3 Open Enrollment Options And What You May Not Know About Them
Healthcare has been one of the most debated topics since President Trump’s inauguration. With all of the turmoil surrounding the status of the Affordable Care Act (ACA) and the industry as a whole, many insurance companies have opted out of the individual marketplace. Kentucky will have two carriers for 2018, but there are a few other options that may be available to obtain compliant coverage.
Congress has struggled to find a replacement for the ACA that would reduce the deficit and provide coverage to as many Americans as possible. After several failed proposals for replacement, the debate wages on and as of November 1st, 2017, people can begin to enroll for coverage through the ACA. Below are 3 options and what you might not know about them going into open enrollment.
1. Individual Health Insurance
The health insurance marketplace provides compliant coverage to individuals who don’t have coverage through their work because they are self-employed or their company simply doesn’t offer it. As mentioned above, Kentucky will have two options in the individual health marketplace, which sounds low, but is better than no coverage at all.
Anthem is providing coverage in all 120 counties and CareSource is providing coverage in about 60 counties, mostly in the Eastern part of the state. Both carriers are providing compliant coverage, meaning that they will cover all of the minimum essential benefits.
Due to the instability of the marketplace, both carriers have increased their rates under threats being made to cut cost-sharing reductions. Anthem will show a 34.1% rate increase and CareSource will show a 20.8% rate increase.
2. Group Health Plans
This option is available to consumers who are a part of a registered business or organization with 2 to 50 employees and provides coverage to all eligible employees and their dependents. Group plans usually provide a choice of health insurance plans, which can provide basic coverage to more coverage, depending on your needs and budget.
Employers offering group health plans typically pay part of monthly premiums, automatically deduct premiums from each paycheck, and are available to answer any questions and provide detailed information regarding coverage.
On the other hand, individual health plans require the consumer to shop for, choose, and purchase the right plan for them, usually without the guidance of an agent or employer walking them through the steps. Consumers of individual plans also need to be familiar with the plan they choose so they can manage it well. Since these plans are not provided through an employer, consumers must pay the total monthly premium payments.
These are the two most popular and available ways to obtain coverage, but what if they don’t work for you?
3. Create an LLC to Obtain Compliant Coverage
It might sound crazy, but this is an option to consider if your place of employment doesn’t provide coverage, you’re worried about excessive costs of individual plans, and you want the perks of group plans.
The requirements for small businesses to be eligible for group health care is that your business employs a minimum of 2 full-time employees. As a small business owner, there are special incentives for enrolling and the money spent on health insurance for employees may be tax-deductible.
To pick a plan right for you and your employees, ask yourself who will receive coverage under the plan, how much cost-sharing you can afford, and what benefits are most important to you and your employees. Then you can begin researching and comparing plans, costs, and coverage before choosing.
Open enrollment only lasts 45 days this year so it’s important to begin this process as soon as possible. Once you have health insurance squared away, we can help you manage your plan with our ACA or Benefit Automation Module. We also offer payroll, time & attendance, and HR services to form a comprehensive Human Capital Management platform. We hope these options are helpful and lessen the stress of open enrollment.