Mike Chaney gives large businesses one-year waiver to make coverage ACA compliant

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Published: August 29,2014

Tags: Affordable Care Act, busiiness, healthcare, Mississippi, Obamacare

healthcare reform_rgbThe Mississippi Department of Insurance says it is encouraged by sign-up levels for an Internet-based small business health insurance exchange that has already completed a series of open enrollments.

The federal Affordable Care Act gives states the option of operating a Small Business Health Options Program, or SHOP, marketplace. Mississippi is calling its SHOP One, Mississippi.

To take part, a business must:

» Employ 50 or fewer workers.

»  Attest to offering coverage to all full-time equivalent employees.

The business can cover its part-time workers through the exchange, as well as dependents of all workers.

Through the digital exchange, employers can select from health-care plans classified as Bronze, Silver, Gold and Platinum. All plans must provide specific essential health benefits, according to One, Mississippi.

The exchange, through a competitive marketplace, is designed to provide businesses coverage at prices below what they would find elsewhere.

The color category has nothing to do with the quality of coverage of a plan, One Mississippi says, though it notes the more the plan pays the higher the premiums.

SHOP coverage brings tax benefits to the employer through the Small Business Health Care Tax Credit. The employer must pay at least 50 percent of full-time employees’ premium costs, or 35 percent of the premiums paid by tax-exempt employees. “The tax credit is highest for companies with fewer than 10 employees who are paid an average of $25,000 or less,” One, Mississippi says.

Insurance Commissioner Mike Chaney said One, Mississippi could help more than 100,000 of Mississippi’s working poor who make too much money to be Medicaid eligible but not enough to qualify for subsidies through the state’s federally operated individual health care insurance exchange.

The workers would have been eligible for Medicaid had the state agreed to expand Medicaid eligibility under the Affordable Care Act. Instead, the workers are in an insurance limbo. “This is a real problem,” Chaney said in an interview last week.

He said leaving such a large part of the state’s population uninsured eventually will hurt Mississippi’s overall economic prosperity. “If we don’t have insurance for that population, we are going to lose potential employers and not have economic development.That is why we are pushing this SHOP exchange.”

Meanwhile, the one-year reprieve the Obama administration gave large businesses, those with 50 or more workers, to insure their workforce ends on Jan.1. With Republican leaders in the U.S. House of Representatives having sued him for extending the coverage deadline, President Obama is very unlikely to OK grant another extension, Chaney said.

Large employers that decline to insure full-time workers will be assessed a series of financial penalties.

The coverage must comply with the Affordable Care Act, though Chaney said he has told the state’s large businesses he will try to keep their plans “grandfathered” to 2016.

“Then they will have to comply with the federal rules,” unless Congress decides otherwise, Chaney said.

“The grandfathered situation says you can have a non-compliant policy as long as it has essential elements in it…. This applies to the big folks: Nissan, Toyota, Ingalls.”

Chaney said he has found “very little difference” in the range of coverage between plans provided by the state’s largest employers and what the ACA calls the “Qualified Health Plan,” or QHP.

But that does not mean the QHP doesn’t carry a much higher sticker price, according to Chaney. “They can expect a significant cost increase. If we went up to a QHP immediately, we are looking at rates going up 65 to 75 percent”

For QHP compliance, companies “have a host of things they will have to do,” the commissioner said. “But by giving the waiver, we have allowed them time to get those plans compliant without a lot of expenditure of funds.”

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