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CoveredCa Update April 2014

CoveredCa Update April 2014. Chris Patton Vice President of Sales. Open Enrollment Summary. 6. SHOP Enrollment. SHOP Enrollment January through April 960 Groups 6250 lives. Small Business Health Options Program (SHOP). 960 small businesses

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CoveredCa Update April 2014

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  1. CoveredCa Update April 2014 Chris Patton Vice President of Sales

  2. Open Enrollment Summary

  3. 6

  4. SHOP Enrollment SHOP Enrollment January through April 960 Groups 6250 lives

  5. Small Business Health Options Program (SHOP) 960 small businesses • representing over 6200 employees and their dependents have enrolled for coverage • Averages • 5.11 employees per group • 2.51 dependents per group • 7.63 enrolled per group

  6. 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

  7. 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

  8. Qualified Health Plans Participating SHOP Health Plans

  9. Plans by Rating Region

  10. 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%

  11. SHOP Enrollment 60% General Agent 22% Agent Direct 18% Consumer Direct

  12. 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

  13. Certified Insurance Agents

  14. Opportunity

  15. SHOP Sales Covered California “Halo Effect” What employers are asking Employer sponsored vs Individual Market Place Making the decision….

  16. Who is eligible for the Tax Credit? • Small businesses are eligible for a tax credit if… • They have fewer than 25 full-time employees • Their average annual wages <$50,000 • 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. *

  17. SHOP Sales Tax Credit Deducible premium Pre-tax employee premium Employee only coverage

  18. 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) David Guevara (dguevara@pinnacletpa.com) Clarissa Sarabia (csarabia@pinnacletpa.com) SHOP Service 877 453-9198 Email: agents@covered.ca.gov

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