While the marketplace for small employers to buy group medical insurance officially opens Friday, some 1,400 companies insured through the Greater Oklahoma City Chamber of Commerce learned this week they would have to look elsewhere for coverage because the chamber's group plan fails to meet the requirements of new health reform laws.
Chamber President Roy Williams called the demise of the chamber's group insurance program “very, very unsettling.”
“It was a good program, otherwise 1,400 companies wouldn't be on it,” Williams said.
Chamber Choice was essentially “outlawed,” he said, because it didn't cover all 10 essential health benefits mandated by the Affordable Care Act, including emergency care, lab services, maternal and newborn care, mental health and substance abuse, prescription drugs and pediatric dental and vision care.
Chamber Choice members on Friday are being presented by Blue Cross and Blue Shield of Oklahoma with 26 plan options. Companies that commit to a new policy by Dec. 1 will be covered through December 2014, Williams said.
“Some may decide not to offer insurance,” Williams said. “Then their employees' only option will be to buy insurance on the (individual) exchange,” he said.
Jenna Manning Harlow, an accountant with Te-Ray Inc., said her family's oil and gas company that employs four people has been insured since 2003 by Chamber Choice insurance through Blue Cross.
“We were completely happy with the coverage we had,” Harlow said. But Te-Ray, which pays $4,700 a month to cover 100 percent of its employees' premiums, is bracing itself for increased costs, she said.
At a Glance
Small-business Health Options Program (SHOP) is an online marketplace (healthcare.gov), which opens Friday, where employers with fewer than 50 full-time employees may shop for group health insurance.
The Affordable Care Act doesn't require small employers to offer health insurance but, starting next year, employers with 50 or more full-time equivalent workers must offer insurance or face fines of up to $2,000 per employee.
In Oklahoma's federally-run SHOP marketplace, Blue Cross and Blue Shield of Oklahoma, CommunityCare and GlobalHealth Inc. are offering seven medical plans, including health maintenance organization (HMO) plans and, the generally more expensive, preferred provider (PPO) plans that allow people to choose their medical providers. For 2014 only, participating Oklahoma employers will be able to select one plan for their employees; employee choice is optional for state-based exchanges.
As an added incentive, employers with 25 or fewer employees (with an average wage of less than $50,000 a year) who buy insurance through the SHOP program may be eligible for tax credits, which will cover up to 50 percent of the employer's cost (up to 35 percent for small nonprofit organizations) for the first two years of participation in SHOP. To qualify, businesses must offer the coverage to all full-time employees, and 70 percent of eligible employees must enroll (excluding those on their spouses' or parents' plans).
In addition to healthcare.gov, small businesses may use the call center to buy insurance through SHOP, by calling (800) 706-7893 from 8 a.m. to 6 p.m. on weekdays, or by meeting with navigators. If you're dealing with an agent or broker, be sure to mention you want to apply through SHOP.
Unlike the six-month enrollment period for individuals, small businesses can enroll in the plans on a monthly basis throughout the year.
SOURCES: Centers for Medicare and Medicaid Services, Blue Cross and Blue Shield of Oklahoma and the Tulsa World.