Smart Benefits: Employers Need To Prepare For Health Exchanges

Monday, October 29, 2012

Amy Gallagher, GoLocalProv Business/Health Expert

The arrival of health exchanges in 2014 will mean significant changes for employers in Rhode Island. Make sure you're prepared.

Next year, employers with more than 50 employees will have a lot more to worry about. That’s because, under healthcare reform, the exchanges being set up by many states around the country – including Rhode Island – must be operational by 2014.

What will be on employers’ to-do lists? First and foremost will be notifying employees of possible opportunities to enroll in the exchange. But determining just who is covered is the bigger issue.

Eligibility for Coverage

When the exchanges are implemented, employers will need to understand how many employees will qualify to leave employer coverage and how many will stay on. But there’s a new way to calculate eligibility for full-time employee coverage that complicates the equation – and may cause employers with more than 50 employees to offer coverage to more workers than they do today.

Coverage Adds Up

Employers will now have to include within the definition of full-time employee (for benefit purposes) those who work an average of 30 hours a week in a month. This means that if an employer offers adequate coverage (as defined by PPACA) and an employee who meets this new definition of FTE is not eligible for the exchange because they’re not income eligible for the federal subsidy, the employer will have to offer them coverage.

Those employers who previously considered only those employees eligible who worked more than 30 hours a week (i.e. 32 hours or 40 hours) may now have to cover more employees -- exposing the organization to additional costs.

Who Will Feel the Impact?

Employers who have a lot of part-time and seasonal employees, and previously didn’t have to worry about offering them coverage, including industries like hospitality, tourism, social service organizations, healthcare providers, and retail, will now have an added financial burden of adding these employees. For these employers, many of whom are small, the impact will be huge.

Amy Gallagher has over 19 years of healthcare industry experience. As Vice President at Cornerstone Group, she advises large employers on long-term cost-containment strategies, consumer-driven solutions and results-driven wellness programs. Amy speaks regularly on a variety of healthcare-related topics, is a member of local organizations like the Rhode Island Business Group on Health, HRM-RI, SHRM, WELCOA, and the Rhode Island Business Healthcare Advisory Council, and participates in the Lieutenant Governor’s Health Benefits Exchange work group of the Health Care Reform Commission.

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Comments:

michael riley

12:31am on Saturday, November 03, 2012

This will affect lots of businesses in South County. Thanks for the heads up.