Private Exchanges and the Small Employer.

Another update from the HR jungle….

Dorothy runs a small retail business with 8 employees. It’s a low margin business so there’s not much room for employee perks. Dorothy always wanted to offer a group health plan to her employees but could never afford it. She had high hopes of lower premiums under the Affordable Care Act (ACA or Obamacare) but after looking at a couple of quotes she doubts if she can ever afford a group health plan for her employees.

Recently at a business networking event, Dorothy learned that a local hospital chain is teaming up with the largest health insurance company in the area to offer a private Exchange. A private Exchange does not offer premium and cost sharing subsidies like the public Exchange (a/k/a Marketplace). But a private Exchange offers some financial certainty to employers.

A private Exchange allows an employer to contribute a fixed dollar amount toward the cost of health coverage. Employees can then “buy up” to a higher premium level of health plan if they want lower deductibles or co-pays.

What options are available to Dorothy?

1. She can contribute a fixed dollar amount that covers the employee-only premium at a bronze plan level. Employees would be responsible for paying the premium for their family members added as dependents.
2. She can pay employees a bit more in wages and allow them to sort out their health coverage options.
3. She can continue doing nothing monetarily but encourage her employees to apply for individual coverage via the Healthcare Exchange (a/k/a Marketplace) in hopes they may qualify for some of the subsidies it offers to lower income individuals.

Is your company struggling to understand how the ACA will affect the employee group health plan? Corporate Compliance Risk Advisor can help you grasp the basics of the ACA and how it affects an employer of your company’s size.

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