How are the SHOP small business exchanges going to work? Part I- process

I have spent several days getting certified to sell on both the Federally Facilitated individual and SHOP Small business exchanges, and the New York State Exchanges, and it proved most interesting.

Here are some of the highlights:

PROCESS- for this year, the Employer can go in and select one companies plans on the exchange.  In future years the theory is you can allow your employees to choose more than one carriers plans.

Heres how it will work:

1)  The Employer will set up an account online with the exchange, give me access, but not their passwords.

2)  Someone – you or your broker – will enter in your census into the exchange site.

3)  The SHOP will generate Plan Options

4)  The employer than selects the “reference plan” for the employees

5)  The Employer identifies their contribution to the plan (in the future you will be able to make this either age-based or a composite “single” rate for all)

6)  You can then run “what-if” scenarios to make sure you are in compliance

7)  Your employees now log in, select a plan, or provide a valid waiver

8)  Plan participation must be 70% or greater with valid waivers.  Valid waivers are spousal coverage, medicare, medicaid, Tricare or other coverage.

9)  The employer reviews the apps, sets the waiting period and pays for the first months coverage.