CSEBA Marketplace

An “Exchange” Built for Schools

On July 1, 2013, The CSEBA Marketplace was launched to allow public school and community college districts with defined contribution plans the ability to offer their employees freedom of choice in selecting quality, affordable healthcare from a source that is known, trusted and built for and by schools. As a district, you will benefit by working with a non-profit organization, jointly managed by Labor and Management. Your employees will benefit by the consumer friendly approach and simplicity of The CSEBA Marketplace. The CSEBA Marketplace is designed to help employees actually “shop” for health insurance coverage online. Their experience will be similar to the way they may currently shop on various web based on line sites. All medical plans will be offered online in a tiered format enabling individual employees to compare plans and options before they “click.” There are four HMO choices and three PPO choices named after various metals, Bronze, Silver, Gold and Platinum. Each provides options related to their coverage in one simple shopping experience.

Bronze

Bronze plans offer the lowest monthly premium, but the employee cost share will be more when health care services are rendered.

Silver

Silver plans offer a low monthly premium with a slightly higher employee cost share when health care services are rendered.

Gold

Gold plans with a higher monthly premium offer comprehensive coverage with the employee cost share being slightly less when health care services are rendered.

Platinum

Platinum plans offer the most comprehensive coverage with the highest monthly premium. The employee cost share is the lowest when health care services are rendered. Currently not available in PPO plans.

Frequently Asked Questions (FAQ)

What are the guidelines to participate in the Marketplace?
The CSEBA Marketplace, also referred to as the Marketplace, is a product designed for qualified public school and community college districts where they can go to buy qualified health plans as described in the Affordable Care Act (ACA).  The Marketplace creates an organized easy to compare choice of plans and costs that can be accessed online.

What are the guidelines to participate in the Marketplace?

In order to participate in the Marketplace, a district must join the CSEBA JPA and abide by the Marketplace Underwriting Guidelines. Either one hundred percent (100%) of the eligible District employees; OR each individual bargaining group must enroll in the medical plans offered by the Marketplace.

What is the coverage term or policy year?

The policy year for the Marketplace is set forth from July 1 to June 30. Alternative renewal cycles/policy years will be allowed for January 1 and October 1 however the published rates will be adjusted accordingly to reflect the varying policy years.

How often can changes be made?

Once a district becomes a member of the Marketplace, they must remain with their initial selection of benefits for at least twelve (12) consecutive months. The district can change benefit plan design upon the next renewal, however, they must remain in the Marketplace for a minimum two year plan.

Does the Marketplace replace traditional health insurance coverage?

The Marketplace is simply a new way and place to shop for affordable health insurance giving the employees flexibility to choose the plan that most meets their needs.  A district can choose either the traditional program or the Marketplace.

Are there employer contribution requirements?

Yes, the district must have a defined contribution strategy.

Can super composite rates be offered in the Marketplace?

No, three tiered rates must be offered.

Is there a wellness component included in the Marketplace?

A robust incentive based wellness program is included in the Marketplace.  Focused employee engagement through goal setting, competition, phone app, and online tools.  Healthy decisions are rewarded with tangible incentives that help drive health behavior.

How will my district be rated?

Districts joining the Marketplace will be offered published rates, by region, adjusted by a Risk Adjustment Factor.  As an example, Marketplace rates for some Southern California regions can fall within a range between $350 and $560 for HMO single.

Contact CSEBA Benefits Team for more information