A BETTER WAY TO TAKE CARE OF BUSINESS SMALL BUSINESS HEALTH OPTIONS PROGRAM (SHOP) I WASHINGTON, DC See how easy health plan enrollment can be through the SHOP Whether you’re a small business or a broker, you can simplify the application process by using DC Health Link, Washington, DC’s online SHOP portal. dchealthlink.com/smallbusiness A BETTER WAY TO TAKE CARE OF BUSINESS DC Health Link — the smart and convenient way for small businesses to offer health benefits What is the DC Health Link health insurance marketplace? DC Health Link is the District of Columbia’s online marketplace for small businesses to purchase health coverage. This online marketplace allows employers to easily compare, purchase, and enroll in any health plan offered by participating providers. Kaiser Permanente’s participation in every metal tier in DC Health Link ensures employers can offer their employees high-quality,* integrated care at an affordable price. What are the benefits of DC Health Link to small businesses? CHOICE AND FLEXIBILITY — By consolidating the buying power of small businesses, DC Health Link provides employers a wide selection of affordable health coverage options. Companies can choose one of three ways to offer coverage to their employees. They can offer: • One metal tier of coverage. This option, known as “employee choice,” allows employers to offer employees the greatest freedom to choose the plan that best fits their needs. At the same time, it allows employers to structure health benefits that meet their budget requirements. Each employee can select any health plan from any carrier within the metal tier selected by the employer. Regardless of the plan(s) chosen by employees, DC Health Link is always the single point of contact for billing across all carriers, so the employer doesn't have to worry about paying multiple bills. • One carrier. With this option, each employee may choose among all benefit plans offered by a single carrier selected by the employer. • One plan. ONE-STOP SHOPPING — Employers and their employees can access an array of health coverage options through the DC Health Link website. They can research, compare, purchase, and enroll in health care and other coverage, such as dental and vision, all from a single portal. LESS PAPERWORK — DC Health Link handles enrollment, plan administration, and billing, which will help employers save time and resources. PRICE AND BENEFIT TRANSPARENCY — DC Health Link empowers companies to easily select a health carrier based on price and quality. ONE MONTHLY PAYMENT — Small businesses get the convenience of making only one monthly payment directly to DC Health Link, no matter how many carriers and plans their employees select. A BETTER WAY TO TAKE CARE OF BUSINESS Who can participate in DC Health Link for small businesses? Employers must meet these four requirements to be eligible to offer coverage through DC Health Link: 1. Have a business location in the District of Columbia 2. Have between 1 and 50 full-time equivalent employees in the prior calendar year 3. Offer coverage through DC Health Link to at least all full-time employees working on average at least 30 hours per week 4. Have a valid federal employer identification number (EIN) What are the eligibility requirements for Small Business Tax Credit? Certain small businesses are eligible for a federal tax credit that can cover up to 50% of their costs for offering health insurance to their employees. To be eligible, a District of Columbia employer must: • Have fewer than 25 full-time equivalent employees (FTEs) • Have average employee wages of less than $50,000 a year • Purchase coverage through DC Health Link • Pay at least 50% of the cost of single coverage for each employee For detailed information on employer eligibility, go to www.irs.gov/uac/Small-Business-Health-Care-Tax-Credit-for-Small-Employers. For-profit businesses can claim the tax credit on the organization’s tax return. S-corporations and partnerships claim the tax credit on the owners’ K-1. Getting help Employers and their employees can get help using DC Health Link from a licensed insurance broker, an assister, or a DC Health Link Customer Service agent. For more information, please call the DC Health Link Call Center at 855-532-5465 or send an email to [email protected]. *The private plan of Kaiser Permanente of the Mid-Atlantic States, Inc., is rated 5 out of 5 among health insurance plans in NCQA’s “Health Insurance Plan Ratings 2015-2016.” Out of 606 plans rated, it is the only one in Maryland, Virginia, and Washington, DC, and one of only 11 nationwide to earn the 5 out of 5 rating. The ratings are based on measures of consumer satisfaction and clinical quality in prevention and treatment services. The private plan was also rated the No. 1 private plan in Maryland, Virginia, and Washington, DC, from 2012 to 2014. Visit reportcard.ncqa.org for more information. A BETTER WAY TO TAKE CARE OF BUSINESS 6 steps for small business owners to enroll employees through DC Health Link 1 Create an Employer Account Go to DCHealthLink.com and register for a small business account by entering the necessary company, coverage, and employee information. 2 Shop, Compare, and Customize Choose from over 100 different plans across 4 levels of coverage to offer to employees. Select which of the following options to make available to employees:1 • One metal tier of coverage, also known as "employee choice" • One carrier • One plan Then, select the percentage contribution to make for each employee and/or his/her family members. 3 Verify Eligibility and Select Broker Verify the company’s eligibility to offer employer-sponsored health insurance through DC Health Link.2 Select a broker who can be assigned to the company’s account to complete the final three steps of the application (optional). 4 Establish Enrollment and Eligibility Rules Select dates for the company’s employee open enrollment period and choose when coverage will be effective for newly eligible employees. 5 Open Enrollment for Employees DC Health Link will email eligible employees at the beginning of the open enrollment period with instructions on how to view available plans and the cost to enroll in each. Employees can select which plan to enroll in for themselves and/or dependents (if eligible).3 Employee elections should be reviewed during the open enrollment period. 6 Pay Newly enrolled DC Health Link companies must pay the first month’s premium before coverage can take effect. Payment must be received by the 12th day of the month in order for coverage to be effective on the 1st of the following month. Once the first payment has been made, the group's carrier will send enrollees member ID cards and additional information about how to access their plans. 1 Choosing to offer one metal tier of coverage allows employers to offer employees the greatest freedom to choose the plan that best fits their needs. At the same time, it allows employers to structure health benefits that meet their budget requirements. Each employee can select any health plan from any carrier within the metal tier selected by the employer. Regardless of the plan(s) chosen by employees, DC Health Link is always the single point of contact for billing across all carriers, so the employer doesn't have to worry about paying multiple bills. Choosing one carrier also provides some flexibility for employees, as they have the opportunity to select any health plan offered by a single carrier selected by the employer. Small2 businesses located in the District of Columbia with 50 or fewer full-time equivalent employees (FTEs) are eligible for participation in DC Health Link. If3 the employer does not offer coverage to family members, they may apply for individual and family plans directly through DCHealthLink.com. A BETTER WAY TO TAKE CARE OF BUSINESS What you will need to enroll employees with DC Health Link • The company’s Federal Employer Identification Number (EIN) • The company’s Washington, DC, business address • Number of full-time equivalent employees (FTEs) with the company during the prior calendar year • Employee list (census) – For each eligible employee: > Date of birth > Social Security Number (SSN) or Tax Identification Number (TIN) > Employee email address (for open enrollment notice only) > Date of birth for all dependents (optional – to increase accuracy of cost estimations only) Why are dates of birth important? Rates will be determined based on the age of each enrollee. For more information, go to DCHealthLink.com or call 855-532-5465. Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. 2101 E. Jefferson St., Rockville, MD 20852 60448110_web MAS 4/1/16–12/31/16 .