Paper Applications Remain the Conventional Enrollment Vehicle During SHOP Portal’s Redesign
SACRAMENTO, Calif. — In response to requests for modifications and enhancements to the Small Business Health Options Program (SHOP) portal, Covered California™ announced today that it is suspending this component of SHOP to implement a series of redesigns. Meanwhile, enrollment in SHOP will continue via the industry standard process of using paper applications.
“The SHOP portal was not meeting the needs of agents or small employers and needed improvements,” said Covered California Executive Director Peter V. Lee. “Taking the portal offline will not affect the paper application process, which has been the preferred enrollment method traditionally used by insurance agents in the small-group market.”
The online portal for SHOP enrollment will go offline today, Feb. 12, and is projected to be back online in the fall of 2014. Small-business owners can continue enrolling in SHOP by calling the SHOP Service Center or working with a Certified Insurance Agent.
Representatives of the SHOP Service Center are available 8 a.m. to 6 p.m. Monday through Friday at (877) 453-9198. The Service Center can assist both small-business owners and Certified Insurance Agents with paper application enrollments, along with answering questions about existing applications. To date, the vast majority of SHOP enrollments have been submitted using paper applications.
“Certified Insurance Agents are critical partners in SHOP, and we want to be responsive to their input about improvements to the program, including their feedback that retooling is needed in the SHOP portal,” said Lee. “We are committed to ensuring the smoothest possible enrollment experience, and we believe the new version of the online portal will significantly enhance the enrollment process.”
The new version of the SHOP portal is expected to increase the efficiency of service and allow better management of applications, including determination of eligibility, implementing group changes and issuing invoices.
As of Jan. 31, 2014, 571 groups were enrolled in Covered California’s SHOP, representing 4,490 individuals. SHOP is currently processing an additional 200 group applications, representing 1,200 individuals. Small businesses can enroll in SHOP plans year round.
About the Small Business Health Options Program (SHOP)
The Patient Protection and Affordable Care Act includes provisions to encourage small businesses to offer health coverage for their employees by making insurance more affordable and easier to purchase. Covered California has created SHOP to facilitate the purchase of affordable health insurance for small-business owners.
SHOP is a second marketplace — separate from the one for individuals — and is designed to give employers and their employees more options for health coverage. Using this marketplace, small-business owners can shop for health insurance in ways that offer convenience and choice, which is comparable to how large companies shop for employee health insurance today.
Small-business owners with one to 50 eligible employees can enroll in Covered California’s SHOP plans. Like the health insurance plans in Covered California’s individual market, Covered California’s SHOP plans were negotiated to bring a standardized set of benefits, a robust provider network and a broad choice of health insurance plans with competitive pricing to employers and their employees.
Many small-business owners qualify for a federal tax credit to help offset contributions toward employee premiums. The only way for small-business owners to access the tax credits is to purchase insurance through Covered California’s SHOP. Small businesses are eligible for a federal health care tax credit if they have fewer than 25 full-time-equivalent employees for the tax year, pay employees an average of less than $50,000 per year and contribute at least 50 percent of their employees’ premium cost. Employers with 10 or fewer full-time-equivalent employees with wages averaging $25,000 or less per year are eligible for the maximum amount of tax credits.
In 2014, health insurance companies participating in SHOP are: Blue Shield of California, Chinese Community Health Plan, Health Net, Kaiser Permanente, Sharp Health Plan and Western Health Advantage. These plans will be sold through Certified Insurance Agents, trained and certified by Covered California.
Small businesses are not required to buy insurance for their employees. SHOP is completely voluntary, and small businesses will not be penalized for non-participation.
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. With coverage starting in 2014, 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 on Covered California, please visit www.CoveredCA.com.