Group items tagged

More often than not, those plans are individual policies that are not available on the government-run exchange.

An employee who worked 1,800 hours over the course of the measurement period would average 34.6 hours per week, and would thus be eligible for coverage.  The “administrative period,” which can be up to 90 days, is the period where you enroll these eligible employees. The “stability period,” which has to be at least as long as the measurement period, defines how long they will have coverage.

Just remember that, starting in 2015, employees always have to be in a stability period for full compliance. So employers should not wait until October of next year to start planning.  Even though the mandate is delayed, employers still have to prepare.

Ryan White, a hospital consultant with Eide Bailly LLP, said one concern is that more people who buy private insurance, including through the online exchanges being set up by the federal government and some states, could opt for plans with high deductibles. He said the lowest-cost plans offered through the exchanges could have deductibles as high as $7,000. That creates a problem if they get sick.“A lot of the individuals signing up for those plans probably don’t have $7,000 sitting in a bank account to pay general hospital of Milwaukee,” White said.

All health plans offered on a state exchange must provide comprehensive coverage that includes doctors’ visits, lab work, hospital stays, emergency room services, maternity care, prescriptions, mental health services and children’s dental and vision care.

Policies with the most generous benefits will be “platinum” plans; they will have the highest monthly premiums but fewer out-of-pocket costs and lower deductibles. The “gold” and “silver” plans will be somewhat less generous, while those in the “bronze” category will have the cheapest premiums but may require high out-of-pocket costs and deductibles.

Be aware that the plans may have narrow provider networks — your favorite doctor or the hospital down the street may not be a participant. You’ll need to check to see if a certain provider is in the network, advised Sabrina Corlette, a research professor at Georgetown University’s Center on Health Insurance Reform.