Last week, we traveled to Washington DC to attend the National Association of Health Underwriters’ 2015 Capitol Conference. It’s a trip we look forward to every year – not just for the opportunity to break out our coats and scarves, but also for the chance to make our voices heard and lobby for health reform changes.

Our trip included speaking with members of Congress regarding some fixes or delays we believe would be beneficial to employers with respect to health care reform. Some of the topics of particular interest included:

  • A two-year delay in the enforcement of the “small group” employer definition. Currently, an employer with 2 to 50 employees is considered a small group in many states. However, the small group size will change to 1 to 99 employees as of January 1, 2016, unless a delay is put in place. For groups with 51 to 99 employees, this provision will cause significant change to the benefits they offer and will drastically change their rating/premium (from composite rating to the new ACA Age Rating). While at the conference, we requested that Congress reach out to the Department of Health and Human Services (HHS) to put this delay into effect.
  • Medicare fixes.There are several ways we feel that the Medicare system could be improved. These include restoring the open enrollment period, moving Medicare annual election period to a time that does not coincide with the new Exchange open enrollment period, and allowing hospital “observation time” to count toward the three-day inpatient hospital admission requirement if patients need nursing home care after their hospital stay.
  • Full-time worker definition change. Under the ACA rules, an employee is generally considered full time if he or she works an average of 30 hours a week or 130 hours per month. And, employers with 50 or more full-time equivalent employees must offer affordable medical coverage. There’s been a lot of effort to reduce the burden on businesses by changing the FTE definition to 40 hours rather than 30. In fact, the House already passed a bill to make this change and it is now sitting in the Senate. In addition to advocating for this bill, we also discussed reporting requirements which are beyond burdensome for employers as well as treatment of account-based consumer-directed health plans.
  • Other reform adjustments. We also collaborated on other changes to improve the ACA and health care in general, such as promoting the increased use of value-based insurance design principles and increasing the ACA’s age rating bands from the current 3:1 ratio to a system that more closely resembles the natural breakdown of age (with at least a 5:1 ratio, which reflects decades of age). We also discussed eliminating or delaying the new national premium tax that will cost a typical family more than $500 annually.

As always, BeaconPath’s goal is to keep health care benefits affordable and easy to administer for small and mid-size businesses. Contact us if you have questions about any of these reform issues, or if you’d like to explore cost-effective health care solutions for your company.

Leave a Comment