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California Operates Its Own Health Insurance Marketplace, and It Works

Just a few days after the federal government delayed online enrollment, California announced better news for small businesses who want to buy health insurance.

By Anna Gorman

 

Just a few days after the federal government delayed online enrollment, California announced better news for small businesses who want to buy health insurance.

Businesses with up to 50 employees can begin signing up online for coverage through the state’s new marketplace, officials announced Monday.

Last week, the federal department of Health and Human Services said that businesses in 36 states could not get coverage online until November 2014 – the latest bump on the road to implementing the Affordable Care Act.

California operates its own health insurance marketplace, however, so it isn’t affected by the federal government’s delay, said Peter Lee, executive director of the Covered California insurance exchange.

“We have planned for this day,” he said during a press conference at the Los Angeles Area Chamber of Commerce. “We’ve tested for this day. And we are ready and open for business.”

The Small Business Health Options Program, or SHOP, is separate from the more-familiar insurance exchanges for individuals or families. It’s voluntary and open year round.

On the Covered California website, firms can compare health insurance plans and choose what to offer to employees. Their workers can then select from among different plans. Participating insurers include Kaiser Permanente, Blue Shield of California and Health Net, among others.

Many companies will be able to receive a tax credit, meaning the federal government will help cover their portion of the employee premiums. To be eligible for tax credits, businesses must have fewer than 25 full-time employees, pay employees less than $50,000 a year and cover at least half of the full-time employees’ premiums.

The state expects about 7,000 companies to enroll by the end of 2014. Businesses can also purchase Covered California insurance through licensed agents.

Covered California board member Paul Fearer said providing insurance keeps employees healthier and makes them less likely to miss work. It also enables businesses to recruit and retain talent and to operate on “equal footing” with larger companies, he said.

About half of the 650,000 small businesses in the state do not now provide coverage to their workers, ­ mostly because of the cost, said John Arensmeyer, CEO of the Small Business Majority, a Los Angeles–based advocacy organization.

“This could not come at a better time for California’s small businesses,” he said. “Small businesses are going to have the same opportunities as big businesses to pool together to negotiate the best prices and the best quality and reduce administrative costs.”

Even with tax credits, however, some still won’t be able to take advantage of the program. “They will not be able to offer coverage tomorrow just as they can’t today,” Lee said.

He said the small business program is not the “be all, end all,” but rather part of the broader state effort to make sure all Californians get coverage.

 

Daniel Luzer is GOVERNING's news editor.
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