What is Obamacare?

Santa Rosa Obamacare Insurance Coverage | 726 Mendocino Avenue, Santa Rosa, California, 95401, 707-526-5222The exchanges. What is an exchange? How is it different from what exists now?

Currently, under Obamacare, a small group can buy from multiple carriers but if it is a very small group (less than 5 employees) the employer typically has to choose one insurance carrier. Over 5 employees, you can combine two insurance carriers assuming you have a certain percentage with the main carrier.

Private exchanges exist already that allow you to combine multiple carriers even with as low as two employees. They will still continue to operate.

In California the exchange will be  managed by Covered California. (Covered California will also run the exchanges for individuals.) The exchange for small groups is called SHOP.

For group insurance, Covered California has selected 4 Carriers for Sonoma county: Blue Shield, Health net, Kaiser and Western Advantage. Blue Cross was not selected. (Blue Cross will keep offering small group plans and will be part of the exchange for individuals).

All insurance carriers will keep selling insurance outside the exchange but all their plans will have to be designed in a similar way as the exchange plans. It means that everybody’s plan will change, whether they buy from the exchange or not, unless their plan is old enough to be grandfathered.

There will be 4 level of plans: Bronze, Silver, Gold and Platinum. The coverage is similar but the premium and out of pocket or deductible will change. You either pay a higher premium and have a lower deductible or the opposite.

Covered California will work with insurance agents as the preferred distribution mode. Agents will not be the only distribution method. There will also be certified solicitors who will not have any insurance licenses.

Just as it is now, the cost will be the same if you buy directly from a carrier, or from an insurance agent.

The goal is to have a maximum outreach and enroll a maximum of currently uninsured Californians, especially between 25 and 35 years old for the program to be viable. In California, the goal is to enroll 5.2 Million currently uninsured people.

Nobody has been trained yet and nobody is currently allowed to advertise themselves as certified. The first trainings will be in September. I will of course take that training. Starting October 1st Californians will be able to enroll for insurance coverage, effective 01/01/2014.

Businesses and non-profit will be eligible for tax credits. (some credits are available since 2010)

Employees will be able to choose between multiple plans. The administration will be simple as the employer will make only one payment to Covered California.

What To Look For

Any employer with questions. There will be a lot of advertisement, media attention. Groups will think they can save money and they might, so it will disrupt the market at the same time that it will attract new buyers. I will have links to Covered California on my website and will be constantly updating my information. Anytime a business owner is asking a question about the exchange refer them to me. A good question might be: Are you happy with your health insurance premium? Have you looked into the exchanges yet?