Early Cassidy amp Schilling Inc Why Why After the passage of the Patient Protection and Affordable Care Act of 2010 PPACA each state and territory had the option to set up a Marketplace or Exchange in order for individuals and small businesses to purchase health insurance ID: 644044
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Slide1
The Basics of the DC Health Link
Early, Cassidy & Schilling, Inc.Slide2
Why?
Why?After the passage of the Patient Protection and Affordable Care Act of 2010 (PPACA), each state and territory had the option to set up a Marketplace or Exchange in order for individuals and small businesses to purchase health insurance.
The District of Columbia has such a small population that it was considered economically disadvantageous to have a Marketplace that incorporated only individuals in DC.
To solve this Law of Large Numbers problem, the District Government required all businesses with less than 51 employees to use their Marketplace to purchase group health insurance.Slide3
How and When?
How and When?The passage of the law has been phased in for DC Small Businesses.
In 2014 the Small Business Marketplace came online, and businesses purchasing new coverage were required to use the DC
Health Link
(Marketplace).Changing insurance carriers at this time became equated to buying new coverage.
On January 1, 2016 all DC Businesses with under 51 employees were to begin renewing on the DC
Health Link
. Due to concerns about the readiness of systems and carriers being able to upload census information to the DC Health Link, this deadline was pushed to 7/1/16.There have been no other delays and appears there will be no other.Slide4
How will this work in practice?
Step 1Three months prior to a group’s renewal
date,
the renewal premiums will be released to the DC
Health Link. (January 1, 2017 will be released October 1, 2016.)
An Employer will need to establish their Employer
Account.
The contact person listed on your renewal must create an Employer AccountThis information will be verified, and the account with employee and basic plan data already loaded will be able to be accessed.
In the Employer application the
Employer:
Confirms the data on their census.Chooses a reference plan.Reference Plan is the plan on which the Employer bases their contribution.Reference Plan is often the current “base plan” .Sets the Percentage contribution they will cover of the plan.Because premiums are age based, it must be a percentage.The DC Health Link will calculate the maximum cost based on the census.Slide5
How will this work in practice?
Step 2Open Enrollment (Employer)
May begin at the earliest 2 months prior to group’s renewal
date.
Must begin at the latest by the first week of the month prior to the renewal date. (January 1, 2017, must begin December 5,
2016.)
Must be completed by approximately the end of the second week of the
month. 30 days prior to the renewal date. (January 1, 2017 renewal date, open enrollment must be completed by approximately December 13, 2016.)Open Enrollment (Employee)
Will receive a notification e-mail when their Employer has completed the Employer Application to log into the DC
Health Link
and make their choice of plans.When they log in they will see:Their per-payroll cost based on the Reference Plan and Employer Contribution.Have the option to add dependents to their plan; this cost will also be reflected,Have the option to shop for alternate coverage to the Reference Plan.Per paycheck costs will be reflected based on the Reference Plan.Decision Tools will include Plan Types, Carriers, Coverage Area (Nationwide vs. Local), etc.Slide6
How will this work in practice?
Step 3Finalizing Open Enrollment
Open Enrollment must be completed by approximately the end of the second week of the
month,
30 days prior to the renewal date . (January 1, 2017 renewal date, open enrollment must be completed by approximately December 13, 2016.)
Billing by DC
Health Link
will begin immediately after open enrollment closes.Ongoing Plan ServiceBilling and Enrollment for Health Insurance will occur only on DC Health Link.
Invoices will come
from
DC Health Link.Employees need to be added and deleted on the DC Health Link.Ongoing Enrollments will not receive an e-mail; they will need to go to DC Health Link to establish an account and choose you as their employer to apply shop for coverage.Claim and Coverage IssuesThe Employee’s carrier will handle these issues.When escalation is needed an Employer can still get a Broker involved.Slide7
What
To look forward to:Employee ChoiceHorizontal: Employer chooses all carrier plans in one Metal Level to be available to all employees. Employees can pick the carrier that works for them and often will “buy down” their coverage.
Vertical: Employer chooses all Metal Levels for a single carrier to be available.
Tight
TimelinesRenewal dates are disclosed.Employers are not left to
wait.
To watch out for:
No ExceptionsEmployees must comply to timelines or risk losing coverage.Invoices must be paid on time and in full or employers risk losing
coverage.
What is the Long Term
Carriers are not happy with having to conform to the system and may pull out.Claim Losses may lead to:Carriers pulling outCarriers limiting choiceEver increasing premiumSlide8
Early, Cassidy & Schilling, Inc. and the DC Health Link
We have served businesses in The District for our entire lifetime, and we plan to continue to do so going forward.We placed our first business on the DC
Health Link
9/1/14.
A very large portion of our client base (in terms of premium) is being forced on to the DC Health Link.Our entire Employee Benefit TeamIs trained on The Health Link.
Strategized on our approach to the
DC Health Link.
Will continue to serve DC Small Employers.Slide9
Early, Cassidy & Schilling, Inc. and the DC Health Link
7/1/16-6/1/17 - DC Small Business Renewal Strategy at Early, Cassidy & Schilling, Inc.
We will sit with clients either in person or teleconference to complete Employer Application on DC
Health Link
.Consulting on Reference Plan ChoicesEmployer Funding ModelsWe will present Open Enrollments at
client’s office for
employees. Open Enrollments will cover:
Metal LevelsBasic Insurance Terms so that Employees know what they are shopping forDifferences in plan types, carriers and networksWe will stay involved beyond first invoice till next renewal with:Assistance on the DC
Health Link
Providing tools for HR Support and Regulatory Assistance
Continuing our decades of superior client supportSlide10
Contact US
301-948-5800