Hundreds of small businesses, non-profits, and municipalities are using this new self-funded plan for small employers
The health insurance industry has undergone many regulatory changes in the past several years, some of which have forced companies to have to change their health plans and pay substantially higher premiums. To help companies struggling with such changes, the Southern Ohio Chamber Alliance (SOCA) has created a new health insurance program called the SOCA Benefit Plan (SOCA BP). The SOCA BP is a self-funded multiple employer welfare arrangement (MEWA) designed specifically for Chamber of Commerce members. The SOCA BP presents an innovative alternative to the Affordable Care Act (ACA).
The Southern Ohio Chamber Alliance has chosen Anthem Blue Cross and Blue Shield’s top (“Champion” and “Elite”) brokers to bring this new health plan to market. Our member companies can expect the highest quality of service and dedication while receiving valuable advice on a wide variety of comprehensive insurance products designed to meet the needs of Chamber of Commerce members.
Frequently asked questions and answers are listed below. Please call us at (866) 486-9482 for more information.
Is the SOCA BP permitted by the ACA?
Yes. The SOCA BP is a self-funded option allowed under the ACA.
How is the SOCA BP different from the ACA?
Unlike the current ACA structure, the SOCA BP:
- is a self-funded plan
- offers a variety of plan designs that meet the minimum essential coverage requirements, including: four PPO and three HSA options, utilizing the Anthem Blue Access PPO Network and National Rx Formulary
- is an alternative to comparable options under the ACA
- will allow changes in benefits and contribution rates at renewal, without being “locked in” by the grandfathered status
As today’s small businesses continue to search for cost-saving health coverage options, Chambers of Commerce throughout Ohio have banded together to offer a new self-funded medical plan for small employers. The Northern Ohio Area Chambers of Commerce (NOACC), Central Ohio Chambers of Commerce, Southern Ohio Chamber Alliance (SOCA), Dayton Area Chamber, and the Youngstown Warren Regional Chamber have collaborated to create a new health program that can lead to more rate stability and is a smart solution that offers potential savings for groups with 50 or fewer employees.
More than 270 Chambers of Commerce in the state of Ohio have teamed up with Anthem Blue Cross and Blue Shield to administer this plan and to provide stop loss coverage.
This new self-funded medical offering called the SOCA Benefit Plan is a multiple employer welfare arrangement (MEWA). MEWAs enable smaller employers to join together to share in the overall claims risk. By being part of a larger, self-funded pool, employers have financial protection backed by Anthem’s stop loss coverage.
In addition to financial protection, this innovative alternative offers:
- Competitive rates
- Fixed, predictable monthly payments
- A variety of plan designs, including four PPO and three HSA options
- Anthem’s broad Blue Access PPO Network and National Rx Formulary
- Coverage for claims run-out /terminal liability coverage
Please see the 4 page Brochure for more details.
What is the best insurance option for my company – SOCA BP or an ACA plan?
Anthem Champion and Elite brokers will help you understand all of your options and help you choose the best benefit option for your company’s unique needs.
Do I need to be a member of a SOCA Chamber of Commerce to participate in the SOCA BP?
Yes, you need to be a chamber member in good standing to participate in the SOCA BP.
Do I have to switch doctors?
The SOCA BP uses Anthem Blue Cross and Blue Shield’s health care provider network – one of the largest provider networks in the state. You should, however, always check to make sure doctors are in-network prior to any service using the “Find a Doctor” tool (to which you’ll find a link under the “Useful Tools” section at that right) on anthem.com (https://www.anthem.com/health-insurance/provider-directory/searchcriteria).
What is the monthly contribution rate for my company’s coverage under the SOCA BP?
Each group will have a monthly contribution based on a variety of factors including but not limited to your members’:
- Medical History
Why should I consider the SOCA BP now?
Due to the constant evolution of the ACA and the uncertainty of future premiums, many groups will be able to experience a competitive rate that may not be available through Ohio’s ACA Marketplace. Anthem Champion and Elite brokers will provide you an easy-to-Understand comparison between the ACA plans and the SOCA BP.
If I leave my current plan (including an ACA plan), will I be subject to pre-existing condition limitations?
No. There are no pre-existing condition limitations.
Can my company withdraw from the SOCA BP at any time?
Members may elect to withdraw from participation in the plan at the end of a calendar month by giving written notice to the plan at least thirty (30) days prior to the end of that month.
Does the SOCA BP provide the employer with a Summary Plan Description (SPD)?
Yes. We provide each employer with an SPD for the SOCA BP that meets ERISA compliance regulations. (All employers are responsible for providing SPDs for all of their health and welfare benefits.)
What is the SOCA BP’s legal structure?
The SOCA BP is technically known as a multiple employer welfare arrangement (MEWA). A MEWA provides health and welfare benefits to employees of two or more employers who pool their contributions, enabling them to offer contribution rates and benefits that are typically available only to larger groups
What government entities oversee the financial operation of the SOCA BP?
The Ohio Department of Insurance and several federal government agencies coordinate the oversight and regulation of the SOCA BP.The multi-jurisdiction gives the State of Ohio’s Department of Insurance primary responsibility for overseeing the financial soundness of the SOCA BP, while the U.S. Department of Labor provides oversight for employee benefit plans, and the Internal Revenue Service ensure the nonprofit status of the SOCA BP.