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Health Care Reform:

Health Insurance & Affordable Care Act

Some States Are Pushing ‘Employee Choice’ For Small Business Insurance


Under the state programs moving forward, a business owner could pay a set amount toward coverage for each worker, then let each employee go to the Small Business Health Options Program, known as the SHOP exchange, to select from a variety of plans. Workers could choose to pay the difference if they wanted a more expensive plan, or potentially see all or most of their premium covered if they chose a less costly one.

Insurers raised concerns late last year that the SHOP marketplaces will be very complex – and feared the marketplaces would not be ready to handle those issues this fall. They did not want to be required to participate unless there was a delay.

On Wednesday, Alissa Fox, a senior vice president of Blue Cross Blue Shield Association, said it is “news to us” that so many states were moving forward.

“Our strong recommendation for the past three years is that the focus needs to be on getting the individual marketplace up and running and getting the core functions done right,” said Fox. “Any functions not critical to that core mission should be put off so we get it right for consumers.”

Seven states – Hawaii, Minnesota, Nevada, New York, Oregon, Rhode Island, and Vermont – will allow workers the widest variety of choices, selecting from across multiple insurers and coverage levels, the report says. Other states will allow workers to choose among plans at a specific level of coverage selected by the employer.

State marketplaces, Dash said, are responsible for ensuring they have the technology available to track the worker choices, a complex challenge. At least two states have slowed their effort: In Washington state, not enough insurance carriers applied, so the state will pilot its employee-choice program in only one region of the state, said Dash.

In Maryland, the small business section of the online marketplace won’t open for enrollment until Jan. 1, 2014, three months behind the opening of the market to individuals. Coverage under the small business program won’t begin until March 1, 2014, according to minutes from the board overseeing the state’s marketplace.

Thu, Jul 11 2013

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