Covered California Announces Health Insurance Plans for Small Businesses

PeterLee

Peter Lee, Executive Director–Covered California

Covered California, the state’s new health benefit exchange, announced the insurance carriers and rates for its small-group market, the Small Business Health Options Program (SHOP). In October, California businesses with 50 employees or fewer can choose from health insurance plans similar to those that are usually only available to larger employers. In 2015, the SHOP is expected to offer plans to businesses with 100 or fewer workers.

The mix of HMOs and PPOs will be sold through licensed agents who are trained and certified by Covered California. Licensed agents will soon be able to pre-register for Covered California certification by visitingwww.healthexchange.ca.gov. In addition, in the coming months, Covered California will host a series of events to familiarize agents with Covered California products and the certification process.

Covered California’s executive director Peter Lee said that employers will have a choice of more plans, strong provider networks, online tools for year-round shopping and enrollment, and streamlined invoicing. The SHOP will also make health care coverage more affordable by offering tax credits for small businesses that qualify. Small businesses are eligible for a federal health care tax credit if they have fewer than 25 full-time-equivalent employees for the tax year, pay employees an average of less than $50,000 per year, and contribute at least 50% of their employees’ premium cost. Employers with 10 or fewer full-time-equivalent employees with wages averaging $25,000 or less per year are eligible for the maximum amount of tax credits. To be eligible for the federal tax credits, small businesses must purchase coverage through Covered California’s SHOP.

There is no penalty for small business owners who choose not to participate in the program. While rates vary by region, Covered California SHOP premiums are generally comparable to 2013 small-group market rates and, in some cases, can save small businesses money on their premiums.

Chart4Covered California has selected the following health plans to participate in SHOP:
• Blue Shield of California
• Chinese Community Health Plan
• Health Net
• Kaiser Permanente
• Sharp Health Plan
• Western Health Advantage

Small businesses are not required to enroll in Covered California’s SHOP, and there is no penalty for not participating or not providing health insurance to their employees. However, Covered California SHOP health plans will offer expanded choices, online tools for convenient shopping and enrollment, and streamlined invoicing.

Federal tax credits are  available to some businesses with fewer than 25 full-time-equivalent employees to offer coverage to their workers. Small-business owners can enroll in the SHOP plans when the health exchange opens Octpber 1. Like the insurance plans in Covered California’s individual market, the SHOP plans were negotiated to bring a standardized set of benefits, a robust provider network, broad choice for employers and their employees, and competitive prices to the Covered California portfolio.

Lee said, “Employer-sponsored health coverage has historically played an important role in insuring Californians, and our launch of a full-choice small-group market is a testament to the state’s commitment to build on the critical role of employer-based coverage. California is offering plans that will encourage thousands of employers to participate, ultimately increasing the number of insured Californians, which is the mission of the landmark federal law. For years, small businesses have been effectively shut out of the health insurance marketplace. High administrative burdens, lack of choice for employees, the challenge of comparing plans and costs – all these have meant that the overwhelming majority of California’s small businesses – roughly 86% – do not offer health insurance to their workers, even though many want to and understand the clear benefit of a healthy workforce. But change is on the way and the opportunity for small businesses to offer their employees quality coverage at a more reasonable cost will soon be real for small businesses throughout California.” For detailed information, visithttp://www.coveredca.com/news/PDFs/Covered-California-SHOP-booklet.pdf.

Last Updated 09/16/2020

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