CoveredCa Update April 2014 Chris Patton Vice President of Sales
Jan 04, 2016
CoveredCa UpdateApril 2014
Chris PattonVice President of Sales
OPEN ENROLLMENT SUMMARY
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SHOP Enrollment
SHOP Enrollment January through April960 Groups6250 lives
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Small Business Health Options Program (SHOP)
960 small businessesrepresenting over 6200 employees and their
dependents have enrolled for coverage
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Averages5.11 employees per group2.51 dependents per group7.63 enrolled per group
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
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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
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Participating SHOP Health Plans
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Qualified Health Plans
Plans by Rating Region
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SHOP Agent Commission
• 1st Year 6.5%
• 2nd Year 6.2%
• 3rd Year 5.9%
• 4th Year 5.6%
• 5th Year 5.3%
• 6+ Years 5.0%
SHOP Enrollment
60% General Agent22% Agent Direct18% Consumer Direct
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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
Certified Insurance Agents
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Opportunity
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SHOP Sales
Covered California “Halo Effect”What employers are askingEmployer sponsored vs Individual Market PlaceMaking the decision….
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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.
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SHOP Sales
Tax CreditDeducible premiumPre-tax employee premiumEmployee only coverage
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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 ([email protected])
David Guevara ([email protected])
Clarissa Sarabia ([email protected])
SHOP Service 877 453-9198
Email: [email protected]
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