Beginning in 2016, the Affordable Care Act (ACA) will be expanding the definition of a small employer group from 1-50 to 1-100 employees. This means that groups with over 50 full time (30 hrs) employees and/or full time equivalents (two or more part-time employees whose hours total 120 hours in a month) will be required to abide by the rules and regulations governing the small group market. Examples of these regulations are community rates, actuarial value (metal level) plans, and small group benefit plans. As these 51-100 segments enter the market or renew in 2016, these changes will be effective. This does not change the ACA requirement that employer groups with over 50 employees must still offer group health insurance or face penalties. The "Pay or Play" law also goes into effect in 2016 for this 50-100 size group. Employers that are self-insured however, are not subject to these requirements.
Blue Cross Blue Shield of Minnesota recently sent agents some very helpful information regarding these changes in 2016, and announced that they will be sending their clients a survey to obtain information about the number of employees employed by each group that may be affected by this new definition. I predict that HealthPartners, Medica, and Preferred One may do something similar in coming months. The fallout from these changes will be good news for some groups and bad for others, because underwritten rating will become a thing of the past. We will continue to keep you updated on Health Care Reform, and do all that we can to help you prepare for this transition. Please contact us if you have any questions or concerns.