Survey Says: Some Large Employers Will Consider Dropping Group Health Coverage

By TOM MURPHY, AP Business Writer

INDIANAPOLIS (AP) — Nearly one of every 10 midsized or big employers expects to stop offering health coverage to workers once federal insurance exchanges start in 2014, according to a new survey from a large benefits consultant.

Towers Watson also found in a survey completed last month that an additional 20 percent of the companies are unsure about what they will do.

Another big benefits consultant, Mercer, found in a June survey of large and smaller employers that 8 percent are either “likely” or “very likely” to end health benefits once the exchanges start.

Employer-sponsored health insurance has long been the backbone of the nation’s health insurance system. But the studies suggest that some employers, especially retailers or those offering low wages, feel they will be better off paying fines and taxes than continuing to provide benefits that eat up a growing portion of their budget every year.

The exchanges, which were devised under the health care overhaul, may offer an alternative for their workers. These exchanges aim to provide a marketplace for people to buy insurance that can be subsidized by the government based on income levels.

A large majority of employers in both studies said they expect to continue offering benefits once the exchanges start. But former insurance executive Bob Laszewski said he was surprised that as many as 8 or 9 percent of companies already expect to drop coverage a couple of years before the exchanges start.

Such a move comes with potential payroll-tax headaches and could subject firms to fines. It also would give their employees a steep compensation cut if companies don’t raise pay in exchange for ending coverage.

“Dropping coverage is going to be very difficult for these (companies) to do,” said Laszewski, a consultant who was not involved with the studies.

Towers Watson’s Randall Abbott said the survey results should be seen as a snapshot of how companies are thinking now. They can’t be viewed as a final decision because there are still many unresolved variables. No one knows what the exchanges will be like or whether consumers will accept them, and companies may change their thinking once they learn more about the overhaul.

The health care overhaul also faces court challenges, and President Obama is up for re-election next year, two more variables that could shape what happens in 2014.

Copyright © 2011 The Associated Press. All rights reserved.

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Farewell to the ARRA COBRA Subsidy!

 

The federal COBRA subsidy, first available Feb. 17, 2009, covered 65 percent of the cost of COBRA health insurance premiums for up to 15 months. To qualify for the subsidy, recipients must have originally become eligible for COBRA as a result of an involuntary termination of employment occurring between September 2008 and May 2010. The subsidy was originally available to employees laid off from Sept. 1, 2008, to Dec. 31, 2009, but several extensions pushed the end date to May 31, 2010. The subsidy for the recipients who were terminated as late as May 31, 2010, will end on Aug. 31, 2011.

 The DOL has updated its FAQs page with questions related to the sunset of the ARRA COBRA Subsidy:

http://www.dol.gov/ebsa/faqs/faq-cobra-premiumreduction.html

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CCIIO Issues Guidance on HRAs and Restricted Annual Limit Waiver Process

  On Aug. 19, 2011, the Center for Consumer Information and Insurance Oversight (CCIIO) introduced supplemental regulatory guidance regarding the annual limit waiver application process. Specifically, the guidance clarifies that sponsors of stand-alone HRAs will not be required to seek waivers from PPACA rules that restrict annual dollar limits on the coverage of essential benefits.

As background, PPACA Section 2711 generally prohibits group health plans and issuers from offering coverage that imposes lifetime or annual limits on the dollar value of “essential health benefits,” but PPACA allows restricted annual limits with respect to essential health benefits for plan years beginning before Jan. 1, 2014. The waiver program is an application process permitted under PPACA whereby the secretary of HHS is permitted to temporarily waive the restricted annual limits for limited benefit or mini-med plans if compliance would result in a significant decrease in access to benefits or a significant increase in premiums. For plan years beginning on or after Jan. 1, 2014, all group health plans may not impose annual dollar limits on essential health benefits.

 Prior regulations provided that HRAs that were integrated with group health coverage were exempt as long as the other group health coverage complied with the restricted annual limit requirements, meaning a waiver would not be needed. In those prior regulations, the CCIIO also requested comments on the process that should be imposed with respect to stand-alone HRAs.

 The new guidance recognizes that “all HRAs set limits on the amount that can be spent” and that the limits would always be less than the applicable restricted annual limit amounts, which would ultimately result in a “significant decrease in access to HRA benefits.” Therefore, the guidance “exempts as a class all HRAs that are subject to the requirements of Section 2711 and that were in effect prior to Sept. 23, 2010, from having to apply individually for an annual limit waiver for plan years beginning on or after Sept. 23, 2010, but before Jan. 1, 2014.” This means that HRAs established prior to Sept. 23, 2010, which were otherwise subject to the restricted annual limit requirements, such as stand-alone HRAs, have been granted a waiver from the requirements without the need to actually request a waiver.

 Significantly, while stand-alone HRAs are now exempt from the restricted annual limit waiver process, they still must comply with the record retention and annual notice requirements contained in the “Technical Instructions for the Waiver Extension and Waiver Application Process,” available below.

 Finally, if an employer that maintains an HRA also maintains other coverage, whether or not that coverage is integrated with the HRA, that other coverage must meet the annual limit requirements or obtain a waiver. All waiver and waiver extension applications must be received by Sept. 22, 2011, as set forth in the previous guidance issued on June 17, 2011.

 Technical Instructions for the Waiver Extension and Waiver Application Process
CCIIO Supplemental Guidance
Additional Information

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