Dive Brief:
- An article in Kaiser Health News reported that the federal calculator used to certify insurance for employers in 2015 is allowing businesses to provide plans that lack basic benefits including hospital coverage. The online calculator is meant for use by employers who are self-insured, which encompasses most large businesses, to ensure their plans meet the standards of the Affordable Care Act.
- Workers at these companies are not eligible to purchase plans through the marketplace using federal tax credits. The ACA mandates that employees pay no more than 9.5% of income for healthcare coverage. These specific plans typically cost about $200 a month, meaning employees making more than about $25,000 annually could be required to pay nearly the entire cost of their premiums.
- It is unclear how many companies will offer these plans, but according to the Kaiser article, various insurance brokers, including Assurance and The American Worker Plans, are working with companies that either offer or are considering the coverage for 2015.
Dive Insight:
The purpose of the ACA was to provide health insurance to a greater number of individuals at an affordable price. There have clearly been some hiccups in the legislation, and this is the most recent one. Critics of the calculator claim that it is nothing less than businesses shirking their responsibility.
"Employers who offer these types of plans as the only option for their employees really need to search their consciences," Sabrina Corlette, project director at Georgetown University's Center on Health Insurance Reforms, told Kaiser Health News.
Others seem to think the flaw may not be an accident, but rather a way for employers to meet standards without going broke.
"I think they knew what they were doing and were trying to avoid placing unreasonable constraints on large employers," said Edward Lenz, senior counsel at the American Staffing Association.
According to Brian Robertson, executive vice president at Fring Benefit Group, temporary staffing firms are particularly interested in offering lower-value plans.
"They are being forced into this game kicking and screaming and they’re trying to figure out, 'What is my lowest cost to comply?'" with the ACA, Robertson said.