Blue Access for Employers

Health Insurance Exchange

Starting in 2014, individuals — and small employers — are being introduced to a new way of buying health insurance.

Who

What

Individual

New Mexico Health Insurance Exchange

Small Employers

Small Business Health Options Program (SHOP)


Small Business Health Options Program (SHOP)

Small employers can buy group health care coverage by selecting a SHOP Exchange plan on behalf of their employees. Or, pass and keep buying like they do now with a group contract.

Beginning in 2015, you'll have a few options for offering group health plan coverage based on your state.

Small Business Health Care Tax Credit

You may qualify for the Small Business Health Care Tax Credit if all of these apply:

  • You have less than 25 full-time equivalent employees
  • Your employees have average annual wages of less than $50,000
  • You pay the same percentage for all employees and that percentage is equal to at least 50% of the premium cost for employee-only insurance coverage
  • You've bought group health care through the SHOP Exchange

The tax credit is worth up to 50% of your contribution toward your employee's premium costs (up to 35% for tax exempt employers).

Please visit Healthcare.gov  to find out more about Small Business Health Care Tax Credits.

Individuals can apply for
coverage online, over the
phone or by mail.


Metallic Level Plans

Exchange health plans will fall into one of four metallic levels. You'll find a variety of plans offered across the tiers, all covering essential health benefits (EHBs):

  • SHOP - Each level shows much you'll pay into the total cost of your employee's coverage

  • Exchange - Each level shows a range for health coverage costs

Level

Plan Pays

You'll Pay

Cost
Details

Bronze

60%

40%

  • Lower monthly payments

  • Higher out-of-pocket costs when you receive medical care

Silver

70%

30%

  • Higher monthly payment than a Bronze plan

  • Lower out-of-pocket costs than a Bronze plan when you receive medical care

Note: Silver plans eligible for cost-sharing assistance
based on income.

Gold

80%

20%

  • Higher monthly payment than a Silver plan

  • Lower out-of-pocket costs than a Silver plan when you receive medical care

Platinum

90%

10%

  • Highest monthly payments

  • Lowest out-of-pocket costs when you receive medical care





Since this is an overview, detailed information on this
topic — and more — is available.