Module: 202 Create and Manage a SHOP Account. It is recommended that Agents, assisting Employers with Setup and Plans in NMHIX, take this course.

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Presentation transcript:

Module: 202 Create and Manage a SHOP Account

It is recommended that Agents, assisting Employers with Setup and Plans in NMHIX, take this course.

 An Employer in creating their account  Set up worksites  Create and upload an employee list  Select a coverage effective date  Determine contributions and costs  Select the appropriate levels and plans  An employer understand how employees will be notified of open enrollment Upon completion of this training, you will be able to help:

 Create Employer Account  Complete Employer Application  Set Up Employee List  Set Up Coverage The following topics are covered in this training:

Log in as you normally would. 1.Click the Employers drop down. 2.Click Pending Requests. 3.Click the Actions drop down. 4.Click Accept. 5.Click the Employers drop down again. 6.Click Active Employers. 7.Click the Actions drop down. 8.Click Details.

The Employer details are displayed. 1.Click View Employer Account. 2.Click Employer View.

This screen supplies information for set up. 1.It itemizes what you need to complete. 2.When you’re ready, click Start. As you complete each step, a checkmark will replace the number.

Here you identify your company and the number of employees. 1.Enter your Legal Business Name. 2.Enter your Federal Employer Identification Number. 3.Click the drop down and select the Type of Company. 4.Enter the number of Employees. IMPORTANT : An EIN is not a mandatory field when you apply, but you must provide your EIN to the Exchange within 30 days of enrollment, or you will be disenrolled.

Now identify your company’s primary worksite. 1.Enter the Address 1 (street number and street name.) 2.Enter the City. You don’t need to enter the State because it is already entered for you. 3.Enter the Zip Code. 4.Click Next.

Enter the primary phone number where you want to be contacted. 1.Enter your primary contact Phone number. 2.Click Next.

Enter the employees that are currently eligible to receive healthcare coverage from your company: 1.Click How to handle out-of- state employees, to see answer. 2.Click the X to close the message. Only add those employees that have no waiting period to apply for benefits. 3.Click Do I need to include part-time employees to see answer. 4.Again, click X to close the message.

There are two ways to enter employee records to NMHIX. 1.Click Download CSV template.  Upload a pre-populated Employee List Or  Manually Add Employees 2.Enter information for each employee and the number dependents. For each employee to receive an invitation to enroll, a valid Phone and address are required. 3.Click Upload Employee List. If you need to save your CSV template and this message appears, click Yes. This will save the file as a *.csv which is compatible with NMHIX. xls or xlsx files are not compatible. Dependent details are not required and can entered at later time by employee.

After you have uploaded the Employee List it is important to review it. 1.Make sure every employee Name appears on the list. 2.And their designated Dependents as well.

There may be times when edits are needed or you want to add a new employee.  If you need to edit or add a new employee record, click the drop down. Or  If you want to add a new employee.

First enter Employment information. 1.Enter the employee’s First and Last Name. 2.If there is more than one Worksite Address, click the drop down and select the appropriate address. The default is the primary worksite. 3.Enter the Average Hours worked per Week. 4.Enter the Estimated gross Annual Wages. If you land on this page unintentionally, You will be directed back to Review Employees. click Done

Then personal employee information. 5.Enter the Date of Birth. 6.Enter the employee’s Tax ID Number or Social Security number. 7.Click the appropriate Gender radio button.

Whenever you add Employees to the List, it is important to review the list again. 1.Review your manual entry. 2.Make sure the list of employees is complete. 3.Then make sure the number of dependents is correct for each employee. 4.If all are correct, click Next.

The final step is to review your company information. 1.Review your company entries. 2.Read the Attestations and click all three attestation check boxes. 3.Type your full name as your electronic signature. 4.Click Submit Application.

Next you are going to select plans and determine your company contribution. Click Next to get started.

Here you want to select the effective date for coverage. 1.Click the radio button for the appropriate effective date. Open Enrollment begins two months prior to effective date. The First Payment is due approximately 15 prior to the effective date. 2.Click Next. REMEMBER: The go live effective date for NMHIX is January 01, 2014

In New Mexico, minimum contribution to employees is 50%. 1.You can increase the amount your company’s contribution to employees by sliding the bar to the right. 2.You can also increase your dependent contribution, but this is not required. Your potential Employer Cost and Tax Credit are automatically calculated and displayed below.

This is the range of potential monthly cost to cover employees and dependents. These costs may increase if your employee list changes. If your company:  Contributes at least 50%of premium costs towards employee plans. Your company may be eligible to receive a tax credit.  Has less than 25 full-time employees,  Offers coverage to all full-time employees,  The average annual salary of all employees (full and part-time) is less than $50,000, and Contact your tax advisor for more information about this small business tax credit.

These screens allow you to compare plans by cost coverage average. Look at: 1.The number of Plans offered by the average percentage of cost tier. 2.The Premium Range dollar amount. 3.The Least to Most comprehensive plans. Scrolling down on the Select Plan Level screen to the monthly costs. 4.What the Monthly cost to you is for each plan based on proposed contributions to employees and dependents. 5.What the Monthly cost to each employee is based on your proposed contribution towards employees. 6.Scroll back to the top page. 7.Select the appropriate tier. For this example we will select the SILVER tier. 8.Then click Next.

The next step is to choose a reference plan. Here ‘s what it does:  Locks in your costs  Gives employees flexibility 1.Click Next.  Assures fairness across your company

Based on the tier previously selected, there are two plans from which to choose as a Reference. 2.Scroll down to the monthly costs. 3.Review the cost per plan.  In this case the left side is the PPO.  The right side is the HMO. 4.Scroll back up.

Now that you have determined which plan, its time to select it. 4.For this training we will select the PPO. 5. Click Next.

This is the final step to set up Coverage. 1.Review all Your Selections and Your Monthly Contribution Costs one last time. 2.When you are happy with your choices, click Confirm. The Start open enrollment popup message displays informing you that employees will be notified about the pending enrollment. 3.Click Yes.

All individuals who are eligible to enroll for insurance coverage will receive an stating the following:  The company name sponsoring enrollment.  The enrollment period.  The enrollment web site URL.  Enrollment expiration time and date.  New Mexico Health Insurance Exchange contact phone.  Contact phone for your company.

This concludes the Create and Manage a SHOP Account module. You should now be able to:  An Employer in creating their account  Set up worksites  Create and upload an employee list  Select a coverage effective date  Determine contributions and costs  Select the appropriate levels and plans  An employer understand how employees will be notified of open enrollment

If you have questions we can discuss them now or you can send your questions to: