Q: Will Salesforce still offer benefits when the health insurance marketplace opens?
A: Yes. We will still be providing health care benefits when the marketplace opens on January 1, 2014.
A: The marketplace, or state exchange, is like a mall operator, setting up the infrastructure and ensuring good quality merchandise for customers. The law requires exchanges to take specific measures on behalf of Americans:
- Review and certify that the health plans they offer meet minimum standards (also called qualified health plans) and rate each plan based on quality and price.
- Maintain a website with tools that allow shoppers to compare costs and quality and purchase a plan, plus operate a toll-free hotline for questions.
- Help the health plans communicate with buyers in plain language, in a timely manner, on cost sharing, payments, claims policies/procedures, value, and participants’ rights.
Q: Who is eligible to buy insurance through the marketplace?
A: The health insurance marketplace is intended for people who can’t get affordable coverage through their work and also for employees of small businesses.
However, anyone can shop in the marketplace. Since you have access to affordable coverage through Salesforce, you are not eligible for a premium tax subsidy. And we’re fairly confident that you won’t find anything that beats our plan.
Q: Should I look for a plan on the marketplace? Would I find options that are better than my current benefits?
A: Since you’re benefits-eligible, you have access to affordable coverage through Salesforce. However, you might hear that you can get a better deal elsewhere through the health insurance marketplace. Since benefits-eligible employees are not eligible for a premium tax credit and our plans are equivalent to a Platinum plan available through the marketplace, we’re fairly confident that you won’t find anything that beats our plan. If you decide to explore the marketplace options, use this form [PDF].
Q: If I have family members who are not eligible for Salesforce’s benefits or for another company’s benefits, how do I help them get coverage?
Q: Which states have a marketplace and which don’t?
A: States have three options: set up an exchange, operate their exchange in partnership with the federal government, or let the government operate their exchange for them.
Sixteen states (including Washington, D.C.) will operate their own exchange: California, Colorado, Connecticut, District of Columbia, Hawaii, Idaho, Kentucky, Maryland, Massachusetts, Minnesota, Nevada, New Mexico, New York, Oregon, Vermont, and Washington.
Seven states are planning for a partnership exchange: Arkansas, Delaware, Illinois, Iowa, Michigan, New Hampshire, and West Virginia.
The remaining states will use the federal government marketplace: Alabama, Alaska, Arizona, Florida, Georgia, Indiana, Kansas, Louisiana, Maine, Mississippi, Missouri, Montana, Nebraska, New Jersey, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin, and Wyoming.
Q: How are state marketplaces financed?
A: States can charge user fees, taxes, or other means to finance their exchange. All state exchanges must be self-sustaining by 2015. Nearly all states plan to finance their marketplaces with a tax or surcharge on premiums that insurers will pass on to policyholders.
Q: What are subsidies for people who can’t afford insurance?
A: Affordable coverage has a very technical definition. Of course, what is affordable to one person may not be affordable to another, depending on income and priorities. People who don’t have access to affordable coverage through their job can apply for coverage through a state exchange to determine whether or not they are eligible for a premium tax credit to help pay the premiums. The credit is basically a cash advance to help cover part of the health insurance premium. The advance may have to be returned if a person becomes ineligible. The exact amount of the credit is determined by the state exchange. If you decide to explore your state’s marketplace options, use this form. If you are benefits-eligible, you have affordable coverage through Salesforce and, therefore, you are not eligible for a premium tax credit.
Q: What are the minimum requirements for plans offered through the exchanges?
A: State exchanges are required to certify that each health plan offered through the health insurance marketplace meets qualified health plan standards.
Q: Our insurer has plans available through the state exchange. Is it the same as ours, better or worse?
A: Health insurers work with companies like ours to offer a group plan to all employees of that company. Many also sell individual plans to individual families. We work hard to create health plan options that offer access to a strong network of health care providers, financial security, and other unique features. It would be impossible to review the thousands of different variations of health plans available in the new state exchanges to compare. Each health company has to follow the same consistent plan levels for any plan they offer. (See qualified health plans.)
Q: Are there specific dates when can people buy from exchanges?
A: Yes, from October 1, 2013, through March 31, 2014. People who select a plan by the 15th of the month will be covered starting the following month. However, there are special enrollment periods for people to buy through an exchange—for example, 60 days after the loss of coverage.
Q: What is the Cadillac tax?
A: It is a tax on high-cost health plans. Specifically, the law defines high-cost plans as those with total premiums of more than $10,200 for self-only coverage (or $27,500 family coverage) beginning in 2018. Those numbers include contributions that you and Salesforce make to flexible spending or health savings accounts (FSA or HSA). However, those total costs do not include stand-alone vision or dental benefits. Learn more here.