May, 2013 Sample Employer Letter Dear Small Group Employer,

May, 2013
Sample Employer Letter
Dear Small Group Employer,
You’re a valued business partner, and we’re committed to improving the health of your
employees and your business. As part of that commitment, we’re here to provide the
information you need to help make the right decisions for your business. Under the health
care reform law, called the Affordable Care Act (ACA), there will be changes in health
coverage that affect small business owners and their employees. You don’t need to make
any decisions right now, but this overview will help you understand the options small
employers will have for their plans beginning in 2014.
Four categories of coverage: bronze, silver, gold, and platinum
To comply with the ACA, for plan years beginning on or after January 1, 2014, all
insurers must offer small group plans that meet new standards for coverage. This
excludes grandfathered plans, which are plans that have covered at least one employee
and continued unchanged since March 23, 2010.
All of Kaiser Permanente’s non-grandfathered plans will fit into four main categories of
coverage, also called “metal tiers”: bronze, silver, gold, and platinum. These four
categories will offer different levels of copayments, coinsurance, and deductibles for
essential health benefits. For example, bronze plans will have lower premiums with
higher out-of-pocket costs, while other metal tier plans will have higher premiums and
lower out-of-pocket costs. And since all insurers within each tier are required to offer
similar levels of coverage, it will be easy for you to compare pricing, benefits (other than
essential health benefits), and features to make more informed decisions.
For your renewal in 2014, Kaiser Permanente will automatically provide you with
coverage from one of these categories that best matches the plan(s) your business offers
today. But you can choose the level of coverage that's right for you.
60126710
Kaiser Foundation Health Plan of Georgia, Inc., Nine Piedmont Center, 3495 Piedmont Rd, Atlanta, GA 30305
Increase in the small business tax credit
Under the ACA, some small businesses with 24 or fewer full-time equivalent employees
for the taxable year may qualify for a small business tax credit of up to 35 percent to help
them afford the cost of health care premiums (25% for tax exempt employers). In 2014,
the tax credit goes up to 50 percent (35% for tax exempt employers) and will be available
to qualified small businesses that purchase coverage through the new health insurance
marketplace in Georgia, called the Small Business Health Options Program (SHOP). You
can turn to Kaiser Permanente or your broker to help make this transition.
The SHOP marketplace and how it will work
The SHOP marketplace will open in October of this year for coverage that takes effect on
January 1, 2014, or later. And since Kaiser Permanente plans will be available in the
SHOP marketplace, businesses can continue offering employees the high-quality,
integrated care they already know and trust.
In Georgia, the SHOP marketplace will be facilitated by the federal government.
You will be able to go to the SHOP website and compare coverage options from many
qualified health plans (QHPs). You will then choose one plan (QHP) to offer to your
employees. You and your employees can also enroll online.
The SHOP marketplace will handle the enrollment paperwork and the QHP issuer
providing your health coverage will send you the bill.
Benefits of the SHOP marketplace
Here are some of the many features the SHOP will provide to small business owners:
• Tax credit — Beginning in 2014, the small business tax credit will only be
available through participation in the SHOP.
• One – stop shopping — Employers can research, compare, and select, certain
primary and ancillary coverage, such as pediatric dental and vision, all through
the SHOP website.
60126710
Kaiser Foundation Health Plan of Georgia, Inc., Nine Piedmont Center, 3495 Piedmont Rd, Atlanta, GA 30305
• Less paperwork — The SHOP will handle enrollment and plan administration
which will help employers save time and resources.
And of course, for small employers that do not qualify for the tax credit, you can continue
to purchase coverage directly from Kaiser Permanente for all of your employees, just as
you do today.
No action needed at this time
Don’t worry. There’s nothing you need to do right now. You won’t have to make any
decisions until your renewal period for plan years beginning in 2014. If you’re currently
offering your employees a grandfathered plan, you can also renew your existing plan for
2014 without the benefit changes mandated by the ACA.
Later this year, we’ll send you more information about new Kaiser Permanente plan
options. At your renewal, you’ll receive specific information about your 2014 plan,
benefits, and rates. We want to make it easy for you to have plans that work best for your
business and your employees, so we’ll stay in touch throughout the year to help you
understand the new world of health care.
For more information, please visit businessnet.kp.org, contact your broker, or contact
me directly at 404-364-7006.
Sincerely,
Victor Houston
Kaiser Permanente Georgia Region
Small Group Account Manager
60126710
Kaiser Foundation Health Plan of Georgia, Inc., Nine Piedmont Center, 3495 Piedmont Rd, Atlanta, GA 30305