insurance

Another Delay Leads to More Certainty, More Uncertainty

In the coming days, HHS will announce another change in the health care roll out. This time, they are going to allow carriers to keep and issue policies that do not meet ACA guidelines. This adds to the recent pushback on the employer mandate to 50-100 employee companies AND the lessening of enrollment requirements on larger employers.

The Certainty. 

Groups and individuals that embraced the “early renewals” last December will now have the choice to keep those plans for another year. This will make the late summer and early fall less noisy as many will likely sign back on for another year.

The Uncertainty.

Will new products emerge?  If carriers are allowed to issue policies that do not conform with ACA, will some move to issue less expensive policies or even offer lower rates to underwritten non-ACA plans? Employers and Individuals may buy these plans if they are less costly, even if they may be available only for a year.

Will this push back the “individual mandate?” Since the mandate requires one to have a “compliant plan,” how will the IRS enforce this when HHS allows non-compliant plans to be offered?

ACA’s goal, in large part, is to regulate the market. While this and other adjustments to ACA may make the short term more quiet, it raises questions about how they will enforce the law down the road. At some point HHS is going to have to decide what they are going to stand behind (and enforce) and what they are going to abandon.

As the law gets tweeked, it increases the chances that companies will do whatever makes sense to them and stop focusing on what they need to do in order to follow the law. If employers conclude that the law is a moving target, they may just create their own strategy, their own certainty.

More Changes / Delays to the Employer Mandate

3 Employer Take-a-ways

The administration announced late Monday yet another change-up to one of the major focal points embedded in the Affordable Care Act  –  the employer mandate. Here are the three biggest aspects of the announcement that employers of all sizes need to know:

Employers with 100+ Employees

Employers with 100 or more workers will only have to cover 70% (down from 95%) of eligible employees in 2015 to avoid fines. The original 95% benchmark now goes into effect in 2016 and beyond.

Employers with 50 – 100 Employees

Employers in this category get a reprieve of sorts through 2015 as the mandate is delayed altogether for another year. As things stand today, they must begin offering coverage to eligible employees in 2016 in order to avoid fines associated with the new law.

Employers with fewer than 50 Employees

Under 50 employers (already exempt from the employer mandate to provide coverage) will now be exempt in 2015 and each year going forward from the reporting requirements they were subject to as originally outlined in the new law.

Despite speculation by many, as of yet there have been no changes or reprieves to the individual mandate that went into effect on January 1 of this year. It remains unchanged.

For more detailed information on Monday’s announcement see articles that appeared in the Washington Post and Fiscal Times

For an expert analysis, read Bob Laszewski’s piece at Health Care Policy and Marketplace Review.

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