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Renewal season is just around the corner. Do you have all the information you need to make an informed decision? As implementation of the Affordable Care Act (ACA) progresses, you may want to take advantage of the “transitional relief” that’s available. Here’s a brief outline of what you’ll need to know.
What is ‘transitional relief’?
Under a “transitional” policy for non-grandfathered coverage in the small group health insurance market (issued in November 2013), health insurers can continue offering the same coverage to small groups without adopting all of the market rule changes set to take place in 2014. In other words, small group employers can keep their current plans.
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This transitional policy has now been extended for an additional two years, to policy years beginning on or before Oct. 1, 2016. So employers who wish to keep their current plans can renew them each year through October 1, 2016. This may allow for multiple renewal cycles over the next two years. If an employer wishes to keep their plan through 2017 they must either renew their plan prior to October 1, 2016 or move their effective date to start their plan year on or before October 1, 2016.
How do I decide whether to keep my current plan?
It's important to know that if you choose to renew your current policy, it may not provide all the protections of the Affordable Care Act. For example, your coverage may not meet standards for the following:
- Fair health insurance premiums – based on factors such as gender and age
- Guaranteed availability – excluding individuals based on factors such as pre-existing medical conditions
- Guaranteed renewability
- Nondiscrimination with respect to health care providers
It’s also possible that your coverage may not cover essential health benefits or limit annual out-of-pocket spending. It also might not meet standards for participation in clinical trials, which could affect coverage for services related to a serious or life-threatening disease.
ADP can help you determine whether your existing plan is compliant with all necessary rules and regulations, ensuring that you avoid exposure to risk, fines and penalties. You have options for quality health insurance, and we can help with your decision.
How do I get more information?
Finding the right coverage at the right price can be complicated. ADPIA is here to help. We can guide you, help you understand your plan options and make the right choice for your company and your employees.
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We can be reached at: (866) 892-3383, Monday through Friday from 8:30AM to 8:00PM.
- For employers with five or less enrolled employees, please use Option 2, then 2 again to reach our Licensed Employer Contact Center.
- For employers with six or more enrolled employees, please use Option 3 and enter the extension of your dedicated Licensed Client Executive.
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