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