CHA News Article

Covered California Announces Four Companies as ‘General Agents’ for Small-Group Employer Market
Companies will provide product and sales training to the broader insurance agent market

Covered California has selected four health insurance general agents for its small-group employer market. The selected companies were required to demonstrate sufficient scope and staffing to support sales distribution for either a geographic region or statewide, with the first contract term extending from Aug. 12, 2013, through Aug. 31, 2014. Covered California believes the general agents will make a substantial contribution to its mission of increasing the number of insured Californians, improving health care quality, lowering costs and reducing health disparities. The general agents selected for the exchange’s Small Business Health Options Program (SHOP) in 2014 are:

  • Claremont Insurance Services of Walnut Creek
  • Dickerson Employee Benefits of Los Angeles
  • LISI Inc. of San Mateo
  • Warner Pacific Insurance Services of Westlake Village

The General Agents for Covered California’s SHOP are required to:

  • Complete all required training and certification for the SHOP and Covered California policies and procedures, and on use of Covered California systems;
  • Fairly and objectively promote the full array of the SHOP products for agents to sell;
  • Convert paper applications to electronic format to promote and support online applications;
  • Provide Covered California quotes, either on the approved general agent proprietary quote engine, approved third-party quote engine or on the California Healthcare Eligibility and Enrollment Retention System (CalHEERS) platform;
  • Recruit agents to promote enrollment in the SHOP;
  • Train agents on the SHOP products and provide field training and sales support to agents. Assist agents with new business submissions;
  • Ensure that new business submissions include all information, documents and forms required by the SHOP;
  • Ensure that all new groups being submitted are eligible for coverage, and that the information included with each new group submission supports that eligibility;
  • Provide agents assistance with open enrollment in the field and by telephone, in Spanish and in other languages as necessary; and
  • Participate in Covered California marketing events (e.g., road shows) with Covered California.

Through the SHOP, California businesses with 50 or fewer employees will be able to choose from competitively priced, quality health insurance plans similar to those usually only available to larger employers. Small businesses are not required to enroll in Covered California’s SHOP, and there is no penalty for not participating or not providing health insurance to their employees. However, Covered California SHOP health plans will offer expanded choices, online tools for shopping and enrollment and streamlined invoicing. Small businesses are eligible for a federal health care tax credit if they have fewer than 25 full-time-equivalent employees for the tax year, pay employees an average of less than $50,000 per year and contribute at least 50 percent of their employees’ premium cost. Employers with 10 or fewer full-time-equivalent employees with wages averaging $25,000 or less per year are eligible for the maximum amount of tax credits. To be eligible for the federal tax credits, small businesses must purchase coverage through Covered California’s SHOP.

Small business owners with 50 or fewer employees may enroll in the Covered California SHOP plans when the health benefit exchange is launched on Oct. 1, for coverage that will begin Jan. 1, 2014. Initially, Covered California will serve businesses that have one to 50 eligible employees. Starting in October 2015, Covered California will enroll businesses with no more than 100 full-time equivalent employees for coverage that begins in January 2016. Beginning in 2017, states will be allowed to open up their exchanges to larger employers.

 

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