SACRAMENTO, Calif. — Covered California is bringing greater flexibility to employers, additional options for adult dental coverage, and more choice of benefits employees can select through the Small Business Health Options Program (SHOP). The news comes as Covered California announces the insurance carriers SHOP will offer for the 2015 plan year.
“The increased choice and flexibility available through SHOP will expand the options for employees who are offered health insurance through their employer,” said Covered California Executive Director Peter V. Lee.
For those small businesses starting coverage Oct. 1, 2014, or later, employers can offer their employees coverage from two different metal tiers preselected by the employer. In this system, called “dual metal tiers,” the tiers offered must be adjoining: Bronze and Silver plans, Silver and Gold plans or Gold and Platinum plans. This new flexibility through SHOP affords small businesses a competitive edge when recruiting employees.
Also new to SHOP is the availability of alternate benefit designs offered through three of SHOP’s carriers, Health Net, Kaiser Permanente and Western Health Advantage. These alternate benefit designs meet the essential health benefits requirement of the Affordable Care Act but vary from the standardized benefits established by Covered California. The addition of these plans allows for expanded employee choice of options being available through SHOP.
Other additions include the ability for employers to offer separate dental plans for adults beginning in 2015. Dental benefits are employee-paid, with no additional cost to employers.
The six health plans and 10 dental plans offered through SHOP are a mix of health maintenance organizations, preferred provider organizations and exclusive provider organizations. The health plans are from the following health insurance companies:
- Blue Shield of California.
- Chinese Community Health Plan.
- Health Net.
- Kaiser Permanente.
- Sharp Health Plan.
- Western Health Advantage.
SHOP added an additional dental carrier for 2015. The successful bidders for Covered California’s SHOP dental coverage are:
- Access Dental Plan.
- Blue Shield of California.
- Delta Dental of California.
- Dental Health Services (new for 2015).
- Guardian.
- Liberty Dental Plan of California.
- Managed Dental Care of California.
- MetLife.
- Premier Access.
- Safeguard Health Plans Inc.
Businesses are not mandated to enroll in SHOP, and there is no penalty for not participating. California businesses with 50 or fewer employees can choose from quality health insurance plans similar to those available to larger businesses.
Those businesses with fewer than 25 employees are eligible for tax credits exclusively available through Covered California’s SHOP.
Currently, Covered California’s SHOP has enrolled 1,714 businesses, which accounts for 11,510 employees and their dependents. Open enrollment for SHOP is available year-round.
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. 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 about Covered California, please visit www.CoveredCA.com.
