General

Health Care Reform Act Affects Big Business, Employers and Employees

With the passing of the Health Care Reform Act, employers will be dealing with America’s health brokers in a different way. Many of the provisions for larger business employers (over 100 employees) will remain very similar to the status quo, but there will be a few changes that may be beneficial to the employee.

SEC. 311. HEALTH COVERAGE PARTICIPATION REQUIREMENTS

(3) CONTRIBUTION IN LIEU OF COVERAGE- Beginning with Y2, if an employee declines such offer but otherwise obtains coverage in an Exchange-participating health benefits plan (other than by reason of being covered by family coverage as a spouse or dependent of the primary insured), the employer shall make a timely contribution to the Health Insurance Exchange with respect to each such employee in accordance with section 313.

What this means is that the employee can opt to enroll in the business health insurance plan, or the employee can opt to seek a more affordable health insurance plan by seeking out a prospective deal through America’s health care brokers via the exchange. The details of the exchange have not been thoroughly set, as of now, but the direction of it is leaning towards a state to state variance where many of America’s health brokers compete to offer health plans at an affordable price.

It may be in the employee’s best interests to enroll in an employee medical insurance plan, because group health insurance will always be more affordable than individual health insurance. Another alternative would be to collaborate with a group of individuals to create an affordable group health insurance plan through the exchange.

A key point of interest for employees who work for a large company (over 100 employees), and are seeking health insurance coverage, is that their health insurance premium will automatically be covered by “not less than 72.5% of the applicable premium” {SEC. 312(1)(A)}. For spouses and children, “Not less than 65% of such applicable premium of such lowest cost plan” {SEC. 312(1)(B)}. As far as family health insurance plans go, it may be difficult to find a medical benefit plan that through the exchange that can compete.

 

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