Avenue H is Utah's small business health insurance solution. It began operating in 2010 with the goal of helping the state's small businesses — those companies with 1-50 employees — offer affordable health insurance benefits. Avenue H helps small businesses control costs while offering expanded health coverage options to their employees. Participating businesses are able to harness the power of defined contribution plans, which offer multiple advantages for both the employer and their employees.
Enrolling on Avenue H takes place entirely on AvenueH.com through our innovative enrollment tool. New for groups joining with 2014 effective dates, employers are able to use a credentialed broker or enroll their group themselves. If you are not currently using a broker and wish to explore that option, then please use our Agent Search tool to find an authorized agent in your area.
Look for a broker who is displaying Avenue H's official Authorized Broker logo. These logos are only given to those who have completed training on Avenue H and are the only brokers who can enroll businesses on Avenue H. Broker compensation is pre-loaded into the coverage rates by the carriers, so it cost employers nothing to work with an authorized broker.
- online tool to see the medical and dental rates and plans available to employees 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. Get a quote — Talk to your broker or use our
- Download Wage & Tax form — Download an encrypted copy of your most recent Wage & Tax form from the Utah Department of Workforce Services. Please refer to the Obtaining a Wage & Tax Form document for further instructions. If you have not filed a Wage & Tax form, please refer to this list of other documentation options.
- Create a Avenue H account — Beginning November 7, 2013 you can create an account for your business on Avenue H. 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. Beginning November 7, 2013 you or your broker can login to your Avenue H account and begin 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, you pay a single combined invoice. Behind the scenes, our financial partner routes the correct portion of your payment to each carrier. You only have to worry about paying one bill, rather than several.
- Login to the Enrollment System using your administrator access or as an employee.
- 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.
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 you have a POP in place already, you're covered. If not, here are a couple of options you can consider:
You can find out more about the many other POP options that are available by contacting your broker.
Avenue H Participating Medical, Dental and HSA Providers for 2014
The following providers offer coverage to employees participating on Avenue H. Since 2010, Avenue H has included health insurance and health savings accounts (HSAs). New for 2014, employers are able to offer dental insurance to their employees. To learn more about each carrier, click on the provider's name below.
Small Employer Premium Tax Credit
Available only on Avenue H, small employers who offer insurance can qualify for a tax credit of up to 50% of the premiums they paid toward their employees' health care. To qualify, a company must meet the following criteria:
- Must have fewer than 25 full-time equivalent employees
- Must pay an average wage of less than $50,000 (excluding owner's wages)
- Must contribute at least half of the premium of an employee-only plan for each employee
More information about the credit is available on the IRS website. They also have a calculator you can use to determine how much you could qualify for if you meet the above criteria. You can explore the calculator on the IRS's Taxpayer Advocate site.
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.
Employer Registration Requirements
Beginning in November 2013, employer registration will be completed via the application portal. The following information will be required during the registration process:
- Information about your company
- Your current health insurance plan information (if applicable)
- Your new hire waiting period
- Your latest Quarterly Wage and Tax Form (an encrypted copy downloaded from DWS, click here for instructions)
If an employer does not have a Quarterly Wage and Tax form, they can supply either a copy of their business license and a copy of their payroll, OR a copy of their Articles of Organization or Incorporation and a copy of their payroll. However, the process of reviewing and approving the company may take additional time.
Avenue H is currently open for business.
In 2014, open enrollment will be available from the 1st through the 15th of every month, and coverage will begin on the 1st of the following month.
Employers can register as late as the 10th of the month, and open enrollment closes on the 15th. We recommend that employers complete their registration prior to the 1st of the month so their employees can have a two-week open enrollment time frame.
The Benefits of Defined Contribution
Defined contribution health benefit plans are employer group health plans individually selected by an employee. In a defined contribution arrangement, rather than providing a certain level of health benefit, the employer provides a predetermined level of funding that the employee uses to purchase their choice of health insurance. Employers are able to choose a flat-dollar amount that fits their budget, rather than a percentage of each employee's coverage costs. Each employee chooses their own insurance plan, but they are combined as a group; essentially, it's group insurance but with individual choice. There are numerous benefits to defined contribution:
- Simplified Benefit Management — Defined contribution plans greatly simplify the planning and management of a company's health benefit options. By enrolling in a defined contribution plan on Avenue H, the only decision an employer has to make is how much to contribute toward each employee's health benefit. Employers will no longer be responsible to choose between multiple plans, insurance companies and provider networks.
- Predictable Costs — By electing to make a defined contribution rather than choosing a company-wide health plan, employers can predict and contain health benefit costs.
- Expanded Benefit Offerings — Enrolling in a defined contribution plan on Avenue H also allows employers to offer greatly expanded health plan options to their employees. Employees will use Avenue H to compare plans, providers and select the option best tailored to their individual needs — no more one-size-fits-all benefit packages. Offering a tailored health benefit will help businesses attract and retain high-quality employees in a competitive marketplace. It allows employers to offer large employer benefit options regardless of their size.
- Preserve Tax Benefits — A defined contribution plan also allows employers to continue offering the tax benefits of an employer-sponsored plan. Employees can pay their portion of their health premium with pre-tax dollars, which reduces the employee's taxable income and also reduces the employer's FICA obligations.
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
Quality & Transparency
One of the initiatives of Utah's Health System reform efforts is to provide consumers and businesses with greater quality and transparency information regarding their health choices. Here you will find information that will help you to make better and more informed choices. Quality & Transparency »