STAGE DEV MAY, 2013

Covered California SHOP

Covered California SHOP

A New Way to Provide Health Coverage for Your Employees

Choosing the right health plan coverage is important to the success of your business. It helps attract and retain valuable employees by giving them the peace-of-mind they need to be more productive and your business more competitive. The Affordable Care Act contains provisions that encourage more employers to offer health insurance to employees by making it more affordable and easier to purchase.

Covered California opened a Small Business Health Options Program (SHOP) specifically for small businesses with 1-50 eligible employees. This marketplace allows employers to compare a number of qualified health insurance plans from private insurance companies like CCHP and offer different plans to employees. Businesses with fewer than 25 full-time equivalent employees who are paid an average annual salary of less than $50,000 can qualify for tax credit of up to 50%. Consult your broker or benefits consultant for details.

CCHP is in Covered California SHOP

In recognition of the importance of the Bay Area community, Covered California has selected CCHP as one of only six in the state to offer health plan options in the SHOP marketplace. Employers and employees now have access to quality, affordable coverage from a local provider through Covered California.

What You Will Find in SHOP

Covered California's SHOP will help business owners provide affordable insurance to their employees and make administration easy.

Easy Comparisons. Covered California lets employers easily compare and contrast a variety of health plans. 
Predictable Costs. Regardless of which plans employees choose, a business owner's premium contribution will remain constant, allowing employers the ability to predict and manage their health insurance budget.
Simple Administration. SHOP makes it easy for employers pay for insurance, even when employees choose different health plans. 
Employer Control. The employer decides whether and when to participate in Covered California. The employer chooses the level of coverage, the amount of contribution and any amount of dependent premiums, if any. Once these decisions are made, employees can then choose the plan that best meets their needs, budget and lifestyle. 

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2017 Benefit Highlights

 

Finding the Right Plan

All 2017 CCHP plans in Covered California SHOP meet the new health care law’s requirements which includes the Essential Health Benefits that are designed to help everyone stay healthy and well. See the complete list: Essential Health Benefit List

There are several CCHP plan options available through Covered California:

CCHP Platinum90 HMO
Summary of Benefits
Evidence of Coverage
Health Plan Benefits and Coverage Matrix

(By clicking on this link, you will leave CCHP's website.)
 
(By clicking on this link, you will leave CCHP's website.)

 

CCHP Gold80 HMO
Summary of Benefits
Evidence of Coverage
Health Plan Benefits and Coverage Matrix

(By clicking on this link, you will leave CCHP's website.)
 
(By clicking on this link, you will leave CCHP's website.)

 

CCHP Silver70 HMO
Summary of Benefits
Evidence of Coverage
Health Plan Benefits and Coverage Matrix

(By clicking on this link, you will leave CCHP's website.)
 
(By clicking on this link, you will leave CCHP's website.)

 

CCHP Bronze60 HMO
Summary of Benefits
Evidence of Coverage
Health Plan Benefits and Coverage Matrix

(By clicking on this link, you will leave CCHP's website.)
 
(By clicking on this link, you will leave CCHP's website.)

 

** (Note: Please note that this is an estimate only. Actual cost depends on the status of your deductible balance, if any, and any applicable limitations or exceptions.)

You can find the details of these plans from our Summary of Benefits and Coverage pages or you can review the complete 2017 Evidence of Coverage.

 

Find a Physician

We think it is important for you choose a caring physician who is conveniently located near you. You can see CCHP’s provider list at  www.cchphealthplan.com/doctor-locations.

Check the Formulary

To see if a prescription medication you need is covered, check with our CCHP Exchange Complete Formulary. * (No changes made since 06/2017).

Formulary Changes for 2017 (English)

* There are four tiers in the drug formulary. Tiers include the types of drugs that are covered. Please refer to your Evidence of Coverage and Disclosure Form for details.

Tier Definition
1 1) Most generic drugs and low cost preferred brands.
2 1) Non-preferred generic drugs or;
2) Preferred brand name drugs or;
3) Recommended by the plan's pharmaceutical and therapeutics (P&T) committee based on drug safety, efficacy and cost.
3
 
1) Non-preferred brand name drugs or;
2) Recommended by P&T committee based on drug safety, efficacy and cost or;
3) Generally have a preferred and often less costly therapeutic alternative at a lower tier.
4

 

1) Food and Drug Administration (FDA) or drug manufacturer limits distribution to specialty pharmacies or;
2) Self administration requires training, clinical monitoring or;
3) Drug was manufactured using biotechnology or;
4) Plan cost (net of rebates) is >$600.

Pharmacy Directory

Pharmacy Directory (English)

CCHP Pharmaceutical Management Procedures (English)

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2016 Benefit Highlights

 

Finding the Right Plan

All 2016 CCHP plans in Covered California SHOP meet the new health care law’s requirements which includes the Essential Health Benefits that are designed to help everyone stay healthy and well. See the complete list: Essential Health Benefit List

There are several CCHP plan options available through Covered California:

CCHP Platinum90 HMO
Summary of Benefits
Evidence of Coverage
Health Plan Benefits and Coverage Matrix

CCHP Gold80 HMO
Summary of Benefits
Evidence of Coverage
Health Plan Benefits and Coverage Matrix

CCHP Silver70 HMO
Summary of Benefits
Evidence of Coverage
Health Plan Benefits and Coverage Matrix

CCHP Bronze60 HMO
Summary of Benefits
Evidence of Coverage
Health Plan Benefits and Coverage Matrix

You can find the details of these plans from our Summary of Benefits and Coverage pages or you can review the complete 2016 Evidence of Coverage.

 

Find a Physician

We think it is important for you choose a caring physician who is conveniently located near you. You can see CCHP’s provider list at  www.cchphealthplan.com/doctor-locations.

 

Check the Formulary

To see if a prescription medication you need is covered, check with our CCHP Exchange Complete Formulary. * (No changes made since 12/2016).

Formulary Changes for 2016 (English)

* There are four tiers in the drug formulary. Tiers include the types of drugs that are covered. Please refer to your Evidence of Coverage and Disclosure Form for details.

Tier Definition
1 1) Most generic drugs and low cost preferred brands.
2 1) Non-preferred generic drugs or;
2) Preferred brand name drugs or;
3) Recommended by the plan's pharmaceutical and therapeutics (P&T) committee based on drug safety, efficacy and cost.
3
 
1) Non-preferred brand name drugs or;
2) Recommended by P&T committee based on drug safety, efficacy and cost or;
3) Generally have a preferred and often less costly therapeutic alternative at a lower tier.
4

 

1) Food and Drug Administration (FDA) or drug manufacturer limits distribution to specialty pharmacies or;
2) Self administration requires training, clinical monitoring or;
3) Drug was manufactured using biotechnology or;
4) Plan cost (net of rebates) is >$600.

Pharmacy Directory

Pharmacy Directory (English)

CCHP Pharmaceutical Management Procedures (English)

How to Get Started:

Contact your Broker or Agent. CCHP is also ready to answer questions or help you with understanding your plan options. Call or visit CCHP’s Sales Department. 

To call CCHP: 1-415-955-8800 ext. 3318

You can also visit Covered California's website SHOP page to learn more. You will find information about Small Business Tax Credit, Compare Plan Options and Request Rates: Small Business Pages

(By clicking on this link, you will leave CCHP's website.)

 
 
STAGE DEV MAY, 2013