Female/Male Distinction
The law contains other important changes for health insurance. One that many are not familiar with is that starting in January there will no longer be a distinction between males and females when it comes to health insurance premiums. Currently, a female of childbearing age pays approximately 40% more than a male of the same age for equal coverage. As of January, there will be unisex rates.
As a general rule, health insurance premiums are going up for everyone. However, the percentage increases for young males are going up significantly more than females. In essence, young males will be subsidizing coverage for females due to maternity costs.
Enrollment Period
There will be an open enrollment period every year, both in the private market and through the FFM. This year it started on October 1, 2013 and continues through March 31, 2014. In future years it will be October 15 – December 7 for an effective date of January 1.
The exception to the open enrollment period is through a qualifying event. Qualifying events include things like marriage, birth, or losing your existing coverage.
Business Owners
Business owners will be facing quite a few challenges with the new health insurance laws. One of the first questions they are going to ask is should I offer a group health insurance plan for my employees, and if I have an existing plan should I keep it? Decisions will be made based on many factors, such as if the business has a grandfathered or non-grandfathered plan.
Only larger businesses (50+ full time equivalent employees) will be required to offer health insurance to their employees or face a penalty. That mandate was originally scheduled to go into effect in 2014, but it has been delayed at this point at least a year.
For businesses with less than 50 full time equivalent employees, it is not required and has never been required for the business owner to offer health insurance. However, it may make sense to keep a group plan for several reasons such as to attract and retain quality employees and to be competitive with other employers. But for certain businesses, particularly those who will have many employees who qualify for subsidies, it may make more sense to stop offering a group plan and let their employees get insurance on their own. This decision should be discussed and considered carefully with your insurance advisor.
