2. Cover Oregon is a new
online marketplace
where Oregonians can
compare and enroll in
health coverage that
fits their needs and
budget, and also
access financial help.
WHAT IS COVER OREGON?
3. Improving the health of all Oregonians
by providing health coverage options,
increasing access to information, and
fostering quality and value in the health
care system
MISSION
4. BACKGROUND
• Created in 2011 by
Oregon Legislature
• Formed as public
corporation
• Key piece of
Affordable Care Act
• Custom-built for
Oregonians
5. • October 2013:
Open enrollment
• January 2014:
Coverage begins
• January 2016:
Groups to 100
Employees
TIMELINE
6. CHANGES
• Can’t be denied for pre-
existing condition
• Essential health benefits
• Financial help
• Medicaid expansion
• Requirement to have
insurance
• Health insurance
marketplaces (exchanges)
• Carriers must spend 80%
of premiums on care
18. INDIVIDUALS
AND FAMILIES
• Financial help
• Clear information and
price transparency
• Side-by-side
comparisons
• One-stop shopping
• Quality coverage and
grades
• Help enrolling
• HSA-eligible plans
26. Go to
CoverOregon.com
or call 1-855-
Cover-OR
You’ll be
connected to a
community partner
or agent in your
area
Community
partner or agent
will find a plan
that’s right for you
INDIVIDUALS AND FAMILIES
(THRU MID-OCTOBER)
27. INFORMATION YOU’LL NEED
Social security number, residency card or
immigration documentation
Income documents and self-employment records
such as last tax return, most recent pay
stub, financial statements or other sources of
income
Documentation about any health insurance
plan(s) that cover household members
28. SEARCH FOR PLANS BY:
• Geography
• Price
• Provider
• Quality rating (11 metrics first year)
• Carrier
• Plan type (e.g., HMO, PPO)
• Deductible
• Out-of-pocket maximum
• Metal tier (bronze, silver, gold, platinum)
33. CONNECT WITH US
Sign up for email alerts
at CoverOregon.com
@CoverOregon Facebook.com/CoverOregon
www.LinkedIn.com
(search “Cover Oregon”)
www.Plus.Google.com
(search “Cover Oregon”)
CoverOregon.com
www.YouTube.com/Cov
erOregonVideo
Introduce other CO staff in attendance and have them raise their hand so they can be identified laterTELL PERSONAL STORY
CUT IF TOO LONG
Cover Oregon is a public corporation (similar to the Port of Portland) We’re one of the first states to build a state-based online health insurance marketplace, For example, our call centers are in Oregon
Walk through slide
Walk through slide briefly (more detail later)
These are the insurance companies who have filed to offer individual medical plans through Cover Oregon, and plans are in the process of being certified. Not every insurance company listed here will offer plans where you live.
These are the insurance companies who have filed to offer group medical plans through Cover Oregon, and plans are in the process of being certified. Not every insurance company listed here will offer plans in your county.
Here are the 5 dental carriers available for small businesses.
ability to make side by side comparisons of plans to determine the right one for you. For every plan, you will also be able to see the costs and what is covered in plain language.shows you how you can make more informed decisions about the plan for you and your familyAt the platinum level, you will pay each month in premiums but will pay only 10% of the cost of the care. The bronze plan, in the same way, might be better for those who require less care.
Rates and plans were just approved and now they are being certified by Cover OregonWile the number of plans available will vary by county, there will be plans available throughout the state.
And, as mentioned before, you can enroll some family members in public medical programs like Healthy Kids and the Oregon Health Plan, while also enrolling others in private insurance plans – all at one time and in one place.
As mentioned before, all plans must cover essential health benefits, which include….list them
Businesses with less than 50 employees can also shop on Cover Oregon. Those with less than 25 employees may be eligible for a tax credit too, only available through Cover Oregon.
For small businesses we know that providing health insurance helps their workers stay healthy and productive, reduces sick days, and gives them an edge in recruiting and retaining top talent.Cover Oregon offers small businesses:Choice. Compare and select from a broad range of plans from multiple carriers, and give your employees more options. Clear information. The site will describe each plan in plain language so you can make side-by-side comparisons. Set contribution. You decide the amount you will pay toward premiums, and then let your employees shop. Quality coverage.: Every plan will provide coverage you can count on—even for people with a pre-existing health condition. The plans will provide coverage for doctor visits, hospital stays, maternity care, prescriptions, mental health services, emergency room care, preventive care and vision coverage for kids, and more.Streamlined administration. Manage your plans directly through Cover Oregon, and receive just one monthly bill, no matter how many plans you choose. Help. Purchase online, work with an insurance agent, or access our trained specialists for help online, in person, or over the phone.
If you’re a small business with fewer than 25 employees, and those employees’ average annual wages are less than $50,000, and you’re paying at least 50% of the employees’ premium costs, you will be eligible for a 35% federal tax credit that will go up to 50% in 2014
The best part is that employers who shop on Cover Oregon can now get out of the business of choosing a health plan for all of their employees that likely only meets the needs of a percentage of them.Employers can choose from these 4 ways to shop: They can still offer one plan through one carrier Or all plans at a certain metal tier across all carriers One carrier and any tier level that carrier offers Or broad choice where the employer determines a reference plan and employees can choose any plan at that level or below and up to one metal tier above.
Right now, only small businesses with 50 or fewer employees can shop on Cover Oregon. That goes up to 100 employees in 2016 and we’re still waiting to hear what will happen after 2017.
Finally, here are a few more details about the portal itself. No matter if you’re an individual, family or small business, you’ll all go through the same door to access health coverage.
Consumers will be able to search by:Geography, Price, Provider, Quality rating, Carrier, Plan type (e.g., HMO, PPO), Deductible, Out-of-pocket maximum, Metal tier (bronze, silver, gold, platinum)
Consumers will be able to search by:Geography, Price, Provider, Quality rating, Carrier, Plan type (e.g., HMO, PPO), Deductible, Out-of-pocket maximum, Metal tier (bronze, silver, gold, platinum)
Here is a screen that shows you side by side comparisons of different plans that meet your search requirements and needs.You see here that there are ratings. Much like Yelp or Angie’s list, we will be developing consumer ratings over time so you can hear from your peers about the best plans out there.
You can visit coveroregon.com/meetings for an updated list of Cover Oregon events and meetingsFollow us online and sign up for email updatesOrder materials from our Cover Oregon online store
Before we break out into our small groups where you’ll have the chance to ask questions of Cover Oregon staff, I would like to invite Marvin Revoal to come say a few words. Many of you probably know him as he’s very active in this community and we’re so thankful to have him here tonight. Marvin has 27 years of experience in management, underwriting, training and brokering with regional and national carriers to the field of employee benefit, and is currently and senior principal at PBP Insurance. He is involved in the Eugene Chamber of Commerce, the Portland Business Alliance and has been appointed to Gov. Kitzhaber’s “Oregon Workforce Investment Board. He also sits on the Advisory Board for the African American Chamber of Commerce. With that, please welcome Marvin Revoal.
