August 19, 2013Presented by Patty Conner, Director

Where small business shops for health insurance

Utah’s MarketPlace Solution

• Individual Application

•Medicaid Assessment

• Tax Subsidies/Cost Sharing Reductions

• Enrollment in Private Insurance Plans

• Medicaid/CHIP Determination

• Enrollment in Medicaid

• Re-certification

• Group Application

• Plan Comparison

• Enrollment

• Single Invoice for Premium Payment

• Sm. Employer Tax Credit

Avenue H

Carriers

Operated by Federal Govt.

Utah Department of Workforce

Services

Enrollment files/subsidies

Carriers collect premiums

Individual Small Business

www.healthcare.govwww.avenueH.com

Public Insurance/Subsidized Private Insurance

Private Insurance

Avenue H, Health Insurance Marketplace

ACA State-based Marketplace for Utah

Market-oriented, competitive environment

One stop shop for Medical, Dental and Health Savings

Accounts

Defined Contribution Approach

Flat dollar amount, no minimum

Pre-tax Benefits for employee and employer

Employee Choice

Plan Comparison Tools and Transparency

Administrative Ease

Small Employer Premium Tax Credit3

Broker Credentialing

To assist clients on Avenue H, producers must:

Have a current Utah Health Producer license

Be appointed by all participating carriers as a producer

Attend training for Utah Premium Partnership (UPP)

Attend Avenue H Training

All Producers must get re-credentialed this fall

2 hour CE courses will start on August 15th, every Thursday through

October

Register for course at www.avenueh.com

Options-Do the MathIndividual Small

EmployersLarge

Employers

Who Individuals and their Families

1-50 FT 50 + FT

Access • Individual Marketplace

• Commercial Market

• Avenue H• Commercial

Market

• Commercial Market

Subsidies • APTC• CSR

• Sm. Employer

Premium Tax Credit• UPP

None

Premiums Post-Tax Pre-Tax Pre-Tax

Open Enrollment

Oct 2013-March 2014

Begins Oct 2013

Anytime

Penalties 2014: $95 pmpy2015: $325

pmpy

None $2,000 or $3,000 pepy

EHB Applies Applies N/A