Step-by-Step Timeline for Enrolling

in the DC Health Insurance

Exchange for January 1, 2015

Enrolling your employees in DCHealthLink without losing your head

By Julie Gallion, PHR

Step 1: Find a Good Broker

When: July 2014

• A good broker is there to help you and your employees understand the nuances of the plan options available and to keep the organization on track for a timely enrollment.

• When creating a DCHealthLink account, you, as the employer, can designate a broker as an “Assister" enabling your broker to access your plan options help to employees choose the best plan and enroll themselves.

• Brokers who are not certified as an Assister in the Exchange or are unwilling to understand the Exchange or are unwilling to work one-on-one with employees should be replaced now.

Step 2: Create a DCHealthLink Account

When: July/August 2014

• By creating a login, employers can explore current plans and pricing options in order to decide which options to offer to employees. Understand that the prices are likely to change by October 1.

Step 3: Decide What Plan(s) to Offer

When: July/August 2014

• Employers will have three choices of programs to offer to their

employees including:

1.One plan/one carrier (Carefirst, United, AETNA or Kaiser).

2.All plans/one carrier (Carefirst, United , AETNA or Kaiser).

3.All plans/all carriers on a single metal level (Platinum,

Gold, Silver, Bronze).

The Three Options

1. One Plan/One Carrier - If you currently offer just one plan through CareFirst, you will be able to offer the same option through the Exchange. However, this may not be the best option for you and your staff based on costs and employee needs/desires for more options at lower prices.

2. All Plans/One Carrier - Employees may choose between all plan options within the one carrier you have selected. If you currently offer 2 or 3 plan options, this would be a good choice.

3. All Plans/All Carriers, One Metal Level - If your employees are interested in choosing from more than one carrier, you can opt to offer all plans at a specific metal level. For example, employers choosing the platinum level would be "offering" 48 different options including 4 from Kaiser, about 20 from United and about 24 from CareFirst. Employees will then narrow down their options by choosing a carrier, type of plan (PPO, POS, HMO, etc) and deductible/coinsurance levels.

A Note on Selecting a Plan

Making the choice between the three options requires you to consider not only what you currently offer, but also your budget, overall benefits philosophy and requests from employees. An employer who wants to keep things simple may offer option 1 where an employer who wants to reduce or maintain their costs while allowing employees to opt into a higher level of coverage may choose options 2 or 3.

Step 4: Gather and verify employee data

When: August 2014

• You, as the employer, will need to enter data for all eligible employees in the system either manually or via a census upload. Each employee will then complete his/her own application online in the Exchange website.

• The data you enter as the employer and the data entered by the employee, on the user end, must match EXACTLY.

• Take the time now to have employees verify that the data in your files is accurate.

• Ask your accounting software provider to provide (or pull from your HRIS) a report for you based on the Census template. This will enable you to run the report and upload it quickly once you are able to complete the employer application (October 1).

Step 5: Select a reference plan

When: September 2014

• Employers choosing option 2 or 3 (see slide 4) will choose a reference plan. The reference plan is a specific plan within the options offered to employees. This plan is what employer contributions will be based upon.

• Employees can opt to enroll in a more expensive or a cheaper plan than the reference plan depending on their own personal circumstances.

• The invoice will be based on the employee’s plan selection.

Step 6: Decide on employer contributions

When: September 2014

• Employers enrolling in the Exchange must enter the percentage that the employer will contribute. You may not enter a dollar amount contribution or any unique contribution amounts such as a higher percent for lower wage workers or a lower percent for more expensive plans. (e.g. employer contributes 100% toward employee coverage and 50% toward family coverage).

• When an employee enrolls, he/she will see the total payroll deduction based on the percentage of employer contribution entered by the employer and their individual plan choice.

• Following the percentage arrangement set through the Exchange significantly limits the opportunity for unique and easy to use cost sharing arrangements and easy payroll deductions. On the other hand, not following the percentage arrangement could present significant communication challenges.

• You should consider the benefits and challenges of both approaches as well as your cost sharing philosophy and budgeting issues well in advance of completing the employer application.

Step 7. Complete the employer application

When: October 2014

• This is a 3-4 step process prone to typos and submission errors. It is highly recommended that you complete this process as early in October as possible to leave time for any issues to be corrected.

• When completing the employer application it is highly recommended that you take a screen shot or print every page. This will help the Exchange staff identify the cause of any issues with submitting the application.

• The hard deadline for application completion is November 26 for a January 1 effective date.

Step 8: Employee Open Enrollment Meetings

When: Late October 2014

• During open enrollment meetings, the Exchange should be explained. It is crucial that the employer explain during these sessions the general differences between the various options being made available to employees and the important points for employees to consider in making their selections.

Step 9: Open enrollment for employees

When: November 1-21, 2014

• Starting open enrollment as soon as possible (November 1) gives your employees plenty of time to select their plan, set up their account and enroll in the plan.

• If you so choose, the Exchange will send an automated email to all employees regarding open enrollment (which should begin November 1).

• Indicate an open enrollment end date of November 21 to give employees three weeks to make a decision and allow time for stragglers and for the resolution of errors in setting up the account.

Step 10: Open enrollment ends

When: December 10, 2014

• The Exchange will allow no entry after December 10, 2014.

• January 2015 premiums are due December 12 2014.

• The Exchange will make no exceptions on these deadlines. The Exchange will send an invoice based on your employees’ enrollment. Unlike in the current group market, payments cannot be late.

• In the event that payment is not received, your employee’s insurance coverage will be in jeopardy.

Feeling overwhelmed?

• Call or email Julie Gallion at 202-785-2060 (jgallion@nonprofithr.com) for support with Exchange enrollment or general benefits questions.