Quote and Subsidy Calculation and the employer is not contributing, then we need to get you into a SHOP program and write it up as employee only, by NOT selecting dependents on page 3, step 2 question 11 of the SHOP employer application.
    • Learn More  * 

Child Pages

SHOP Covered CA for Small Business Program 
Get a Free Quote 

Get free no obligation quote & proposal

Covered CA Video's

What is Covered for Small Biz 2015

 

How can Covered CA help your Small Business?

 

Covered CA - Certified Agent

Covered CA - Certified Agent

Historical

Summary of Plans & Benefits for 2017 4 page pdf

Anthem Blue Cross has chosen not to participate  in the SHOP Exchange according to the LA Times.    Dave Jones CA Insurance Commissioner asked that they not be in the exchange due to excessive rate increase as reported in the LA Times.

Blue Cross will be in the Individual Exchange.  Both exchanges allow you to use your own Agent at no extra fee!

I find a disconnect here as Health Care Reform mandates 80% of premiums be paid out in claims.     It’s the same MD’s and hospitals that the public and Insurance Companies are using, aren’t they?  Does Blue Cross have a better MD’s & Hospitals?   Here’s the provider lists.   Here’s information on the rising costs.

Even in 1993, we were shocked at Hospital Costs.

Insurance Consumers can get a lot of variety in Cal Choice, a private exchange operating for years.  CA had a similar exchange to the SHOP exchange called HIPC – Pac Advantage with 1992 Reforms – AB 1672?  that fell apart.

$64K Hospital Bill
Double Bypass & Aortic Valve Replacement
1993 Life Magazine

www.life.com/ archives
Nightline Transcript  11/12/1993

 

This is an HISTORICAL Page.
See Covered CA for Small Business for current enrollment information.

 

2016 plans & benefits

SHOP Proposed Regulations Webinar0 8 15 2013

Minimum Value Standard

See the Change,

AetnaBlue CrossCalifornia Choice – (Private Exchange), UHPSharp,  Ben E Lect (Self Funded)

Covered-California-SHOP-booklet.8.1.2013 Educational Use ONLY (SHOP Booklet Official Version)

Click here to see Covered CA – SHOP Summary of Benefits 7.2013.  I’m not a happy camper with this literature and am hoping something “nicer” comes out soon.

(KFF Calculator)

We will post more information, as it becomes available.

Michael Lujan Marketing Director of Covered CA resigns.  Sacramento Biz Journal

Pinnacle Claims Management awarded the contract to manage the SHOP Program.

No extra charge to use an Agent! healthcare.gov

While the Federal SHOP has been delayed a year, CA announced recently that everything is up and running.

Insurance Agents and Enrollment Counselors are knowledgeable of both subsidized and non-subsidized health coverage and qualified health plans. They are equipped with the information and expertise needed to assist families and individuals to enroll in coverage. https://apply.coveredca.com/apspahbx/login.portal

 

Employers can offer two metal tiers per 9.17.2014 1 PM email blast

SHOP delays announcement of what carriers will participate in 2015 californiahealthline.org/

https://www.coveredca.com/hbex/shop/

Shop taken offline – must do paper applications
https://www.coveredca.com

SHOP FAQ’s
https://www.coveredca.com

2.13.2014

Covered California Suspends Small-Business Online Enrollment to Implement Improvements
Paper Applications Remain the Conventional Enrollment
Vehicle During the SHOP Portal’s Redesign
SACRAMENTO, Calif. — In response to requests for modifications and enhancements to the Small Business Health Options Program (SHOP) portal, Covered California™ announced today that it is suspending this component of SHOP to implement a series of redesigns. Meanwhile, enrollment in SHOP will continue via the industry standard process of using paper applications.

“The SHOP portal was not meeting the needs of agents or small employers and needed improvements,” said Covered California Executive Director Peter V. Lee. “Taking the portal offline will not affect the paper application process, which has been the preferred enrollment method traditionally used by insurance agents in the small-group market.”

The online portal for SHOP enrollment will go offline today, Feb. 12 and is projected to be back online in the fall of 2014. Small-business owners can continue enrolling in SHOP by calling the SHOP Service Center or working with a Certified Insurance Agent.

Representatives of the SHOP Service Center are available 8 a.m. to 6 p.m. Monday through Friday at (877) 453-9198. The Service Center can assist both small-business owners and Certified Insurance Agents with paper application enrollments, along with answering questions about existing applications. To date, the vast majority of SHOP enrollments have been submitted using paper applications.

“Certified Insurance Agents are critical partners in SHOP, and we want to be responsive to their input about improvements to the program, including their feedback that retooling is needed in the SHOP portal,” said Lee. “We are committed to ensuring the smoothest possible enrollment experience, and we believe the new version of the online portal will significantly enhance the enrollment process.”

The new version of the SHOP portal is expected to increase the efficiency of service and allow better management of applications, including determination of eligibility, implementing group changes and issuing invoices.

As of Jan. 31, 2014, 571 groups were enrolled in Covered California’s SHOP, representing 4,490 individuals. SHOP is currently processing an additional 200 group applications, representing 1,200 individuals. Small businesses can enroll in SHOP plans year round.

For more information, please check out our FAQ “What Does Removing the Online SHOP Portal Mean to Agents?” which will be available on CoveredCA.com tomorrow.

is part of Covered California and meets Exchange Requirements of Health Reform.  2015 Coverage announcements.

Technical Resources

Title 45: Public Welfare
  PART 157—EMPLOYER INTERACTIONS WITH EXCHANGES AND SHOP PARTICIPATION
[1]   Subpart C—Standards for Qualified Employers   [Context]
[2]   § 157.205   Qualified employer participation process in a SHOP.   [Context]
    PART 156—HEALTH INSURANCE ISSUER STANDARDS UNDER THE AFFORDABLE CARE ACT, INCLUDING STANDARDS RELATED TO EXCHANGES
    Subpart C—Qualified Health Plan Minimum Certification Standards
[3]   § 156.285   Additional standards specific to SHOP.   [Context]
[4]   PART 157—EMPLOYER INTERACTIONS WITH EXCHANGES AND SHOP PARTICIPATION   [Context]
    PART 155—EXCHANGE ESTABLISHMENT STANDARDS AND OTHER RELATED STANDARDS UNDER THE AFFORDABLE CARE ACT
    Subpart H—Exchange Functions: Small Business Health Options Program (SHOP)
[5]   § 155.725   Enrollment periods under SHOP.   [Context]
[6]   § 155.705   Functions of a SHOP.   [Context]
[7]   Subpart H—Exchange Functions: Small Business Health Options Program (SHOP)   [Context]
    PART 156—HEALTH INSURANCE ISSUER STANDARDS UNDER THE AFFORDABLE CARE ACT, INCLUDING STANDARDS RELATED TO EXCHANGES
[8]   Subpart C—Qualified Health Plan Minimum Certification Standards   [Context]
[9]   PART 156—HEALTH INSURANCE ISSUER STANDARDS UNDER THE AFFORDABLE CARE ACT, INCLUDING STANDARDS RELATED TO EXCHANGES   [Context]
[10]   PART 155—EXCHANGE ESTABLISHMENT STANDARDS AND OTHER RELATED STANDARDS UNDER THE AFFORDABLE CARE ACT   [Context]

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