For some, Health care rules start next year

The new health-care law is requiring many employers to more carefully consider their insurance coverage.

Representatives with Blue Cross Blue Shield of North Dakota held an employer’s health-care forum Monday in Minot, one of the first being held around the state, to explain aspects of the law affecting group plans.

Luther Stueland, director of health policy impact and exchange operations for the Blues in Fargo, said employers are facing increases in the cost of health insurance, and it’s important that they understand the many complexities of the law in deciding how they will respond.

The rise in premiums that had been slowing picked up again about a year and half ago. Although the amount of the increase varies based on a number of factors, Stueland said, “Some are seeing significant increases. It’s enough to make you pay attention.”

Along with rising premiums is a delayed health insurance mandate for group plans that now kicks in next year. Employers need to know the rules and determine how their companies will be affected, he said.

“There are several strategies that employers are wrestling with,” Stueland said. “They have to make a decision whether to continue offering coverage, and if they don’t, what are the ramifications.

Beginning next year, companies with more than 100 full-time equivalent employees must offer insurance to full-time employees or pay an annual $2,000 fine for each employee after the first 30. A mandate begins for companies of 50 to 99 employees, starting in 2016.

The health-care law also has provisions to ensure that people receive affordable coverage. One element of affordability is that premiums not exceed 9.5 percent of a household’s income.

Employers who are offering plans that don’t fit the level of affordability could be penalized if employees turn instead to the health-care exchange and are eligible for a subsidy. The penalty could cost up to $3,000 for each employee affected.

Stueland said employers may respond by increasing pay so that employees can afford insurance. They could cut hours so employees aren’t eligible for the insurance, shop around for more affordable coverage or make adjustments to their plans to reduce costs, Stueland said.

Employers whose existing plans are grandfathered could lose that grandfathering, though, if they decrease benefits or shift more than 5 percent of premium costs to employees. Giving up grandfathering may mean adding new preventive care benefits that are required under the health-care law. Those requirements potentially can add up to 3.5 percent to premiums.

In North Dakota, where the job market is strong, employers also have to consider what changes in health plans will mean to recruiting and retaining employees, Stueland said.

“We have seen some small shift from employer to individual, which we expected because there’s incentive for people to go to the exchange. But enrollment for our company continues to grow overall,” he said.

The purpose of the forums is to provide employers with information they need to consider in making their decisions, he said. The forum also provided information related to new Internal Revenue Service reporting requirements that will begin next year for larger employers and the following year for employers with 50 to 99 employees.