Premium Increase Kept to 5.2 Percent on Average; Three Plans to Offer Embedded Children’s Dental
SACRAMENTO, Calif. — Health insurance premiums for Covered California’s Small Business Health Options Program (SHOP) have been proposed and submitted to state regulators. Small-business consumers can expect to see a statewide weighted average increase of just 5.2 percent for the 2015 plan year.
In its role as an “active purchaser,” Covered California was able to keep increases low for a majority of SHOP consumers. Some consumers can expect to see an increase of less than 2 percent. Covered California worked as an active purchaser to get consumers the best rates and coverage value available to them and their families.
“As with the rates negotiated for the individual market, the rates for SHOP were established with the consumer in mind,” said Covered California Executive Director Peter V. Lee. He added, “SHOP can be an important tool for California’s small businesses, not only to help keep their current employees healthy, but also as a recruitment tool for prospective employees. These rates will help give those businesses added incentive to offer their employees health coverage and give the companies the ability to remain competitive with their larger counterparts.”
Consumers who want to enroll in a health insurance plan through their small employer have several options when making their choice. New to SHOP in 2015 is the dual-tier option, which allows for the employer to offer plans at two metal tiers as long as they are contiguous (e.g., the Bronze and Silver levels, the Silver and Gold levels or the Gold and Platinum levels). Also, additional plan designs will be offered by Health Net, Western Health Advantage and Kaiser Permanente, which will provide consumers with the essential health benefits required under the Affordable Care Act but also a little more flexibility with their premiums.
“Californians have come to expect choice and competitive rates. The rates announced today for SHOP will provide both. Consumers will have the flexibility to not be locked into one plan, but rather have the option of shopping around for coverage that is more useful to both the small businesses and their employees,” Lee said.
Also new to Covered California’s SHOP is the addition of embedded children’s dental coverage. In the regions of Sacramento, San Francisco and San Diego, small-business owners will now be able to offer employees coverage that includes embedded dental plans for children. The plans offering embedded children’s dental are Chinese Community Health Plan, which is contracting with Delta Dental of California’s dental health maintenance organization (DHMO); Sharp Health Plan, which is contracting with Access Dental Plan’s DHMO; and Western Health Advantage, which is also contracting with Access Dental Plan’s DHMO.
In addition to the pediatric dental plans already offered, most of the dental carriers will now offer new family dental plans, giving the consumer the option of purchasing both adult and children’s dental. This optional coverage is purchased by the employee at no cost to the employer and is not required.
“Dental coverage for families, especially children, is key and is another way Covered California is working with the small-business community, providing them worthwhile options not previously available. This just gives additional incentive to those businesses we’re trying to reach,” Lee said.
In September, Covered California announced the health insurance plan and dental plan carriers that will participate in SHOP. For a complete list of those carriers, visit http://news.CoveredCA.com/2014/09/covered-california-announces-insurance.html. To see how small businesses can benefit from enrolling in SHOP, call your agent or SHOP sales at (877) 453-9198.
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.
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.
