SACRAMENTO, Calif.
— In response to requests for modifications and enhancements to the Small Business
Health Options Program (SHOP) portal, Covered California™ announced today that it
is suspending this component of SHOP to implement a series of redesigns.
Meanwhile, enrollment in SHOP will continue via the industry standard process
of using paper applications.
“The SHOP portal was
not meeting the needs of agents or small employers and needed improvements,”
said Covered California Executive Director Peter V. Lee. “Taking the portal
offline will not affect the paper application process, which has been the
preferred enrollment method traditionally used by insurance agents in the small-group
market.”
The online portal
for SHOP enrollment will go offline today, Feb. 12, and is projected to be back
online in the fall of 2014. Small-business owners can continue enrolling in SHOP
by calling the SHOP Service Center or working with a Certified Insurance Agent.
Representatives of the SHOP Service Center are available 8 a.m. to 6
p.m. Monday through Friday at (877) 453-9198. The Service Center can assist
both small-business owners and Certified Insurance Agents with paper
application enrollments, along with answering questions about existing applications.
To date, the vast majority of SHOP enrollments have been submitted using paper
applications.
“Certified Insurance
Agents are critical partners in SHOP, and we want to be responsive to their
input about improvements to the program, including their feedback that retooling
is needed in the SHOP portal,” said Lee. “We are committed to ensuring the
smoothest possible enrollment experience, and we believe the new version of the
online portal will significantly enhance the enrollment process.”
The new version of the SHOP portal is expected to increase the
efficiency of service and allow better management of applications, including
determination of eligibility, implementing group changes and issuing invoices.
As of Jan. 31, 2014, 571 groups were enrolled in Covered
California’s SHOP, representing 4,490 individuals. SHOP is currently processing
an additional 200 group applications, representing 1,200 individuals. Small
businesses can enroll in SHOP plans year round.
About the
Small Business Health Options Program (SHOP)
The Patient Protection and Affordable Care Act includes provisions to
encourage small businesses to offer health coverage for their employees by making
insurance more affordable and easier to purchase. Covered California has
created SHOP to facilitate the purchase of affordable health insurance for
small-business owners.
SHOP
is a second marketplace — separate from the one for individuals — and is designed
to give employers and their employees more options for health coverage. Using
this marketplace, small-business owners can shop for health insurance in ways
that offer convenience and choice, which is comparable to how large companies
shop for employee health insurance today.
Small-business owners with one to 50 eligible
employees can enroll in Covered California’s
SHOP plans. Like the health insurance plans in Covered California’s individual
market, Covered California’s SHOP plans were negotiated to bring a standardized
set of benefits, a robust provider network and a broad choice of health
insurance plans with competitive pricing to employers and their employees.
Many small-business owners qualify for a federal
tax credit to help offset contributions toward employee premiums. The only way for small-business owners
to access the tax credits is to purchase insurance through Covered California’s
SHOP. 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
percent 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.
In 2014, health insurance companies participating
in SHOP are: Blue Shield of California, Chinese Community Health Plan, Health
Net, Kaiser Permanente, Sharp Health Plan and Western Health Advantage. These
plans will be sold through Certified Insurance Agents, trained and certified by
Covered California.
Small
businesses are not required to buy insurance for their employees. SHOP is
completely voluntary, and small businesses will not be penalized for
non-participation.
About Covered
California
Covered California is the state’s marketplace for the federal Patient Protection and Affordable Care Act. Covered California, in partnership with the California Department of Health Care Services, was charged with creating a new health insurance marketplace in which individuals and small businesses can get access to affordable health insurance plans. With coverage starting in 2014, Covered California helps individuals determine whether they are eligible for premium assistance that is available on a sliding-scale basis to reduce insurance costs or whether they are eligible for low-cost or no-cost Medi-Cal. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget. Small businesses can purchase competitively priced health insurance plans and offer their employees the ability to choose from an array of plans and may qualify for federal tax credits.
Covered California is the state’s marketplace for the federal Patient Protection and Affordable Care Act. Covered California, in partnership with the California Department of Health Care Services, was charged with creating a new health insurance marketplace in which individuals and small businesses can get access to affordable health insurance plans. With coverage starting in 2014, Covered California helps individuals determine whether they are eligible for premium assistance that is available on a sliding-scale basis to reduce insurance costs or whether they are eligible for low-cost or no-cost Medi-Cal. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget. Small businesses can purchase competitively priced health insurance plans and offer their employees the ability to choose from an array of plans and may qualify for federal tax credits.
Covered California is an independent part of the state
government whose job is to make the new
market work for California’s consumers. It is overseen by a five-member board
appointed by the Governor and the Legislature. For more information on Covered
California, please visit www.CoveredCA.com.
