Access Health Connecticut SHOP Marketplace (Small Business Health Options Program)

So many ways into the complex health care system

One guide to make shopping for your employees’ health insurance simpler.

For small businesses

simplerinsurance shopping

welc me to

Use this guide to find coverage for your employees. It’s easier than you might think. And we’re here to help.

2 Open Enrollment

3

UnitedHealthcareAccess Health Connecticut SHOP Marketplace

(Small Business Health Options Program)

Small Business Health Insurance

Let’s get started.Finding health insurance for your small business is as easy as 1, 2, 3.

1How to choose

insurance.Learn how to compare insurance plans and

when to sign up.

2Compare

plans.Look closely at the plans to see which

one is right for your employees.

3What comes

next?Get health insurance for your employees and find out what

happens next.

Have questions? | 1-877-856-2430 | uhc.com/sbSHOP | uhcbroker.com | accesshealthct.com 3

3 easy ways to sign up:

Shop on your own.accesshealthct.com

1-877-856-2430uhc.com/sbSHOP

Work with us.

sign up by the 15th to start coverage on the 1st of the following month

Work with a broker.uhcbroker.com

4 Open Enrollment

GoldSilverBronze Platinum

Monthly Premium $ $$ $$$ $$$$

Co-pay (cost per visit/drug)

$$$$ $$$ $$ $

Is this plan category right for you?

You rarely see a doctor, and you´re willing to pay a higher co-pay when you do.

You want to balance monthly premium, co-pay and deductible costs. There are

several of choices in between the bronze and platinum plans.

You see doctors more often and are willing to pay higher monthly premiums to lower your co-pay.

4 Open Enrollment

1

1) See if your business is eligible. You’ll need to meet three requirements before buying a SHOP group health plan.

Principal employee work site.Your business must have an employee office or work site in the state where you’re buying coverage.

Number of employees.You must have 50 or fewer full-time equivalent employees (FTE). A sole proprietorship that employs only the sole proprietor or the spouse of such sole proprietor is not eligible for coverage in the SHOP Marketplace. Get help calculating how many FTEs you have at accesshealthct.com

Offer health insurance to all FTEs.You’ll need to offer coverage to any employee that works an average of 30 or more hours a week.

3 key decisions.

How to choose insurance.

2) Choose coverage options.You can offer your employees one plan or a choice of plans. There are four categories (metal levels) of plans.

3) See if you qualify for a tax credit.If you have fewer than 25 full-time equivalent employees (FTEs), you could be eligible for the small business health care tax credit worth up to 50% of your premium costs. Plus, you could also deduct the remaining part of your premium on your taxes.

5Have questions? | 1-877-856-2430 | uhc.com/sbSHOP | uhcbroker.com | accesshealthct.com

Additional Considerations.

Wide variety of coverage and premiums.You control coverage options and how much of your employees’ monthly premiums you pay. There are a variety of plans and options that offer the flexibility to customize your employees’ insurance.

Saving you time and money.Through a variety of affordable insurance plans and cost estimator tools, your employees may meet their health and budget needs. That’s because we negotiate with in-network doctors and hospitals to keep costs down.

Easy access to care.Your employees have access to top doctors, clinics and hospitals with all our insurance plans. In fact, we screen all of our providers and facilities for care quality and cost-savings. If you simply have a question or need advice, call our NurseLine℠ to talk with registered nurses 24/7.

Your employees can use tools to manage their health and costs. Through online resources, mobile apps and myuhc.com®, your employees will find:

Virtual visits:With virtual visits, your employees can see a health care provider for minor health issues right from their computer, tablet or mobile phone.

More than 45 million*people across the nation rely on UnitedHealthcare for their health insurance.

* UnitedHealthcare serves 45 million domestically and internationally through its market facing business. Source: UnitedHealth Group 2014 Annual Report, pg. 6.

24/7 access to benefit info.

Health care providers.

Health care cost estimator.

Apps, tools and programs

to manage health.

6 Open Enrollment

Plan Code AE-OV AE-OR AD-BJ AE-OP AE-OG AE-ON AE-OX AC-2R AE-OT

HSA Employer Funding Amount

MinimumN/A N/A N/A N/A N/A N/A $0 $0 $0

HSA Employer Funding Amount

MaximumN/A N/A N/A N/A N/A N/A $0 $0 $0

Description 40/5500/60% 30/3400/100% 35/3500/100% 25/1000/100% 25/2500/100% 15/100/100% 5300/90% 30/2500/100% 3000/90%

PCP Office Visit $40 copay $30 copay $20 copay $25 copay $25 copay $15 copay 10% after deductible

$30 copay af-ter deductible

$30 copay af-ter deductible

Specialist Office Visit

$50 copay after deductible $50 copay $40 copay $45 copay $45 copay $45 copay 10% after

deductibleNo charge after

deductible10# after

deductible

Urgent Care $75 copay $75 copay $75 copay $75 copay $75 copay $50 copay 10% after deductible

$75 copay af-ter deductible

10% after deductible

Emergency Room

$200 copay after deductible $150 copay $200 copay $150 copay $150 copay $100 copay 10% after

deductible$200 copay deductible

10% after deductible

Minor Lab and X-ray

$35 copay after deductible $40 copay No charge $30 copay No charge $20 copay 10% after

deductibleNo charge after

deductible10% after deductible

INN Coinsur-ance 60% 100% 100% 100% 100% 100% 90% 100% 90%

INN Individual Deductible $5,500 $3,400 $3,500 $1,000 $2,500 $100 $5,300 $2,500 $3,000

INN Family Deductible $11,000 $6,800 $7,000 $2,000 $5,000 $200 $10,600 $6,250 $6,000

INN Individual Out-of-Pocket

Maximum$6,850 $6,850 $6,500 $3,500 $4,000 $2,000 $6,500 $5,500 $4,000

Pharmacy Plan$5/50%/50%/

50% to $500 after medical deductible

$5/$25/$55/20% to $200

(Tier 4 subject to $150/300 Rx

deductible)

$5/$40/50% to $250 maximum;

$100 Rx deductible

(Tier 2 & Tier 3)

$5/$25/$50/20% to $100 (Tier 4

subject to $25/$50 Rx deductible)

$5/$40/50% to $250 maximum

$5/$25/$40/ 20% to $100

maximum

10%/15%/25%/ 30% to $500 after medical deductible

$5/$40/50% to $250

maximum after medical deductible

10%/10%/ 10%/10% to $200

maximum after medical deductible

(1-50 Employees)UnitedHealthcare Choice Plus plans

Compare plans2

6 Open Enrollment

Choice Plus plans are smart options for cost conscious employers looking to offer quality care to their employees. Choice Plus plans give your employees the freedom to visit any doctor, clinic or hospital in this large, national network – without a referral or choosing a primary care provider. Your employees can also go out of network, but they will likely pay more for covered services.

UnitedHealthcareAccess Health Connecticut SHOP Marketplace

5500 3400 100250010003500 HSA 2500HSA 5300 HSA 3000

Plan Name Bronze StandardChoice Plus

Silver StandardChoice Plus

Gold StandardChoice Plus

Platinum StandardChoice Plus

Bronze Standard Choice Plus

Silver Choice Plus

Notes:

Copay H.S.A.Plan Type

Learn about tax credits.See if you can get a tax credit at accesshealthct.com

Set up. Sign up.

Choose coverage for your employees*. Need help? Visit accesshealthct.com or uhcbroker.com

Enter employee information.Use this simple sign-up checklist.Have everything ready for every employee you’re insuring.

3 First and last name

3 Date of birth

3 Social Security number

3 Date of hire

3 Full- or part-time status

3 Email address

Before your employees’ coverage starts.You can choose how long you’d like your employees to wait before their coverage starts. However, a waiting period cannot exceed 90 days from enrollment.

Employee enrollment period.

Tell employees about coverage and dates.

Let them know what’s offered, when and where to sign up.

Your employees choose the insurance that fits their needs.

Sign up now:

Employer finalizes enrollment.Log on to accesshealthct.com to review your employees enrollment. Submit your application to finish signing up.

Make sure you’re eligible.Visit uhc.com or accesshealthct.com

Sign up by the 15th to start coverage on the 1st of the following month.

7

Pay the first month’s premium.Be sure to pay your bill online to start your employees’ coverage.

3

1-877-856-2430uhc.com/sbSHOP

Work with us. Work with a broker.uhcbroker.com

Shop on your own.accesshealthct.com

What comes next?3

Have questions? | 1-877-856-2430 | uhc.com/sbSHOP | uhcbroker.com | accesshealthct.com

* UnitedHealthcare policies may have exclusions or limitations or terms under which the policy may be continued in force or discontinued. For costs and complete details of the coverage, contact your broker, consultant or UnitedHealthcare Representative.

Choosing your small business health plan just got simpler.

Visit uhc.com/sbSHOP or contact your UnitedHealthcare broker

© 2015 United HealthCare Services, Inc.

Virtual visits are not an insurance product, health care provider or a health plan. Unless otherwise required, benefits are available only when services are delivered through a Designated Virtual Network Provider.

UnitedHealthcare policies may have exclusions or limitations or terms under which the policy may be continued in force or discontinued. For costs and complete details of the coverage, contact your broker, consultant or UnitedHealthcare Representative.

Medical policy underwritten by UnitedHealthcare Insurance Company.

NurseLineSM is for informational purposes only. Nurses cannot diagnose problems or recommend specific treatment and are not a substitute for your doctor's care. NurseLine services are not an insurance program and may be discontinued at any time.

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