Shop Talk

Ask the experts: Affordable Care Act’s open enrollment, renewal period coming

Rand Williams
Rand Williams

It’s been more than four years since the Patient Protection and Affordable Care Act was signed into law. Along the way, regulatory components have been phased in and there have been obstacles and delays.

However, with the first year of ACA coverage coming to an end, small-business owners need to pay attention to upcoming renewal and coverage deadlines. Rand Williams, vice president of employee benefits at The Sorin Group, a Raleigh business insurance and benefits consulting firm, said insurance companies are advising owners to avoid last-minute decisions on keeping, updating or changing their policies.

Individual open enrollment on the healthcare.gov health care exchange runs Nov. 15 through Feb. 15, and small businesses can buy policies from brokers or insurance companies at any time, not just during the ACA enrollment period.

By Nov. 15, employees are supposed to be notified of their current coverage, enrollment status and potential eligibility for health insurance tax credits.

“There is a notice (owners) have to provide to their employees at renewal called a ‘notice of marketplace availability,’ ” Williams said. “It basically gives the employee the information they need to determine whether or not that employee or any of their family members could potentially be eligible for a marketplace plan or subsidy.”

The marketplace is poised to begin offering coverage choices through its Small Business Health Options Program, which is available for companies with 50 or fewer employees and is designed to help owners provide coverage for workers. Businesses with less than 25 employees with average wages near $50,000 may be eligible for tax credits, Williams said. Companies with less than 50 employees that bought policies on the open market and opted for an early renewal in Dec. 2013, need to renew in order to keep their existing policies.

On Jan. 1, companies with 100 or more employees, working 30 hours a week or more, will be required to offer minimum essential coverage that costs less than 9.5 percent of an employee’s income.

“Service industries with 100-plus employees such as retail, restaurant and convenience store chains are among the most concerned as they may see a new six-figure overhead line item due to the law,” Williams said.

Employee health care coverage has always been complex, and with exchanges, credits and subsidies, it’s more important than ever to seek guidance, Williams said.

Owners should be prepared to navigate their staffs through the maze of deadlines, delays and coverage, and be ready for more changes.

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