On May 10, NAHU conducted a one-hour webinar on health insurance exchanges. It was an exceptionally thorough overview of the topic, and I would encourage folks to listen/view it. The link to the Professional Development page of NAHU’s site (the webinar is the first item under the NAHU Webcasts heading):
http://www.nahu.org/education/programs/webcasts.cfm?ibcToken=a0a490fb-9052-4c36-bd08-d7da54f8f2ef.
Just a couple of highlights (there were many):
• Premium subsidies and cost-sharing reduction subsidies will only be available via the Individual coverage exchanges (low-income people who buy coverage via a SHOP exchange are not eligible for subsidies)
• Low-income people who have access to “adequate” and “affordable” group coverage cannot leave the group plan and buy coverage via an exchange
• Employers will be required to help verify coverage in virtually any situation:
o Whether or not any employee purchases coverage through an exchange
o If an employer doesn’t offer coverage at all
o After an employee enrolls in an exchange (and likely every year thereafter)
• The small-business tax credits currently available to any qualifying small employers will only be available after Jan. 1, 2014, to employers purchasing coverage through a SHOP exchange
• If an individual state elects to allow “large” groups to access an exchange on Jan. 1, 2017, or thereafter, and even one large employer elects to participate, all of the SHOP exchange requirements will apply to every insured large group in that state. Examples: modified community rating rules (no more experience rating for an employer’s large group plan), minimum benefit requirements, guarantee issue, etc.
• Private exchanges are not subject to SHOP exchange rules
• Many items that require further regulatory guidance are noted
