How to Enroll in Health Insurance on the Connect for Health Colorado Marketplace


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  • SPEAK SLOW AND CLEARHAVE WATERTHANKSFor the opportunityThe audienceThe partnersThese slides are available electronically. I will give out information a the end of the presentation on how to get them sent to you.At the end of this presentation, if you would like to get more assistance or even schedule an appointment for your particular small business situation, we will be available to do so.
  • If you just want a quote, talk to a broker!
  • We’ll list the steps you need to complete, then do a quick walk-through with pictures of the site so you can get an idea of how the process will look as you’re doing itCensus: if you offer to any full-time employee, must offer to all. No requirement to provide coverage to part-time, although you’re also allowed to offer them the same coverage if you like. .
  • Can also sort high-lowEmployees will have same filter options; can sort by provider, etc.
  • Under ‘Manage Employees’ tab at top of page
  • Segway at the end into biggest two reasons small employers want to offer coverage: 1. “right” thing to do- sometimes employees have been with the company for 15-20 years, and employers want to help to make sure they have healthcare 2. helps to pull in quality employees like a larger business is able to do. Typically, large employers are able to offer healthcare as part of benefits package.
  • The 50 figure. The marketplace is built for those business with 50 employees or less. The tax credit is for those from 2-25.
  • THANKSAudiencePartners – by nameAnd if you feel there are small business groups you know of which would benefit from hearing this presentation or having it in-person, please see me before we depart today.
  • Small Business Majority is not a typical dues paying, membership group. But if you would like to join our network please contact Emma Hollister at email and phone. Additionally follow us through social media at our Twitter address of @smlbizmajority and Facebook Small Business Majority as well as our website Meeting Notes (8/23/13 12:01) -----11,000 businesses involved, share a story with the media. Small business owners intersed in letters to the editor, or become participate in webinars,
  • How to Enroll in Health Insurance on the Connect for Health Colorado Marketplace

    1. 1. How to Enroll in Health Insurance on the Connect for Health Colorado Marketplace Connect for Health Colorado Small Business Majority Jim Sugden Emily Dewey Small Business Marketplace Manager Health Coverage Guide
    2. 2. Agenda • The new marketplace (Connect for Health Colorado) • Health insurance definitions • Enrollment preparation • Applying on • Small business tax credit
    3. 3. About Small Business Majority • Small business advocacy organization – founded and run by small business owners • National – offices in Washington, D.C., Ohio, Colorado, Missouri, Virginia, Washington State, New York and California • Research and advocacy on issues of top importance to small businesses (<100 employees) and the self-employed, including healthcare, access to credit and clean energy • Very focused on outreach to and education of small business owners across the country
    4. 4. What is Connect for Health Colorado? • Competitive marketplace for private health insurance • Makes comparing and purchasing commercial health insurance plans more convenient and competitive • Provides broad array of choices in one place • Helps you make an informed decision by creating transparency about your options • Only place to check eligibility for new tax credits and apply them right away to reduce your costs • Offers you statewide network of trained professionals to help you access the new financial help and find the health plan that is right for you and your family • A new service operated by a non-profit with the mission to help Coloradans
    5. 5. 92 Health Plans for Small Employers Competing for Your Business: • Anthem Blue Cross and Blue Shield / HMO Colorado • Colorado Choice Health Plans • Colorado HealthOP • Kaiser Permanente • Rocky Mountain Health Plans • SeeChange Health
    6. 6. Health Insurance 101 – Premium: The monthly amount that you must pay for your health / dental insurance (coverage) – Deductible: You need to pay this amount before your plans starts helping you pay for most covered services through coinsurance. – Annual Out of Pocket Max: This is the most you’ll pay for care during a policy period (usually a year) before your plan starts paying 100 percent for most covered services. – Copay: A fixed amount (for example, $15) you pay for a medical visit or for medication that is covered under your health plan, usually when you receive the service. This is considered part of your out-of-pocket costs, separate from premiums and deductibles. – Coinsurance: After reaching your deductible, you may start paying a percentage of the total cost for certain services. Coinsurance usually reflects the percentage of medical expenses that you are responsible to cover, for dental expenses the percentage reflects what the dental plan will cover. Source: Cliff Craig, Connect for Health
    7. 7. Health Insurance 101 – HMO: A type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO. It generally won’t cover out-of-network care except in an emergency. An HMO may require you to live or work in its service area to be eligible for coverage. HMOs often provide integrated care and focus on prevention and wellness. (No Out of Network Coverage) – PPO: A type of health plan that contracts with medical providers, such as hospitals and doctors, to create a network of participating providers. You pay less if you use providers that belong to the plan’s network. You can use doctors, hospitals and providers outside of the network for an additional cost. (Out of Network Coverage but at higher cost-sharing) – EPO: A more restrictive type of preferred provider organization plan under which employees must use providers from the specified network of physicians and hospitals to receive coverage; there is no coverage for care received from a non-network provider except in an emergency situation. (No Out of Network Coverage) Source: Cliff Craig, Connect for Health
    8. 8. The Enrollment Process • Gathering information • Employer account creation • Creating enrollment • Employee responsibilities
    9. 9. Info You’ll Need to Enroll • For all employees: • For all dependents: – Date of hire • Date of birth – Email address • Social Security Number – Date of birth – Social Security Number – Home address – Salary – Hours worked per week
    10. 10. Enrollment Process - Employer • Create account • Create roster (list of all employees) • Attest to small business status (2-50 employees) • Create census (list of employees offered coverage) • Create enrollment – Define enrollment period – Select census – Define plan selection options – Define contribution – Browse/select plans – Complete enrollment
    11. 11. Enrollment Process – Employer, cont. • Send welcome message to employees • Check participation rate – At least 70% of employees must accept or decline coverage • When enrollment period closes, submit application – Send payment to Connect for Health Ongoing: • Manage enrollment – Change roster – Manage employee life change events – Pay monthly premium
    12. 12. Enrollment Process – Employees • Receive welcome message with participation code • Create account on employee portal • Enter participation code to associate with employer account • Shop and select plan during open enrollment period • Submit application
    13. 13. Creating an Account • Go to
    14. 14. Creating an Account, cont.
    15. 15. Creating an Account, cont.
    16. 16. Adding Employees
    17. 17. Adding Employees
    18. 18. Adding Employees
    19. 19. Adding Dependents Click ‘Save & Continue’
    20. 20. Create Your Census
    21. 21. Create an Enrollment
    22. 22. Creating an Enrollment
    23. 23. Select Census
    24. 24. Define Plan Selection Options
    25. 25. Define Contribution
    26. 26. Filter Plans Filters: • Employer contribution • Employee contribution • Annual deductible • Carrier • Metal level
    27. 27. Review Enrollment
    28. 28. Send Welcome Message
    29. 29. Small Business Marketplace • Despite not being subject to employer shared responsibility provisions, the Marketplace may help make healthcare more affordable for small employers o How will it be different? o Small business tax credit o Greater employer choice- shop by price, plan, service, level of coverage o Pooling together of small businesses o How will it be similar? o Private insurance competing for business o Option for small employers, insurance still sold outside
    30. 30. Small business tax credits • Available to businesses with employees • Took effect immediately (tax year 2010) • Which businesses are eligible?  Fewer than 25 full-time employees  Average annual wages <$50,000  Employer pays at least 50% of the premium cost
    31. 31. Small business tax credits • Tax credits on a sliding scale: o Up to 35% of premium expenses for 2010–13 o Up to 50% of premium expenses for any two years beginning 2014 • Tax credits do not cover premium expenses of owners or their families • Tax credits can not be claimed by the self-employed • Still as an amendment to your 2010 taxes, or can be carried back to tax year 2010.
    32. 32. Resources Contact Connect for Health Colorado: Call center: 855-PLANS-4-YOU (855-752-6749) For More Information: Emily Dewey Health Coverage Guide Small Business Majority Jim Sugden SHOP Marketplace Manager Connect for Health Colorado
    33. 33. Join Our Network Contact • Emma Hollister, Network Coordinator • Email: • Direct: (202) 535-3229 Ways to Get Involved: Connect with us! @SmlBizMajority • Receive a monthly newsletter • Share your story for media requests • Letters to the editor/Op-eds Small Business Majority • State events/Roundtables • Fly-ins • Webinars for business organizations