ACA Waivers Are Ending. Will Your Business Be Affected?

June 1, 2016
By

Category: Compliance, Benefits

When you get into the office on Monday morning and go over your priorities for the week, “spend time thinking about health insurance policies” is hardly ever at the top of the list. Let’s be honest, it probably isn’t on the list at all – and for the past several years, you’ve mostly been able to keep it that way. The government has allowed small businesses to keep renewing their old health insurance plans, even if those plans don’t comply with the Obamacare healthcare reform rules.

That’s going to change at the end of 2017 – and while you’ve still got more than a year and a half before all small business insurance plans will have to meet the new government standards, the time to start planning for it is now. It’s finally time to put healthcare on your to-do list for the week.

Here’s what’s happening. When the government passed the Affordable Care Act in 2010, it established minimum standards for health insurance in the United States. Essentially, if an insurer wants to be able to sell you a policy, it needs to provide essential coverage in a number of different areas – such as hospitalization and maternity services – in return for your monthly premiums.

This rule went into effect in 2014, and any new group insurance policies bought after that point were required to be compliant with the new rules. But the government also created a waiver –“transitional relief” in government parlance – to allow small businesses to renew their existing plans without having to switch to a new plan. That waiver has been extended several times, but regulators announced in February that the waiver will be ending on December 31, 2017.

The first step is to figure out whether this applies to your business.

If your business signed up for a new health insurance plan after January 1, 2014 (or in some cases, after October 1, 2013), you’re all set. Similarly, if you’re in one of 15 states plus Washington, D.C. that have already started enforcing the new rules, your health insurance plan has already been required to comply with the new standards.

At the other end of the spectrum, if your business has been around for a little while and you’ve been on the same health insurance plan since before the ACA was signed into law (March 23, 2010) you also don’t need to worry about the new deadline. Your old policy was grandfathered under the law, and you can keep renewing it. Depending on your specific circumstances, you may want to consider switching to a new plan anyway – as some businesses have found the new policies have saved them money – but the law isn’t going to require you to do anything at this point.

But if your business (1) purchased a new, small-group health insurance plan between March of 2010 and the end of 2013, and (2) is located in one of the 35 states that are still granting the waiver for non-compliant plans, you will likely need to make a change. One insurer reported that up to three-quarters of its small group policies – sometimes referred to as “grandmothered” plans – will be affected. It’s also possible that your deadline will be even earlier than the end of 2017, depending on what your state decides.

It’s time to get started. What should you do?

Take a look at your current plan and assess whether you need to make a change. It’s straightforward if you know the government’s new healthcare rules and compliance requirements. If you don’t, contact a benefits consultant who does. They can help you determine if you need to make the change and what’s best for your organization. Then you can get back to doing what you do best: growing your business.

Editor’s note: the original publication of this article can be found in Employee Benefits News here

About

Sue is a benefits and insurance specialist with 20+ years of industry experience, including regional brokers (Jenkins Insurance), national brokers (Arthur J. Gallagher), and global benefits consulting firms (Mercer). She joined the Board of Directors of the Golden Gate Association of Health Underwriters in 2016, is a past Board member of the N. California Employee Benefits Council and has moderated healthcare reform panels attended by hundreds of brokers in the Bay Area. Sue has a Certification in Employee Benefits from the Wharton School at the University of Pennsylvania.

Category: Compliance, Benefits


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