The Affordable Care Act: Insurance Exchanges - A New MarketplaceSmall Business OptionsPart 3Bob SemroPolicy AnalystAugust 2013

The Bell Policy CenterResearch • Advocacy • Opportunity

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Health Insurance Exchanges

Connect for Health Colorado (C4HC) Colorado’s new health insurance marketplace for individual and family insurance

purchasers and small businesses

Opens Oct. 2013

Coverage begins Jan. 1 2013

www.connectforhealthco.com/

Exchanges: not just another insurance website1. Create larger risk pools

2. Create a large pool of prospective customers

3. Single location to compare plans side by side

4. Plans must meet minimum qualifications to be federally qualified

5. Plans must minimum essential health benefits defined by the Affordable Care Act

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1. Replace the existing health insurance market

2. Replace insurance agents or insurance brokers

3. Negotiate premium rates between carriers and providers

4. Offer its own insurance product

5. Directly enroll applicants in the state Medicaid program

6. Offer Medicare supplemental insurance plans (Medigap)

7. Operate as a for-profit organization

8. Operate as an agency of the state government

9. Receive funding from the state’s General Fund

Connect for Health Colorado does not:

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The Employer Responsibility Requirement

Implementation has been delayed by one year and begins 2015

Employers of 50 or more full-time employees: subject to penalty if one or more full-time employees enrolls in a plan through C4HC and receives a “subsidy” because:

1. Employee’s annual income is 100-400% FPL• 2013: $11,490 - $45,960 for an individual

2. Employer does not offer coverage to full-time employees3. Coverage offered by the employer is unaffordable

• Employee’s contribution is more than 9.5% of their W-2 form wages

Employers do not need to offer coverage to:•Part-time employees: less than 30 hours per week or at least 130 hours of service in a calendar month•Seasonal employees: 120 days or less per year

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Bob SemroPolicy Analyst, Bell Policy Center1905 Sherman St. Suite 900 Denver, CO 80203

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