Employer group plans with renewal dates on January 1 should receive their new premium information no later than November 1st.
For plans beginning in 2015, employers with 100 or more full-time-equivalent (FTE) employees were required to offer qualifying health insurance benefits or face penalties under the Employer Shared Responsibility provisions of the Affordable Care Act (ACA). The requirement has been extended to employers with 50 or more FTEs in 2016.
On 1/1/16, the ACA will change the definition of a Small Group Employer. Employer groups of 51 – 100 employees have been classified as a Large Employer for employee benefit purposes; but will be reclassified as a Small Group in 2016. This will change the way that premiums are determined and subjects those groups sized 51 – 100 to different regulations. The premiums for Small Group Employers are based on Community Rating criteria and there are no pre-existing condition limitations. Those groups that had high claims experience will see lower rates under Small Group rules while those with low claims will have an increase in premium. However, this scheduled change may be deferred by legislative action before the end of the year.
The annual Open Enrollment for individual and family health insurance plans begins on November 1, 2015 and continues through January 31, 2016. Current policyholders will begin receiving renewal notices in October. There will be double digit increases in premium when compared to 2015, some changes in provider networks, and new benefit plans. Four insurance companies will be available in Nebraska, both on and off the Health Insurance Marketplace – BlueCross BlueShield, Coventry, Medica, and United Healthcare. Medica is new to Nebraskans. The company has been offering health insurance products in Minnesota, Wisconsin, and North & South Dakota for 40 years.
Assurant Health offered products in 2015, but will NOT renew those plans in 2016. If you have an Assurant plan, your coverage will end on 12/31/15 and you must select a new plan for next year.
If you enrolled directly with an insurance company and decide that you simply want to keep the plan you had in 2015, you don’t need to do anything and your policy will renew. Be certain that you are aware of any benefit changes that may occur in 2016.
If you enrolled through the Health Insurance Marketplace, it is highly recommended that you update your application and make a plan selection for 2016. Any determination that the Marketplace makes for you in calculating your Premium Tax Credit or renewing your 2015 plan is based on historical information and does not reflect any changes in your family or financial estimates for next year.
Enrollments that are completed between November 1st and December 15th, 2015 will be effective on January 1st. Those completed from December 16th to January 15th will take effect on February 1st and those done from January 16th to January 31st will be effective on March 1st. Because of the large volume of applications processed during this time, it is wise to do yours as soon as possible.
ComPro offers health insurance products for employer groups and individuals / families. We are specialists in health insurance.
by Chris McPike, Vice President
ComPro Insurance
402-488-5100 |www.comproins.com