EmblemHealth to Offer New, Commissionable Plans on SHOP

EmblemHealth SHOPThe Small Business Health Options Program (SHOP) is a public online marketplace for qualifying small businesses to purchase affordable health plans for their employees.

This year's open enrollment period for employers begins October 1, 2014, and EmblemHealth is pleased to offer new HMO plans on SHOP effective January 1, 2015.

EmblemHealth Offers Seven Plans on SHOP:

  • Three non-standard plans (similar to our existing HMO plans off the Exchange): EmblemHealth HMO 40/60 S, EmblemHealth 35/55 S and EmblemHealth HMO HD6300 S.
  • Four new standard plans: Select Care Bronze HMO S, Select Care Silver HMO S, Select Care Gold HMO S, and Select Care HMO Platinum S.

Note: The S at the end of the plan names differentiates the SHOP plans from the small group plans available for sale directly from EmblemHealth.

EmblemHealth SHOP Plan Features:

  • EmblemHealth's SHOP plans offer a commission rate of 3% for new and renewal business.
  • Each plan covers the same health benefits, but at different costs (both premiums and out-of-pocket costs).
  • All SHOP plans will feature access to EmblemHealth's quality Select Care Network.
  • Qualifying groups can receive tax credits that return up to 50 percent of its contributions to employee premiums.

SHOP Enrollment Period:

For January 1st coverage, an employer must enroll from October 1-31. Open enrollment for employees runs from November 1-30. For coverage effective after January 1, 2015, open enrollment is ongoing for SHOP and groups can enroll throughout the year.

SHOP Certification:

To sell health insurance on SHOP, a producer must:

  • Complete an Exchange-approved training program and pass a test to certify its completion. (You can go to the NYS website to see a list of the Provider Organizations who have an approved certification course for selling through SHOP.)
  • Enter into an agreement with the Exchange to fully disclose their role and compensation arrangement.
  • Be licensed and in good standing with the New York State Department of Financial Services.

We'd Like to Hear From You:

Let us know what you would like to know about our new plans. Write us at brokerfocus@emblemhealth.com, and look out for a special email series in the coming weeks that will further highlight EmblemHealth's on-exchange plans.

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