Avenue H is Utah's small business health insurance solution. We help small businesses with 1-50 employees control costs while offering expanded coverage to those employees. Our approach to developing this portal is unique in that it builds on existing technology instead of starting from scratch. This allows the state to incorporate and build on private solutions. Utah's approach is also designed to support the existing roles of entities in the health system, including insurers, brokers, and health care providers.
Producer Registration Process
Producers are an integral part of the insurance market. Producers help find the best plan that best suits the needs of their clients. Avenue H utilizes producers to help educate the business community and their employees about the benefits of the defined contribution marketplace.
In order to register with Avenue H, producers will need to do the following:
Utah Code Annotated 31A-30-209 was modified during the 2011 General Legislative Session by HB128, Health Reform Amendments. The changes to Utah code clarify the requirements that insurers and their brokers must observe to sell products through Avenue H.
- Broker is required to have an individual producer license which indicates they can sell health insurance in the state of Utah.
This is completed through the Utah Insurance Department. For additional information, please see www.insurance.utah.gov.
- Broker must have a direct individual appointment with all carriers that offer a defined contribution arrangement on Avenue H.
Currently this includes appointments with Arches, SelectHealth and UnitedHealthcare.
- Broker must have a direct individual appointment with all carriers that offer dental on Avenue H. Currently, this includes Alpha Dental, Delta Dental, Dental Select, EMI, Guardian, Premier Access and SelectHealth Dental.
- Broker must complete defined contribution market training that includes training on premium assistance.
Classes are offered by OCHS as approved by Utah Department of Insurance. Courses are free of charge, and producers are able to earn 3 hours of CE credit for attending the courses. See upcoming training sessions here.
Information about who to contact regarding individual appointments can be downloaded by clicking this link.
Once a broker has met all of the legislative requirements, they will display on the Utah Department of Insurance's Agent Search - Authorized Version that is available to small employers looking for a broker on the Avenue H website. If you, as a broker, are not displaying, please verify that you are appointed with all carriers that are participating on Avenue H by visiting Agent Search - All Agents. If you need additional information about broker qualifications, contact the Utah Insurance Department.
Once credentialed, brokers will receive their login ID and password from the Avenue H administrator. They will also appear in the Select Broker dropdown menu during employer registration. Brokers login to the Avenue H enrollment portal using their login ID and password. We suggest that brokers bookmark the portal's web address in their browser. If you have questions, please call the Avenue H Customer Solutions line, and choose 4 for Agents, then 1 for assistance.
- DOWNLOADGet a quote — Use our online tool to get medical and dental rates and plans available for your group on Avenue H. You'll just need some basic demographic information (date of birth, family members to be covered, tobacco use) and a few minutes to input it.
- Download Wage & Tax form — Direct your client to download an encrypted copy of their most recent Wage & Tax form from the Utah Department of Workforce Services. You can send them the Obtaining a Wage & Tax Form document for further instructions. If they have not filed a Wage & Tax form, please refer to this list of other documentation options.
- Create a Avenue H account — Create an account for your client's business on Avenue H using the company contact's e-mail address. Once the account has been established, you can login as an administrator of the group to begin the registration process, using your secure login ID and password.
- Register your company — Registering on Avenue H takes place entirely online. All it takes is logging into your client's Avenue H account and beginning the application process.
- Open enrollment begins — The enrollment window will open for employees once the registration process is successfully completed and you click the COMMIT button. Open enrollment will close on the 15th of the month prior to the month of coverage.
- Invoicing — On Avenue H, your client pays a single combined invoice. Behind the scenes, our financial partner routes the correct portion of their payment to each carrier. The employer only has to worry about paying one bill, rather than several.
- Login to the Enrollment System using your administrator access.
- Renewing groups, along with their agent of record, will receive an email notification from Avenue H approximately 45 days prior to their renewal date. Detailed instructions will be included in the notification.
Small employer group participation with Avenue H is determined by specific criteria. This includes:
- Employer group must have from 1 to 50 eligible employees.
- At least 50% of the group's enrolling employees must reside in the state of Utah.
- Employer group must also meet a 75% participation requirement. A final check is performed after open enrollment closes for the employees.
Specific employer conditions may arise that require review. Some that we have seen and addressed include the following: Groups with multiple owners with equal interest in the company may join Avenue H; Couples that both earn their wages from a single small business with no other employees can get coverage as a single employee plus a dependent; If members of a single immediate family are employed by a company, they each have the choice to be covered by the family or apply on their own. Unfortunately, sole proprietors are not currently served by Avenue H. Sole proprietors should explore their options in either the traditional market or on Healthcare.gov.
For companies with large numbers of out-of-state employees, those employees could explore their options in the traditional market or the marketplace of the state in which they live.
Employers must have a premium only plan (POP) set up to participate on Avenue H. POPs enable employers to take funds from employee paychecks for benefits on a pre-tax basis. If your client has a POP in place already, they're covered. If not, here are a couple of options they can consider:
2014 renewals are currently underway. Producers that have groups with upcoming renewal dates will recieve an email notification from Avenue H approximately 45 days prior to the group's anniversary date. The notification will include renewal instructions. If producers have any questions related to the renewal process, please contact the Avenue H call center at 855-850-2834 (AVEH).
Employees who choose domestic partner coverage must sign an affadavit as required by our partner carriers, and will be required to supply supporting documentation.
- Affidavit of Domestic Partnership — PDF Version
- Beginning in 2014, each carrier will pay broker commissions through their normal protocols.
- Producers can register for upcoming Avenue H courses by visiting our training site.
- The Avenue H Call Center is open Monday through Friday from 8:00 AM until 6:00 PM. Our telephone number is 855-850-2834 (AVEH).
- Upon completing an Avenue H training course, brokers will automatically receive our Producer / Agent Communication Newsletters to keep them "in the know." As reference, here is the latest copy of our newsletter.
- An Open Forum project call is held on the second Wednesday of each month. The conference call is available to the public and brokers are welcome to join. As reference, here is the latest copy of minutes from our last Open Forum Meeting.
- Our Transitional Relief Webinar referenced ways to gather information to use when quoting renewal groups on Avenue H. You can download instructions here: