1. Exchanges – Attracting Small Businesses Presentation by Terry Gardiner Small Business Majority Alliance for Health Reform October 22, 2010

2. Small Business Landscape 5.9 million employers with fewer than 100 employees nationally employ 43 M o 80% (4.8 M) have fewer than 10 employees o 54% (2.6 M) of employers with fewer than 10 employees do not offer health coverage Most small businesses are very small and lack sophisticated HR departments o Average employer in Connecticut exchange has 8 employees

3. Employer Health Coverage Choices Purchase health coverage through the exchange Purchase health coverage in the outside market Maintain a grandfathered health plan Do not offer health coverage Will the exchange offer value – lower price; better coverage; better services?

4. Effective Outreach & Education Only half of employers belong to a business group o IRS postcard succeeded in making small business aware of the tax credit Trusted voices of peers – historical sources: o brokers, business groups, business media Navigators in ACA can work for business o Massachusetts Fishing Partnership Health Plan lowered uninsured rates from 43% to 13% Focus groups & other direct contact in process to ensure needs of small employers are met

5. Single Point of Entry for Employers All necessary information for employer and employees to make decisions on coverage One application One premium payment & detailed accounting One source for enrollment changes Qualification and calculation of the small business tax credit; state programs Coverage of out of state employees Coordinating coverage of Medicare-eligible employees provide additional HR services such as Cobra administration, Section 125 service, HSA/FSA/HRA

6. Role of Insurance Brokers Recognize different role of brokers (agents) for individual and small group markets Brokers will have ongoing role with small business selling other products Initial launch and reception has proven critical for both employers and brokers Studied balance of broker compensation and services Model – Washington Health Insurance Partnership o http://www.hip.hca.wa.gov / http://www.hip.hca.wa.gov /

7. Other Measures to Attract Business Defined benefits option – Utah & Montana Contributions by multiple employers – Utah free choice voucher Support of larger businesses

8. Health Reform Info for Small Businesses Frequently asked questions: o http://smallbusinessmajority.org/hc-reform-faq/index.php http://smallbusinessmajority.org/hc-reform-faq/index.php Small business healthcare reform summary: o http://smallbusinessmajority.org/_docs/resources/SBM_whats_in_it_for_small_biz.pdf http://smallbusinessmajority.org/_docs/resources/SBM_whats_in_it_for_small_biz.pdf For more information: o (866) 597-7431 or Info@smallbusinessmajority.orgInfo@smallbusinessmajority.org