As you prepare for the upcoming Open Enrollment for reviewing your health care benefits, there are several important dates to remember and some changes to the plans you may want to consider. For many small businesses and the self-employed, healthcare options and requirements has been a quagmire of choices and penalties over the past few years. But new options may make it easier to make selections that are accessible and affordable. Continue reading for a guide to the most important open enrollment 2018 dates.
Open enrollment will begin November 1, 2018, and ends December 15, 2018. You will have a 45-day window (unlike the 90-day window of 2 years ago) to make your elections. Options chosen during that enrollment period will be effective January 1, 2019, and will stay in place throughout 2019, unless a qualifying life event allows for additions or deletions to elections.
What’s new about 2019 health care coverage?
Under the Tax Bill of 2017, the individual mandate requiring the purchase of health care coverage or be levied a penalty by the IRS will be eliminated for 2019. Individuals who chose not to purchase coverage will no longer be required to pay a fine.
In addition, a new final rule, issued by the Centers for Medicare and Medicaid Services (CMS) also added several “hardship exemptions” which could allow buyers to avoid penalties retroactively for several years if they qualify.
If you live and work in Massachusetts, however, there is an individual mandate: fines for not purchasing coverage for 2019 are anticipated to be based on their 2017 schedule, available here. For Massachusetts employers who shift the cost of health care for their staff members to the state, costs and penalties also apply. You can find them here.
Currently, New Jersey and the District of Columbia are close to implementing mandates as well, requiring residents to buy health insurance. California, Connecticut, Hawaii, Maryland, Minnesota, Rhode Island, Vermont and Washington also have proposals under consideration. Be sure to check with your local authority to verify whether mandates or employer penalties apply.
In an effort to keep pace with the cost of healthcare, premium tax credits, or premium subsidies, have been in place to help buyers offset the cost of buying insurance. They, as well as cost-sharing reductions, have changed for the coming OEP. Credits will fluctuate, depending on a variety of factors, including age, the category of insurance chosen, location, income and family size. A new schedule of tax and cost-sharing reductions can be found here.
Under the Affordable Care Act (ACA) which remains in place, businesses with 50 or more employees are required to provide health coverage for staff or pay a fine: fines are steep, at $2,000 per employee for every employee in excess of 30 staffers.
For businesses with fewer than 50 employees, no fines are applicable if their staff members purchase coverage through the healthcare exchange.
For employers with 100 or more staff members, state-run exchanges are available to find the best plan.
Depending on the wages they earn, businesses with 25 employees or less may be eligible for tax credits of up to 50%. As with all legislation, be sure to check with your local authority.
The changes for the upcoming open enrollment season can be a significant boon to employees, small businesses and the self-employed. Working with your local carrier may help provide more insight into what is required of you, and how to get the best coverage you can afford.