How CaliforniaChoice Helps Business Owners
CaliforniaChoice has served businesses in the Golden State for more than 20 years. There are many reasons why owners and others like doing business with CaliforniaChoice:
- ACA Compliant Coverage: All of the plans available through CaliforniaChoice comply with the Affordable Care Act – and they offer you the option to choose more than one metal tier, which gives your employees access to even more doctors, specialists, and hospitals
- Budget Control: With CaliforniaChoice, you decide what you want to contribute to your employees’ health care costs – a Fixed Percentage of a specific plan or benefit or a Fixed Dollar Amount
- Employee Choice: CaliforniaChoice gives you and your employees access to dozens of HMO, PPO, EPO, and HSA-qualified coverage options from eight of the state’s leading health plans and carriers
- Easy Administration: Adding or terminating employees’ coverage and making other administrative changes are easier with CaliforniaChoice – and there’s just one monthly bill
- Flexibility: CaliforniaChoice offers you the flexibility to add optional benefits like Dental, Vision, Chiropractic and Acupuncture, and Life and AD&D plus the ability to change your contribution when it’s time for open enrollment
Employees and dependents like CaliforniaChoice, too, because it offers:
- Automated Choice Profiler – a health plan comparison tool that estimates future health care costs and enables you to find coverage that makes sense based on your individual or family needs
- Provider Search – an online directory you can use to search for doctors and specialists based on health plan, gender, ZIP Code, languages spoken, carrier, plan, and hospital affiliation
- Rx Search – find out fast which prescription drugs are covered by each of the health plans you’re considering – you can search by brand or generic name, drug therapeutic class, or health condition
- Hospital Advisor – quickly identify a facility for any health condition or planned procedure
Our website is your gateway to human resources support from HRAnswerLink, information about the Cal Perks employee discount program (with movie, theme park, and professional sports tickets as well as shopping and travel discounts), and a downloadable California Rx Card offering discounts of up to 75% on prescription drugs. Contact a CaliforniaChoice broker to learn more about how CaliforniaChoice can help you control your benefits costs, while still offering choice to your employees.
Three Steps to Understanding Defined Contribution
CaliforniaChoice makes it easy for you to control costs with Defined Contribution. In fact, we introduced the Defined Contribution concept to California businesses in 1996. Today, more than 17,000 employers offer CaliforniaChoice to their employees. Defined Contribution is as easy at 1-2-3:
- Set: You can choose a Fixed Percentage (50% to 100%) of a specific plan’s cost or a Fixed Dollar Amount for your contribution to each employee’s coverage.
- Select: Your employees select the coverage they want and apply your contribution to the option they choose. If the cost of the plan is more than your contribution, the employee simply pays the difference through the convenience of payroll deduction.
- Sit Back: You and your employees get the coverage you want backed by a team dedicated to your satisfaction. There’s just one number to call and one website to visit if you need help.
When it’s time to renew your benefits, you’re free to adjust the amount of your Defined Contribution up or down – giving you complete control over what you spend each year. CaliforniaChoice allows you to set your contribution toward other benefits, too. You can add Dental, Vision, Chiropractic and Acupuncture, and Life and AD&D. It’s your Choice what you spend; these optional coverages can be 100% paid by you, partially paid by you, or offered as a voluntary benefit (with employees paying all of the cost of coverage). Whether you have one employee or 100, we’ll provide you with a single, consolidated monthly bill. Contact a CaliforniaChoice broker to find out how CaliforniaChoice can deliver cost control to you, while offering your employees more choices than ever before.
Top Five Benefits of a Private Exchange for Small Businesses
- Defined Contribution: How much should you pay for your employees’ benefits? The choice is yours with Defined Contribution. You choose the amount you want to contribute – a Fixed Percentage or a Fixed Dollar Amount. Then each employee applies your contribution to the plan he or she prefers. If the cost of the plan your employee likes best exceeds your contribution, the employee simply pays the difference through the convenience of payroll deduction.
- More Choices: One size does not fit all. Every business is unique and offering just one carrier to all of your employees doesn’t give them the ability to choose the coverage that best fits their individual or family health insurance needs. A multi-carrier private exchange, like CaliforniaChoice, gives your employees access to multiple health plans, so they can select the option that makes sense to them.
- Decision-Support Tools: Private exchanges offer tools to help employees find out which health care providers and prescription drug benefits are associated with each available plan. They may also offer tools to help employees identify their potential out-of-pocket health care costs – and to match the right health plan to their needs. Online enrollment is also a big benefit of private exchanges – streamlining your business’s enrollment and giving you the ability to track who’s enrolled and who still needs to submit their enrollment information.
- Simple Administration: Changes, terminations, additions, billing changes, and other administrative tasks are a breeze with a private exchange. You’ll appreciate the dedicated support you get from a single service team throughout the year and the ability to get answers by calling just one number – or visiting one website – whenever you need assistance.
- Even Easier Renewal: A private exchange lets you annually adjust your Defined Contribution based on your changing financial situation . . . without the leaving the program. You control your costs, while still giving your employees the freedom to select the coverage that best meets their individual needs.
Contact a CaliforniaChoice broker to learn more about how a private exchange might benefit your business.
Private Health Exchanges: Explained Simply
The Affordable Care Act has given new life to the term “Private Health Insurance Exchange”, so much so that some people may think that private exchanges are a new phenomenon. The truth is that Private health insurance exchanges have been around for years (The CaliforniaChoice private exchange began in 1996.) So, you may be asking, “What exactly is a private exchange?” Here’s a quick overview:
|Question||Private Health Exchange|
|Who runs the exchange?||Private exchanges are operated by benefit brokerages, employee benefits consulting firms, and other companies (including privately backed firms like CHOICEAdministrators, which operates the CaliforniaChoice exchange).|
|Who uses the exchange?||Businesses who want to offer their employees a greater selection of coverage options. Medicare-eligible retirees may also be offered coverage through a private exchange.|
|Are subsidies available?||Companies offering coverage to employees (and their eligible dependents) typically offer a fixed contribution amount toward the cost of health insurance chosen by the employee||.|
|Does the exchange offer different health plans?||Some private exchanges limit group choices to a single carrier, but give employees the option to choose from multiple plans offered by that carrier. Other private exchanges, like CaliforniaChoice, give employees the ability to choose from a selection of carriers and plans (though all family members need to be insured through the same carrier and health plan).|
Contact a CaliforniaChoice broker if you want to know more about private health insurance exchanges.
Understanding the ACA Metal Tiers
The Affordable Care Act (ACA) introduced four metal tier levels of coverage based on the actuarial value for each health plan. The categories have nothing to do with the quality of care provided by the health insurance carrier, but instead represent the share of in-network expenses paid by the health insurance carrier and the percentage of costs paid by the member – you, your employees, or dependents.
So What Are The ACA Metal Tiers?
|Metal Tier||Payment Based on Actuarial Value (Within +/- 2%)||Member Pays|
|Platinum||Insurance carrier pays 90% of the costs of covered in-network benefits||10% of costs of covered in-network benefits|
|Gold||Insurance carrier pays 80% of the costs of covered in-network benefits||20% of costs of covered in-network benefits|
|Silver||Insurance carrier pays 70% of the costs of covered in-network benefits||30% of costs of covered in-network benefits|
|Bronze||Insurance carrier pays 60% of the costs of covered in-network benefits||40% of costs of covered in-network benefits|
The amount you pay in premium depends on what percentage of covered benefits are paid for by the health insurance carrier. For example, a Platinum plan is typically more expensive, but pays a higher percentage toward covered in-network services. On the other hand, a Bronze plan typically offers lower premiums, and it pays less toward covered in-network services. Costs could be higher in the long term for individuals with a Bronze plan who need a lot of medical care. For small business, group-sponsored health insurance, you (as the employer) select the metal tier to offer to your employees. Some programs, such as the CaliforniaChoice small group private exchange, give you the option to select more than one metal tier. Contact a CaliforniaChoice broker if you want to know more about the ACA metal tiers.
Three Ways the ACA Has Affected Small Business
Since it became law in 2010, the Affordable Care Act (ACA) has significantly affected employers, employees, and families across America. Because most U.S. employers have fewer than 500 employees, the ACA’s largest impact has been on smaller firms. Below are three of the ACA’s provisions affecting smaller businesses:
- Employer Mandate: The ACA Employer Mandate requires businesses with 50 or more full-time equivalent employees to provide health insurance to at least 95 percent of full-time employees and dependents up to age 26 or pay a fee. An employer owes a penalty if coverage is not offered, is not affordable, or does not meet minimum value standards.
- Full-Time Equivalent Calculation: For some employers, calculating the number of employees is easy. However, for businesses that employ part-time or seasonal workers, the calculation is a bit harder. For purposes of the ACA, a full-time employee is one who averages 30 hours per week (130 hours per month). To calculate full-time equivalent (FTE) employees, employers must add the number of hours worked by part-time employees in a given month and divide the total by 120. That number is then added to the full-time employee number to determine whether the business is a 50+ employee group as it relates to the ACA.
- Affordability Test: A health plan is considered “affordable” under the ACA if it costs no more than 9.5 percent of an employee’s household income for employee-only coverage. As a safe harbor, since household income may not be readily available to an employer, a business can make sure the plan costs no more than 9.5 percent of employee-only income.
Contact a CaliforniaChoice broker to find out about other ways the ACA may affect your business and health insurance coverage for your employees.