The Department of Managed Health Care (DMHC), who regulates most of the individual and family plans offered through Covered California, has developed a website to allow consumers to compare health insurance companies. The Health Plan Dashboard website does not assign any performance review ratings. But it does give consumers a high level view of some of the data collect on the health plans such as enrollment, complaints, and enforcement actions for medical, dental, and vision plans.
One of the most frustrating aspects of the Affordable Care Act is that it excludes family members from receiving the premium tax credits to reduce their health insurance if one of the parents is offered affordable employer group health insurance. One way around this problem is for the employer to offer employee only coverage. Covered California for Small Business health insurance exchange offers the employee only option for employers when they set up their group health plans.
Covered California staff is forecasting that SHOP enrollment will double by the end of 2014 and double again during open enrollment for 2015. A list of assumptions was given for the stellar forecast enrollment during the May 2014 Board meeting where the topic was revenue projections from fees charged on individual small group members. Based […]
The Small Business Health Options Program (SHOP) from Covered California has unfortunately proved itself to be just as inept at processing enrollments as the individual and family plan side. What promised to be a stream lined and easy process for small employer groups to offer health insurance to employees through Covered California is beset with a dysfunctional enrollment website and poorly trained support staff. They make Anthem Blue Cross’ decision not to offer plans through SHOP absolutely prophetic.
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.
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.
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.
Whether your group doesn’t offer a health plan for employees or you’re considering dropping your group plan and letting your employees migrate to the new health insurance exchange established by the ACA, your employees will appreciate some assistance with enrollment. States are setting up In-Person Assistance programs to help individuals and families enroll in the new health plans to become eligible for the premium assistance.
While the filed rate increases of Anthem Blue Cross may be unreasonable that hardly justifies their being banned from the Covered California small employer group program. There is also the prospect that Anthem Blue Cross might be forecasting a sharp drop in membership of their small group plans as small businesses abandon the plans or employees leave to purchase subsidized health insurance through Covered California.