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Published byShon Mills Modified over 9 years ago
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CoveredCa Update April 2014 Chris Patton Vice President of Sales
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OPEN ENROLLMENT SUMMARY 2
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SHOP Enrollment SHOP Enrollment January through April 960 Groups 6250 lives 8
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Small Business Health Options Program (SHOP) 960 small businesses representing over 6200 employees and their dependents have enrolled for coverage 9 Averages 5.11 employees per group 2.51 dependents per group 7.63 enrolled per group
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SHOP Overview What are the products and services offered through Covered California’s SHOP Market? Competing Health Insurance Plans Multiple Coverage Options Access to Tax Credits Benefits Administration Enrollment Support Expand Employer and Employee Options Employee only Coverage Available Multi-lingual Customer Service 10
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SHOP Overview SHOP Small Business Health Options Program Employer Defined Contribution Employer selects a single tier and contribution percentage Employer selects a benchmark or defined contribution plan Employer wins: Predictable costs and set budget Employee Choice Employee selects any plan within a single tier Employee wins: Freedom to choose their own plan 11
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Participating SHOP Health Plans 12 Qualified Health Plans
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Plans by Rating Region 13
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SHOP Agent Commission 1 st Year 6.5% 2 nd Year 6.2% 3 rd Year 5.9% 4 th Year 5.6% 5 th Year 5.3% 6+ Years 5.0%
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SHOP Enrollment 60% General Agent 22% Agent Direct 18% Consumer Direct 15
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Certified Insurance Agent Training & Certification Registration on-line In person training 8 hours Review Training Modules: Agent Tools Pass The Exam (80%) Review and Sign Agent Agreement $58.25 Admin fee Certified Insurance Agent
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Certified Insurance Agents 17
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Opportunity 18
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SHOP Sales Covered California “Halo Effect” What employers are asking Employer sponsored vs Individual Market Place Making the decision…. 19
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Who is eligible for the Tax Credit? Small businesses are eligible for a tax credit if… o They have fewer than 25 full-time employees o Their average annual wages <$50,000 o They pay 50% of the premium cost* Starting in 2014, tax credits are only available for businesses that purchase through the SHOP Tax credits do not cover premium expenses of owners or their families; and cannot be claimed by the self-employed Employers are encouraged to consult with their tax professional. * 20
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SHOP Sales Tax Credit Deducible premium Pre-tax employee premium Employee only coverage 21
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SHOP Contacts Vice President Chris Patton Director: Rich Hines- Southern California Director: Shawn Balsdon-Northern California Inside Sales Specialists: 844 332-8384 Jake Mooney (jmooney@pinnacletpa.com)jmooney@pinnacletpa.com David Guevara (dguevara@pinnacletpa.com)dguevara@pinnacletpa.com Clarissa Sarabia (csarabia@pinnacletpa.com)csarabia@pinnacletpa.com SHOP Service 877 453-9198 Email: agents@covered.ca.gov 22
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