Healthcare Reform Timeline

Employers

 

What You Need to Know About Healthcare Reform

  1. If you have 50 or more full-time employees, you have to offer health coverage or pay a penalty (in most cases)—but not until 2015.
  2. We’ll help you ensure your health plan is compliant.
  3. The maximum waiting period for benefits is 90 days.
  4. Premiums will include the cost of expanded benefits as well as new taxes and assessments required by the Affordable Care Act.
  5. You must notify your employees about HealthSource RI.

This information is for all employers, but you can also find information specific to large employers and small employers.

1. If you have 50 or more full-time employees, you have to offer health coverage or pay a penalty (in most cases)—but not until 2015.

The requirement for large employers to offer health coverage has been pushed back to 2015. To determine whether you are a large employer, count all full-time employees working 30 hours or more per week plus all full-time equivalent employees. This means that some employers who purchase small group plans may actually be considered large employers under the Affordable Care Act, the law that created healthcare reform.

If you are a large employer, learn more about coverage requirements and penalties on the large employer page.

2. We’ll help you ensure your health plan is compliant.

When you renew your plan in 2014, we will ensure that you renew into a plan that offers compliant benefits.  If you purchase a Blue Cross plan in 2014, it will:

3. The maximum waiting period for benefits is 90 days.

If an employee is eligible for health coverage, he or she must be able to enroll in health coverage within 90 days of being hired. For example, if your business offers coverage, the waiting period cannot be defined as the “first day of the month following 90 days of employment.” Find out more about how Blue Cross is handling waiting periods in this FAQ.

4. Premiums will include the cost of expanded benefits as well as new taxes and assessments required by the Affordable Care Act.

The Affordable Care Act provides new options and benefits to you and your employees.  However, they are also accompanied by new assessments and taxes, including the Patient-Centered Outcomes Research Fee, the reinsurance fee, and, in 2018, high-cost plans will be subject to the Cadillac tax.

The Affordable Care Act taxes add to existing state fees and taxes. On average, the total impact of taxes and assessments on an employee’s monthly premium cost for a fully insured plan is approximately $58.50, as shown in the chart below. That’s why Blue Cross is continually working on long-term solutions to help manage the overall cost of healthcare for you and your employees. (Please click on the chart below to enlarge it.)

 

5. You must notify your employees about HealthSource RI

All employers are required to give employees a one-time notice explaining coverage options available through HealthSource RI. You must provide a notice by October 1, 2013 to all part-time and full-time employees, even employees not currently enrolled in your plan. In 2014, you must also provide this notice to all new employees within 14 days of their start date.

You can use the model notices created by the Department of Labor. There is one model for employers who offer a health plan to some or all employees (also available in Spanish) and another model for employers who do not offer a health plan (also available in Spanish). For information on creating your own notice or more information, please see this FAQ.