If I say that it’s change that I believe in, can I take a break from change – any change? The small employer health insurance market is still waiting to discover the contours of the small group health plans recently approved for sale by business and professional associations. Now we can also push reset on the definition of “small group.”
Just a couple of weeks ago, health insurers received the following Email from the Washington Insurance Commissioner (OIC):
From: Siems, Jason (OIC)
Sent: Tuesday, September 22, 2015 8:12 AM
To: Siems, Jason (OIC)
Subject: Message regarding small group clarification
Dear Washington Health Carriers,
The Office of the Insurance Commissioner is providing the following clarification regarding its implementation of the new definition of “small group” beginning January 1, 2016. The OIC’s initial message on this subject is included below for your reference.
Pursuant to Washington Administrative Code 284-170-954, groups may not selectively offer early renewal of nongrandfathered group health plans as a means of forestalling application of the new federal definition of small group.
Grandfathered groups are not subject to the federal definition of small group size in the ACA.
Therefore grandfathered 1-100 groups will NOT be subject to the nongrandfathered small group 1-100 community rating effective January 1, 2016.
For questions, please contact Jason Siems, Deputy Insurance Commissioner for the Policy and Legislative Affairs Division at jasons@oic.wa.gov or 360-725-7037.
Thank you,
Jason Siems
Deputy Insurance Commissioner
Policy and Legislative Affairs Division
Washington State Office of the Insurance Commissioner
Now we learn that Congress actually passed a bill and the President signed it! The bill repeals the federal health care reform definition of small group which was changing from 50 to 100 employees on January 1, 2016. So a small group will still be 50 or fewer employees.
Funny thing though (not really), carriers have been revising and filing plans for a small group market of up to 100 employees. Oh well.
Here’s the Congressional summary of the law just signed by the President.
Protecting Affordable Coverage for Employees Act
(Sec. 2) This bill amends the Patient Protection and Affordable Care Act (PPACA) and Public Health Service Act to include employers with 51 to 100 employees as large employers for purposes of health insurance markets. States have the option to treat these employers as small employers. Currently under PPACA, employers with 51 to 100 employees are small employers, but before January 1, 2016, states have the option to treat them as large employers. (Under PPACA, health insurance offered in the small group market must meet certain requirements that do not apply to the large group market, including the requirement to cover the essential health benefits.)
Here is the Washington Insurance Commissioner’s press release in response to the President’s signing of the law keeping small groups at 50.
OLYMPIA, Wash. – Yesterday, President Obama signed the “Protecting Affordable Coverage for Employees (“PACE”) Act, overturning one aspect of the Affordable Care Act (ACA) that applied to small employer health plans.
Under the Affordable Care Act, the size of a small employer was to jump from 1-50 to 1-100 by Jan. 1, 2016. All of our health insurers priced and filed their plans in anticipation of this new change. I supported this move because I believed it would help create a more stable insurance market for our small employers. I even traveled to Washington, D.C. last month to testify against the PACE Act and in support of the changes we’ve already made here in Washington state.
Despite my opposition to this bill, I will support the President’s decision and implement the new change in Washington state as smoothly as possible.
We will communicate with health insurers and producers on what steps they’ll need to take to comply with the federal change. Since all rate filings were based on the small group expanding from its current size of 1-50 employees to 1-100 employees, we may consider allowing a one-time quarterly update of rates. However, any change must be justified and will be carefully reviewed.
Small businesses deserve a robust health insurance market with fair prices and we’re committed to building and maintaining a market that delivers on these promises.
It’s not so much that I need change I can believe in, I just want a status quo I can believe in.
