Health Care Law Comes With Learning Curve

by Tom Hayes, Regions Insurance Inc.  on Monday, Aug. 12, 2013 12:00 am  

Tom Hayes

Second, many employees with families could see an unexpected benefit. Employers that offer coverage only to employees and not dependents are likely to be more cooperative in efforts to get uninsured employees and dependents signed up under the various PPACA programs because they know they won’t face penalties next year.

However, one concern over this delay is a potential erosion of employer-sponsored medical plans in 2014. With the employer mandate on hold and subsidy verification forfeited, could there be significant migration into the individual exchanges, jeopardizing the minimum participation requirements established by many insurers?

Even with a little breather from the pay-or-play requirements, large employers still face implementation of other components of the law that have fast-approaching deadlines. They must still inform employees on Oct. 1 about the availability of health coverage on the exchanges, and the plans they offer must still comply with the PPACA design rules which include no pre-existing exclusions, no annual dollar limits on essential health benefits, no waiting periods beyond 90 days and limits on cost sharing and deductibles.

Small employers on the other hand — those with fewer than 50 employees — have challenges of their own to deal with come 2014. Mandatory benefit changes coupled with the removal of pre-existing conditions and rating-tier compression will more than likely create double-digit premium increases for many small employers.

As industry experts, one thing we know for sure with the Patient Protection and Affordable Care Act is that every day we find out that we have more to learn.



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