The Issue
Under the Affordable Care Act’s Small Business Health Options Program (SHOP), states will create health insurance exchanges to allow small-business owners to pool their insurance buying power. The exchanges will provide these firms with more choice of health plans and help make costs more affordable. However, creating an exchange that appeals to small-business owners will be a challenge: if the exchanges cannot make small-business owners’ lives easier, these entrepreneurs will turn to the outside insurance market. This Commonwealth Fund–supported article in Health Affairs recommends ways the exchanges can reach out to small-business owners to meet their needs.
What the Study Found
Small-business owners need to know that the exchange exists and understand how it works; in this regard, insurance brokers and exchange "navigators" can be important allies. Brokers help small-business owners obtain and manage health insurance products, and they can assist with evaluating health plan options, providing employee benefit education, handling enrollment changes, and administering wellness programs. Meanwhile, navigators will provide small employers (as well as individuals) with the information necessary to make informed health insurance choices.
States can also learn from the experiences of those states that already have launched exchanges. Among the important features of established exchanges are: a single point of entry for employers; the availability of comparative plan information; a single application; a call center or easy-to-use Web site; and a single premium payment for each employer. Exchanges can add further value by helping employers with wellness programs, COBRA coverage, and flexible spending accounts.
Conclusions
Small-business owners will either take advantage of the SHOP exchanges or turn to the outside insurance market. It is critical for the exchanges to get the basics right at launch by offering a strong choice of plans, providing high-value services, and providing excellent customer service.