Office of Consumer Health Services, Avenue H

OVERVIEW U.C.A 63N-11-101 Avenue H is the small business health Avenue Health Insurance Marketplace H insurance solution that works . It offers insurance for small businesses with 1-50 eligible full-time employees . Avenue H provides a unique solution to small business employers and employees, allowing them a variety of health insurance choices while maintaining budget flexibility . Once employers register with Avenue H, they can easily manage their budget by defining a set dollar amount to contribute to each employee’s health plan . Employees then shop online to select their own plan based on their own individual needs . Avenue H provides 75 health care plans through three local medical carriers, Arches Health Plan, SelectHealth and UnitedHealthcare, along with six dental carriers and three health savings account (HSA) options . Employees can filter the variety of health plans by selecting preferences that are most important to them, narrowing down their options to find their ideal health care plan .

Utah’s Health Insurance Solution

Utah’s approach to implementing the Affordable Care Act (ACA) is unique in comparison to the rest of the country . When the ACA was passed, it gave states three options for compliance: state-based exchange, state-federal partnership or federally facilitated exchange . In early 2013, Governor Gary R . Herbert proposed a different option to the U .S . Department of Health and Human Services (HHS) . The Governor proposed a bifurcated approach that would allow the state to continue to run Avenue H as a certified health insurance marketplace (SHOP) for small businesses, leaving the federal government to create and implement a marketplace for individuals . HHS accepted Governor Herbert’s proposal, and now “the Utah approach” is the official fourth option for compliance .

Intermountain Medical Center, Murray UT

Utah’s option complies with the health reform law contained in the ACA, but also retains state control and flexibility . For instance, the state maintains oversight of qualified health plans and administration of Utah’s Medicaid program through the existing in-state structure . The federal marketplace focuses on individual consumers and manages tax subsidies in compliance with the ACA . This is just another example of how Utah continues to be a leader in innovative solutions .

Small Businesses Offering Choice and Value

Avenue H’s current market is small businesses with 1-50 employees . This is because approximately half of the state’s private workforce are employed at small businesses and small businesses represent nearly 98 percent of all employers . Small business owners value good employees, and one way for them to attract and retain their employees is to provide them with quality health insurance, which in turn helps their employees feel more secure and valued . Focusing on small businesses helps the greatest number of Utahns with the highest degree of efficiency .

In addition, Avenue H offers employees choice and value, allowing them the opportunity to really take ownership of their health care needs . Every person and family has their own priorities, and now employees can select their own plan based on those priorities . Avenue H has a total of 75 quality medical health plans provided by local, private health insurance companies . All medical plans offered on Avenue H meet the requirements of essential health benefits required under the ACA .

FY2015: Year In Review

Participation exceeded more than 14,000 covered members in FY2015 .

At the end of FY2010, the “beta testing” phase, Avenue H had 11 small business groups offering health benefits and health savings accounts (HSAs) to their

employees . By the end of FY2011, after its first full year of operation, Avenue H had grown to encompass 157 small business groups . Reporting FY2015 results, 14,047 members have coverage, comprised of 669 small businesses offering health benefits to 5,410 enrolled employees .

This past year, in October 2014, Avenue H hired Cicero Group to conduct a survey and focus group with brokers and small business employers located throughout the state . The results have been instrumental . Avenue H has capitalized on many of their findings and applied them to the goals and marketing strategy throughout the year . Some of these key findings include: • 80% of small business owners call a broker when selecting new coverage • 76% of employers view offering health insurance as important • 75% of employees agree that they would have a better understanding of their health insurance plan if they choose it • 74% of employers choose to enroll in Avenue H as a way to provide employee choice of health insurance plans

Feedback from the market research indicated that Avenue H needed to do more than a 30 second TV spot or billboard to educate and engage with their audiences . Some of these outcomes are demonstrated below .

Brokers . Over the past year Avenue H has trained more than 800 brokers, held broker round tables and kept them informed on the ACA and other influential current events .

Testimonial Marketing Campaign . Avenue H implemented a testimonial marketing campaign that included television and radio advertising and digital ads - driving viewers to the website to learn more about Avenue H and ultimately increase enrollment numbers .

Website Update . In April 2015, Avenue H launched a new website with an updated look and feel . It highlights individuals from the testimonial campaign, providing actual client experiences; in addition, the content was updated to be more clear and concise . The launch of the new website increased traffic to the site, especially with new visitors making up more than half of the website views .

Business Development . In August 2014, Avenue H added a business development resource to the team to educate and build relationships with brokers and small business owners in Utah . In addition to meeting with groups and employers to help them through the administration process, this resource has also built relationships throughout the community with chambers, business resource centers and small business development centers, improving the awareness and growth of Avenue H .

Technology Enhancements . This past year, Avenue H continued their focus on improvements to the consumer experience . For example, a plan comparison tool was developed giving employees the option to review and compare plans

being offered, making a more informed choice . Also, a credit card option was added, providing an additional payment choice for employers . And an automated renewal process was introduced which minimizes administrative work for Avenue H staff and employers .

Nationally . SHOP marketplaces have provided insurance to over 10,700 small businesses across the nation, as of May 2015 . Marketplaces have allowed small businesses the opportunity to offer affordable health insurance to their employees . Of the states that provide health insurance marketplaces, Avenue H has remained at the forefront of the number of covered lives through their health insurance marketplace .

Work in Progress

Effective January 1, 2016, Avenue H is on schedule to expand to mid-size groups of 50–100 employees, with the possibility of expanding to all large groups in 2017 . This expansion will allow more employers to take advantage of the Avenue H competitive marketplace . Avenue H also continues to support Medicaid expansion alternatives and private insurance options in Utah .

The Right Approach for the Future

Public and private health exchanges have the potential to reshape the employer sponsored health insurance market . Surveys have shown that approximately 33 percent of employers will move their group through the marketplace over the next 3-5 years . Employers want streamlined administration, lower costs, expanded choice and innovation . This supports the belief that marketplaces will be the best economic and value-added solution for employers .

For additional information about the Office of Consumer Health Services – Avenue H visit business.utah.gov or contact Patty Conner, at pconner@utah.gov or 801-201-0422