So many ways into the complex health care system One guide to make shopping for your employees health insurance simpler. For small businesses

Transcription

1 So many ways into the complex health care system One guide to make shopping for your employees health insurance simpler. For small businesses Michigan SHOP Marketplace (Small Business Health Options Program)

2 simpler welc me to insurance shopping Use this guide to find coverage for your employees. It s easier than you might think. And we re here to help. 2 Open Enrollment

3 Small Business Health Insurance UnitedHealthcare Michigan SHOP Marketplace (Small Business Health Options Program) Let s get started. Finding health insurance for your small business is as easy as 1, 2, How to choose insurance. Learn how to compare insurance plans and when to sign up. Compare plans. Look closely at the plans to see which one is right for your employees. What comes next? Get health insurance for your employees and find out what happens next. 3 easy ways to sign up: sign up by the 15th to start coverage on the 1st of the following month Work with us uhc.com/sbshop Work with a broker. uhcbroker.com Shop on your own. healthcare.gov Have questions? uhc.com/sbshop uhcbroker.com healthcare.gov 3

4 1 How to choose insurance. 3 key decisions. 1) See if your business is eligible. You ll need to meet three requirements before buying a SHOP group health plan. Principal employee work site. Your business must have an employee office or work site in the state where you re buying coverage. Number of employees. You must have 50 or fewer full-time equivalent employees (FTE). Get help calculating how many FTEs you have at healthcare.gov Offer health insurance to all FTEs. You ll need to offer coverage to any employee that works an average of 30 or more hours a week. 2) Choose coverage options. You can offer your employees one plan or a choice of plans. There are four categories (metal levels) of plans. Bronze Silver Gold Platinum Monthly Premium Co-pay (cost per visit/drug) Is this plan category right for you? $ $$ $$$ $$$$ $$$$ $$$ $$ $ You rarely see a doctor, and you re willing to pay a higher co-pay when you do. You want to balance monthly premium, co-pay and costs. There are several of choices in between the bronze and platinum plans. You see doctors more often and are willing to pay higher monthly premiums to lower your co-pay. 3) See if you qualify for a tax credit. If you have fewer than 25 full-time equivalent employees (FTEs), you could be eligible for the small business health care tax credit worth up to 50% of your premium costs. Plus, you could also deduct the remaining part of your premium on your taxes. 4 Open Enrollment

5 Additional Considerations. Wide variety of coverage and premiums. You control coverage options and how much of your employees monthly premiums you pay. There are a variety of plans and options that offer the flexibility to customize your employees insurance. Saving you time and money. Through a variety of affordable insurance plans and cost estimator tools, your employees may meet their health and budget needs. That s because we negotiate with in-network doctors and hospitals to keep costs down. Easy access to care. Your employees have access to top doctors, clinics and hospitals with all our insurance plans. In fact, we screen all of our providers and facilities for care quality and cost-savings. If you simply have a question or need advice, call our NurseLine to talk with registered nurses 24/7. Virtual visits: With virtual visits, your employees can see a health care provider for minor health issues right from their computer, tablet or mobile phone. Your employees can use tools to manage their health and costs. Through online resources, mobile apps and myuhc.com, your employees will find: 24/7 access to benefit info. Health care providers. Health care cost estimator. Apps, tools and programs to manage health. More than 45 million*people across the nation rely on UnitedHealthcare for their health insurance. * UnitedHealthcare serves 45 million domestically and internationally through its market facing business. Source: UnitedHealth Group 2014 Annual Report, pg. 6. Have questions? uhc.com/sbshop uhcbroker.com healthcare.gov 5

6 2 Compare plans UnitedHealthcare Michigan SHOP Marketplace UnitedHealthcare Navigate and Choice Plus Plans (1-50 Employees) Navigate and Choice Plus plans are smart options for cost conscious employers looking to offer quality care to their employees. With a Navigate plan, your employees will choose a network primary care provider (PCP) to manage their care and refer them to specialists, if needed. There is no coverage for seeing out of network providers. Choice Plus plans give your employees the freedom to visit any doctor, clinic or hospital in this large national network without a referral or choosing a primary care provider. Your employees can also go out of network, but they will likely pay more for covered services. Plan Type Plan Name Silver Navigate Copay Gold Navigate HSA Bronze Choice Plus HSA Plan Code AC-GT AC-GS AC-GU HSA Employer Funding Amount Minimum HSA Employer Funding Amount Maximum N/A N/A $0 N/A N/A $50 Description 40/4000/80% 25/2000/80% 6300/100% PCP Office Visit $45 copay $25 copay Specialist Office Visit $90 copay $50 copay Urgent Care $100 copay $75 copay Emergency Room $400 copay and 20% coinsurance $200 copay and 20% coinsurance Minor Lab and X-ray 20% after No charge INN Coinsurance 80% 80% 100% INN Individual Deductible $4,000 $2,000 $6,300 INN Family Deductible $12,000 $6,000 $12,600 INN Individual Out-of- Pocket Maximum $6,350 $4,000 $6,300 Pharmacy Plan Code DT DT MM Notes: 6 Open Enrollment

7 3 What comes next? Set up. Sign up. Make sure you re eligible. Visit uhc.com or healthcare.gov Choose coverage for your employees*. Need help? Visit healthcare.gov or uhcbroker.com Learn about tax credits. See if you can get a tax credit at healthcare.gov * UnitedHealthcare policies may have exclusions or limitations or terms under which the policy may be continued in force or discontinued. For costs and complete details of the coverage, contact your broker, consultant or UnitedHealthcare Representative. Employee enrollment period. Tell employees about coverage and dates. Let them know what s offered, when and where to sign up. Your employees choose the insurance that fits their needs. Employer finalizes enrollment. Log on to healthcare.gov to review your employees enrollment. Submit your application to finish signing up. Pay the first month s premium. Be sure to pay your bill online to start your employees coverage. 3 Enter employee information. Use this simple sign-up checklist. Have everything ready for every employee you re insuring. 3 First and last name 3 Date of birth 3 Social Security number 3 Date of hire 3 Full- or part-time status 3 address Before your employees coverage starts. You can choose how long you d like your employees to wait before their coverage starts. However, a waiting period cannot exceed 90 days from enrollment. Sign up now: Sign up by the 15th to start coverage on the 1st of the following month. Work with us uhc.com/sbshop Work with a broker. uhcbroker.com Shop on your own. healthcare.gov Have questions? uhc.com/sbshop uhcbroker.com healthcare.gov 7

8 Choosing your small business health plan just got simpler. Visit uhc.com/sbshop or contact your UnitedHealthcare broker Virtual visits are not an insurance product, health care provider or a health plan. Unless otherwise required, benefits are available only when services are delivered through a Designated Virtual Network Provider. NurseLine SM is for informational purposes only. Nurses cannot diagnose problems or recommend specific treatment and are not a substitute for your doctor's care. NurseLine services are not an insurance program and may be discontinued at any time. UnitedHealthcare policies may have exclusions or limitations or terms under which the policy may be continued in force or discontinued. For costs and complete details of the coverage, contact your broker, consultant or UnitedHealthcare Representative. Insurance coverage provided by or through UnitedHealthcare Insurance Company or its affiliates United HealthCare Services, Inc. UHCMI758442_ /15