The health reform law’s new insurance marketplaces are scheduled to open across the country on Tuesday, and we have a sneak peek of what the exchange will look like and how it will function for employers in the nation’s capital.
Commonly called Obamacare, the health care law requires every state to either launch two new health-insurance marketplaces, one for individuals and one for small employers, or allow its residents to use exchanges operated by the federal government by Oct. 1.
Sixteen states and the District of Columbia elected to set up their own marketplaces, which proponents expect to drive down rates by creating more transparent competition between insurance providers.
In the District, a new site, called DC Health Link, will house both the individual and small-business exchange. It passed the federal government’s final operations check last week and city officials say they are now fully ready to launch on Tuesday.
DC Health Link’s Executive Director Mila Kofman sat down with On Small Business to give us a preview of the small-business exchange and the steps employers will go through to choose plans, register their workers and pay their premiums. Here’s a look at how the process will work.
District employers interested in purchasing coverage will first land on the DC Health Link homepage, which includes separate portals for individuals and families, small business owners, insurance brokers and insurance providers.
Many employers currently use brokers to help them find a plan for their business and their budget, Kofman said during the interview, and those that wish to stick with that model will have access to a broker-finder tool inside the small business portal to help them connect with a licensed expert (broker fees are typically paid by insurers).
In order to start, though, all employers — whether they wish to browse plans themselves or solicit help from a broker — will click on the small business link at the top of the page.
Once inside, the first step is to determine whether employers qualify to purchase coverage on the new exchange. During at least the first year, the District’s small-business portal will be available only to firms with no more than 50 full-time employees or full-time equivalents, though the federal government plans to require all exchanges to raise the threshold to 100 workers by the start of 2016.
On the page above, employers can enter the number of full-time and part-time workers they have as well as the average number of hours worked by their part-timers. A calculator will crunch the numbers to determine whether a business has fewer than 50 full-time equivalents and can proceed.
On the next page, employers will be asked to enter some basic information about their company and choose the date they want their coverage to take effect. On every exchange, the earliest start date for new plans will be Jan. 1.
In addition, employers will select whether they want their plans to cover only employees or extend to workers’ family members.
After that, employers will enter an array of information about their workers, including names, dates of birth, dates of hire, and Social Security numbers, to ensure that all employees are eligible for coverage. The exchange also asks for each worker’s e-mail address, so that employees can be notified that the company has signed up for coverage through the exchange.
In order to make it easier for some of the relatively large employers, the site provides business owners the option to upload an Excel file with all of the necessary information, rather than enter the data manually for each worker.
Next, it’s time to pick a plan — or, perhaps, plans (more on that in a moment).
Carefirst, Aetna, United and Kaiser Permanente have all been approved to sell a total of 267 plans this year on the city’s small-business exchange, and each of those plans fits into one of the site’s four coverage levels — bronze, silver, gold and platinum, which cover 60 percent, 70 percent, 80 percent and 90 percent of the cost of medical expenses, respectively.
Here is where the site gets both flexible and a little complicated.
In the District (and in most states that set up their own exchanges), employers will have the option to either choose one plan for their entire company or give their employees a choice between several options. On the federal exchange, the choice option, which is intended to give employers more control over their costs, has been delayed until 2015.
So, District small business owners will actually have three options:
• Choose one plan from one insurer to cover their entire firm.
• Choose one insurance carrier (e.g. Aetna) and allow employees to choose any coverage level and plan from that carrier.
• Choose one coverage level (e.g. gold) and allow employees to choose any insurance carrier and plan from within that level.
On the final page of the registration process, employers will be able to review their selections and receive an estimate for their monthly contribution, which is based on the plan(s) they selected, the number of employees to be covered and their chosen contribution level.
The page will also display the possible range of monthly contributions for employees, depending on which plan they select from the options provided.
Once employers confirm their selections, their workers will be notified that the company has created an account and the workers will be directed to their company’s choice(s).
Due to a rule preventing individuals from signing up for coverage more than 60 days before it takes effect, though, employees cannot lock in their selections until Nov. 1 at the earliest (for plans that start Jan. 1).
Once employees enroll, they and their employers can will be able to pay their monthly premiums online directly through the District’s exchange, even if their employees choose plans from different insurers. For plans that start at the beginning of 2014, the first payments will be due on Dec. 12, giving employers some time before they have to start making final decisions.
Still, DC Health Link officials urged employers to go ahead and start mulling their options.
“On October 1, we’ll be ready to go,” Kofman said.