How Employers Are Getting Ready For Open Enrollment

Some large employers will face penalties if they don’t offer workers health insurance in 2015. In addition, workers can expect to see increased cost-sharing and employers pushing them to “private exchanges” to save money. KHN’s Mary Agnes Carey and Jay Hancock discuss:

MARY AGNES CAREY: Welcome to Enrollment Encore – what you need to know before open enrollment in the health law’s marketplaces begins again on November 15. I’m Mary Agnes Carey. With me now is Jay Hancock, he’s a senior correspondent with Kaiser Health News. We’re going to talk about employers and the health care law. While the law doesn’t require employers to provide health insurance for their workers, some larger employers might face penalties next year if they don’t.

JAY HANCOCK: That’s correct. 2015 is the first year under the law that employers will be subject to penalties if they don’t offer health insurance for their workers reaching a certain value of coverage. Originally it was supposed to take effect in 2014, it’s now going into effect next year. For employers with 100 or more workers, the full mandate applies. For employers with 50-99 workers, they get to wait until 2016. So for these larger companies, it’s D-Day.

MARY AGNES CAREY: And if you’re under 50 workers, you’re exempt from this requirement, correct?

JAY HANCOCK: Smaller employers have always been exempt from the ACA requirements, although many offer their own coverage and that’s changing as well. Particularly, some are deciding that it makes better sense for their workers to buy coverage in the ACA marketplaces rather than through the employer.

MARY AGNES CAREY: You’ve been doing a lot of the work on some of the changes employers are making with their health insurance benefits. Some are in response to the Affordable Care Act, and some are not. Can you take us through that?

JAY HANCOCK: Employees are going to see a continued increase in the deductible in the health plan, which is the amount that the employee or member pays before the insurance kicks in. We’re seeing more cost-sharing with copays, we’re seeing more cost-sharing with some of the more expensive drugs – they’re put in a different tier. Some employers are going even farther: They’re contracting with particular providers to see whether or not they can get a better price for their care. Others are going a little bit of a different route: They’re looking at what are called “private exchanges,” which are similar to the public exchanges that we hear about – these online marketplaces for the ACA. There, people can go on, with a fixed amount from the employer, they shop for insurance, they see what makes sense for them and they buy it. I guess the bottom line is, pay attention when you enroll, because things are changing.

MARY AGNES CAREY: Thank you so much, Jay Hancock with Kaiser Health News.

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