1. What is Avenue H?
Avenue H is an internet-based information portal. It connects consumers to vital information they need to make an informed choice and allows them to execute that choice electronically.
One of the cornerstones of Utah's approach to health system reform is to move our health care system toward a consumer-based system where individuals have greater control over their health, health care and health care financing. A major step in that direction is the development of a workable defined contribution system. Avenue H is a critical component in moving toward a consumer-based system. For example, in order for a defined contribution system to function efficiently, consumers need a single shopping point where they can evaluate their options and execute an informed purchasing decision. For a consumer-based market to succeed, brokers, employers, and individuals must have access to reliable information to allow consumers to make side-by-side comparisons of their options.
Utah's approach to health system reform relies on the fundamental principles of personal responsibility, private markets, and competition. To promote competition in the health care system, consumers need three things: accurate and relevant information, real choice, and the opportunity to benefit from making good choices. The insurance marketplace model enhances private competition in the health care system by providing all three elements of increased competition. In addition to benefiting the consumer, the insurance marketplace model also offers relief to employers who will no longer need to bear the full burden of running a health plan for their employees.
2. How does Avenue H expand choice for employees?
Avenue H puts employees — not employers — in control of health plan decisions. Employers contribute a flat dollar amount to their employees that they can use for health care. Our program gives employees several options regarding their health insurance, dental insurance and health savings accounts (HSAs). Employees use the contributed funds to shop on Avenue H to find coverage that best suits their own needs, preferences, and budget. Avenue H lets them compare plans from multiple providers, calculate their premium contribution, and apply for coverage online.
3. Do defined contribution plans available through Avenue H preserve the tax benefits of traditional employer-sponsored plans?
Yes. Health insurance plans available on Avenue H preserve the tax benefits of traditional employer-sponsored plans. Premium contributions are made with pre-tax dollars, reducing the employee's tax liability. Certain plans available on Avenue H may also allow pre-tax contributions to an HSA that the employee owns.
4. What is the overall goal of Avenue H?
The overall goal of Avenue H is to serve as the technology backbone that enables the implementation of a competitive consumer-based marketplace where employees of the state's small businesses can shop for healthcare coverage.
To accomplish this goal, Avenue H has three core functions:
- To provide consumers with helpful information about their health care and health care financing.
- To provide a mechanism for consumers to compare and choose a health insurance policy that meets their families' needs.
- To provide a standardized electronic application and enrollment system.
5. Aren't these services already available in the private sector?
While it could be argued that the services that a consumer needs already exist in the present system, Avenue H provides several key elements missing in the current system:
- A defined contribution arrangement that gives employers more control over their costs.
- The ability for employees to see multiple health, dental, and health savings account options at a glance and compare them in an online shopping format.
- The ability for employees to choose the health, dental, and HSA that work best for them and execute that choice online.
- The Small Business Health Care Tax Credit, which is only available through SHOP marketplaces.
6. Are there any additional fees charged to consumers?
An administration fee is included in each employee's monthly premium. The fee is the same on and off Avenue H. Commissions are also included in the premiums displayed on Avenue H. Commissions are paid directly by each carrier.