Many of the regulations for implementing the Affordable Care Act are highly technical, and don’t relate directly to the employer-provided side of the health insurance market. However, the feds have recently released rules that employers can use.
Keep your old plan: Final ACA rules released in March gave states the flexibility to allow individuals to renew policies that don’t comply with all of the law’s requirements through the 2016 policy year. Tucked into the final rules was a provision granting the same two-year postponement to employers in the small group market.
Employers in the small group market (generally, those with up to 100 employees) may, if state insurance departments and insurers allow, continue to renew non-ACA-compliant group plans through Oct. 1, 2016.
It’s not a blanket reprieve. Group plans still can’t impose a pre-existing exclusion period on adults. Likewise, plans can’t discriminate against participants based on their health status.
Deductibles for small employers: The ACA originally limited deductibles for small employer plans to $2,000 for employees with self-only coverage and $4,000 for employees with family coverage. A new law, the Protecting Access to Medicare Act eliminates those limits, effective retroactive to March 23, 2010.
2015 reinsurance rate set: Through 2016, insured and self-insured group plans that provide major medical coverage (including COBRA plans, retiree plans and grandfathered plans) must pay annual reinsurance fees. The fees are intended to spread risk, stabilize premiums and ensure stability in the group market.
For 2015, the Department of Health and Human Services has announced that the annual fee is $44 per covered life, or $3.67 a month. The 2014 fee is $63.
For ERISA-covered plans, the fees are permissible plan expenses. For all plans, the fees are tax-deductible as ordinary and necessary business expenses.
Advice: As you plan next year’s health benefits, discuss all these provisions with your insurance advisor, broker or carrier.