Amid the confusion and issues affecting sign-ups for the Affordable Care Act, Utah is still going strong with Avenue H, its health insurance marketplace for small businesses.

As one of the leading states in number of small businesses, according to Patty Conner, director for the Office of Consumer Health Services, the state implemented its own program four years ago. With the recent federal requirement to have insurance by January 2014 or pay a penalty, the number of Avenue H enrollees has soared.