Report to the Colorado Health Benefit Exchange Board:

SHOP and the Small Employer Work Group (SEWG)

November 14, 2011

COHBE Business Concept “Refresh”

Introduce SEWG

Discussion #1: “High Level Market”

Discussion #2: “SHOP in Colorado”

Consensus/Recommendations/Wrap up

November 4 Study Session Format:

Small Employers, Insurers, BrokersActuariesState Officials (CDLE, OEDIT, DOI)NFIB, CACIMSECConsumer GroupsPolicy AdvocatesCompaniesCOHBE Board Members

Who Participated in the Colorado’s Small Employer Work Group?

Utah Exchange Presentation Business Partner Market Research Adverse Selection 12 Priority Areas for SHOP decision-making Perspectives from brokers/underwriters Perspective from insurers Consensus in 6 of 12 Priority Areas

What Topics Did the SEWG Discuss?

1. Small Employer: Should the SHOP start with the current Colorado definition (<50)?-- Yes

2. Merge Markets: Should the small group and individual markets remain separate?-- Yes

3. Separate SHOP Functions: Should there be separate website & business functionality?-- Yes: for the needs of this market

Initial SEWG Recommendations:

4. Services: What services should the SHOP offer?-- A general principle: “Offer services that attract small employers and provide value”

5. Market Rules: Should rules for carriers be the same in/out of the exchange?-- Yes

6. Continue SHOP Exchange?-- Yes (SB-200, proposed rule & value-added)

Initial SEWG Recommendations:

Issues related to federal rule:-- Definition of Employee-- Business Group of One

Issues related to future proposed rules: -- Qualified Health Plans -- Offer all plans? -- Same QHP’s in individual and SHOP markets? -- Colorado’s state requirements?

Specific Planning Issues: -- Services offered -- Collect premiums? (required in proposed rule) -- Defined Contribution

SHOP Questions for Further Planning:

Recognize the Small Employer Work Group for their hard work, thoughtful consideration and collaboration

Accept the SEWG Report

Give their recommendations strong consideration in implementation of the SHOP Exchange

Proposal to COHBE Board: