Compared to existing small group quoting and enrollment systems from the insurers and the Cal Choice private exchange, the Covered California SHOP program seems a little clunky and unfinished. If an employer wants to realize the tax credits for contributing to employee health insurance premiums they have to have a small group plan through Covered California. Except for the option to purchase pediatric dental plans for dependent children, SHOP offers no adult dental or vision insurance.
For a brief window of time, small businesses and nonprofits can enroll in a small group health plan without meeting all the minimum requirements. The Affordable Care Act has a special provision to encourage employers to offer a small group health plan to see if it is right for the employees and the owners. Consequently, some of the rules have been waived so that small groups can test the waters.
Thousands of health insurance agents across California have done what Covered California has asked us to do to become certified to sell their new health plans. Unfortunately, Covered California has not held up their end of the agreement by creating an agent system within the CalHEERS website that allows us to monitor the progress of an application or to know if we will ever get paid. I am now leaning toward taking my client business right to the carriers and boycotting Covered California altogether.
From problems with logging in, bad and missing information to the virtually inoperable agent dashboard, the Covered California web portal to enroll in new ACA health plans has serious issues that no one at the California Health Benefits Exchange wants to address openly.
Many Californians are seeing their individual and family health insurance premiums jump with the inclusion of all the new Affordable Care Act benefits and regulations. A small sampling of the new ACA rates shows that Covered California individual health plans are comparably priced with current and future small group plans offered in California.
Agents that are certified to sell Covered California health insurance sign an agreement which in part states that the agent will fairly represent all the different plans. I have faith that all the agents will accurately represent all the plans, but they are under various incentives and realities that may distort some agent’s presentations to clients.
Beyond the well crafted TV commercials and print ads for Covered California are numerous volunteers that are “walking and talking” with total strangers to spread the news about the new Affordable Care Act health plans. People committed and passionate about health care reform from the Sacramento Mighty Oaks ACA Team are spending countless hours answering questions and handing out literature at libraries, community centers, neighborhoods and small businesses.
With the launch of open enrollment for the Affordable Care Act, now more than ever, consumers who seek out the knowledge, professionalism and experience of a licensed insurance agent need to be reassured that they aren’t drinking from a poisoned glass. In a modest attempt to help guide consumers to agents who won’t engage in misrepresentation or questionable sales tactics, I have developed a pledge and code of conduct surrounding the sales of ACA compliant health plans by agents.
Kaiser Permanente has put together a very simple to use Affordable Care Act tax credit calculator for small groups. The calculator only works for small business groups in California. It is not calibrated for non-profits which have a different tax credit allowance for employer contributions to employee health insurance for 2014.
The new Affordable Care Act health plans offered through Covered California will help many people move out of an expensive COBRA plan and into an insurance plan with lower premiums. However, COBRA is considered “employer offered” health insurance that meets minimum essential benefits and value. Because of this many people and families on, or offered, COBRA will NOT be eligible for tax credits to reduce the monthly premiums of Covered California plans.