Utah's Health Insurance Marketplace, by Patty Conner, Director

1. July 16, 2013
Presented by Patty Conner, Director
Where small business shops for health insurance

2. Utah’s MarketPlace Solution
• Individual
Application
• Medicaid Assessment
• Tax Subsidies/Cost
Sharing Reductions
• Enrollment in Private
Insurance Plans
• Medicaid/CHIP
Determination
• Enrollment in
Medicaid
• Re-certification
• Group Application
• Plan Comparison
• Enrollment
• Single Invoice for
Premium Payment
• Sm. Employer Tax
Credit
Avenue H
Carriers
Operated by Federal
Govt.
Utah Department of
Workforce Services
Enrollment
files/subsidies
Carriers collect premiums
Individual Small Business
www.healthcare.gov
www.avenueH.com
Public Insurance/Subsidized Private Insurance Private Insurance

3. Avenue H, Health Insurance
Marketplace
 ACA State-based Marketplace for Utah
 Market-oriented, competitive environment
 One stop shop for Medical, Dental and Health Savings
Accounts
 Defined Contribution Approach
 Flat dollar amount, no minimum
 Pre-tax Benefits for employee and employer
 Employee Choice
 Plan Comparison Tools and Transparency
 Administrative Ease
 Small Employer Premium Tax Credit
3

4. Broker Credentialing
To assist clients on Avenue H, producers must:
 Have a current Utah Health Producer license
 Be appointed by all participating carriers as a producer
 Attend training for Utah Premium Partnership (UPP)
 Attend Avenue H Training
 All Producers must get re-credentialed this fall
 2 hour CE courses will start on August 14th, every Thursday through
October
 Register for course at www.avenueh.com

5. Options-Do the Math
Individual Small Employers Large
Employers
Who Individuals and
their Families
1-50 FT 50 + FT
Access • Individual
Marketplace
• Commercial
Market
• Avenue H
• Commercial
Market
• Commercial
Market
Subsidies • APTC
• CSR
• Sm. Employer
Premium Tax
Credit
• UPP
None
Premiums Post-Tax Pre-Tax Pre-Tax
Open
Enrollment
Oct 2013-
March 2014
Begins Oct 2013 Anytime
Penalties 2014: $95 pmpy
2015: $325 pmpy
None $2,000 or
$3,000 pepy
EHB Applies Applies N/A