Oklahoma City insurance broker Wayne Pettigrew said he and his staff were in the middle of a federal government webinar on health reform Tuesday morning when the nationwide seminar ended abruptly, pending a “major announcement.”
The report, which came Tuesday afternoon from the Obama administration, was that employer mandates under health reform would be delayed until Jan. 1, 2015. Until then, employers with 50 or more full-time equivalent workers were expected to offer affordable, quality health insurance to those who averaged 30 or more hours a week or, starting next year, face annual penalties of $2,000 per employee.
“Though open enrollment for health insurance is less than 90 days away, I don't think they (officials with the Centers for Medicare & Medicaid Services) knew until yesterday the decision had been made,” said Pettigrew, a senior consultant with Edmond-based Group & Pension Planners Inc.
Pettigrew, his counterparts and employers across the Sooner state, breathed a sigh of relief with the news.
“We are relieved to have more time to make sure the process is ready to work effectively,” said Max Dubroff, human resources director for Oklahoma City-based Buy For Less and Uptown Grocery Co. “With all the changes in the regulations still occurring, it was unsettling.”
Dubroff said his company, which employs 1,170, was concerned mainly with the increased cost of moving the full-time qualification threshold to 30 hours. Current eligibility for health insurance is 38 hours, he said.
Sharon Hodnett, human resources director for 180 Medical, an Oklahoma City-based company that employs 250 and supplies urinary catheters and other durable medical equipment to consumers nationwide, said she's comforted with the reprieve in federal reporting requirements.
“We've passed the test of what employers have to do, but we want to make sure all facets are in compliance,” Hodnett said.
No news on Insure OK
Connie Prewitt, office manager of Stroud Health Care Center, said she's hopeful the delay could mean the federal government will extend Insure Oklahoma, a state-federal program that currently offers premium assistance to 28 of the 38 employees on her group health plan.
“Otherwise, we're looking at asking all employees to pay half of their premiums, and raising our deductibles if we have to,” Prewitt said.
But Insure Oklahoma spokeswoman Jo Kilgore said Wednesday the Oklahoma Health Care Authority recently submitted its expiration plan to federal officials and plans to start sending the official notification letters to insurance agents and businesses later this month.
“We have not received any indication from the federal government that the program can continue in its current form,” Kilgore said. “However, at the request of Governor Fallin, we are continuing to ask CMS (Centers for Medicare & Medicaid Services) to allow us to continue the program.”
The delay in the employer requirement doesn't affect Obamacare's requirement that individuals carry health insurance starting next year or face fines.
Penalties lack punch
Larry Gundlach of Oklahoma Business Insurors points out the individual mandate “lacks teeth,” with next year's penalty being $95 or 1 percent of annual salary. “Who's going to sacrifice their budget to buy insurance versus pay $95 or $200 a year (for a $20,000 salary) versus $200 a month?” Gundlach said.
Sierra Branch, 26, of Moore concurs. “I'm responsible,” Branch said. “I checked into it after I was kicked off my parents' insurance at age 26,” she said. “But it makes more sense for me to stay uninsured and if needed, self-pay where I've learned you can get discounts of 30 percent or more.”
Pettigrew believes the delay in employer mandates likely could spark a delay in the introduction of the federally-run online insurance exchange in Oklahoma. “They (federal officials) haven't done anything on time,” Pettigrew said. “They're just pushing the snowplow.”
Kevin Gordon, president of Crowe & Dunlevy and a member of the U.S. Chamber of Commerce Employee Benefits Committee, said the delay will give employers a chance to look at the insurance products offered in the exchange and “dovetail their group coverage in a way that makes sense.”
Blue Cross and Blue Shield of Oklahoma, which provides plans for many Oklahomans, will offer a similar portfolio of products on and off the exchange, spokeswoman Ashley Hudgeons said.
Businesses with 50 or more full-time equivalent employees must offer health insurance to employees who average 30 or more hours per week from the preceding year or pay annual penalties of $2,000 per full-time employee, excluding their first 30.
The formula to determine large employer status takes employees' total number of monthly hours worked during a designated three-month to 12-month measurement period. Employees who work more than 130 hours for the period are considered full-time.
If the company has fewer than 50 full-time employees, it also will want to count full-time equivalent employees by taking the total hours worked for a month divided by 120 then add the two together.
The waiting period for insurance for new hires can't exceed 90 days without penalty.