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Tennessee Healthcare Exchange Update

The Obama administration recently revealed plans to delay additional health insurance options for small employers through the healthcare exchange program until 2015. At the same time, small groups may realize significant savings renewing early, and individual policy options are rapidly evolving towards a January 1, 2014 implementation date. Are you on top of the situation? Read more…

Tennessee Healthcare Exchange Update
While the Tennessee Exchange will still be operational as of January 1, 2014 for individual coverage, the Small Business Health Options Program (SHOP) for small group coverage multi-carrier options will be delayed until 2015. There may be a single plan option offered for small groups beginning Jan 1st, but pricing and plan design is still not defined.

Individual Policies
Individual policy rates and plan outlines won’t be available until the fall. Individuals will have to fill out an extensive application, and provide a W-2, social security number, and any policy numbers and employer benefit information. There will be no underwriting or health questions, and rates will be based on sex, age, and geographical location. There will be no exclusions for pre-existing conditions on these policies.

Coverage for small groups (less than 50 employees)
Small groups (less than 50 employees) will be limited in 2014 to a $2,000 maximum deductible for the individual, or the actuarial equivalent. It may be possible for a small group to offer a $3,000 deductible with 100% coinsurance, but right now this is a matter of interpretation. Additional guidance, and a plan calculator to help you determine if your plans meet the actuarial requirements, should be forthcoming in the near future.

Small groups should consider renewing early on December 1, 2013!
A loophole in the provisions does allow an early plan renewal for small groups. An early plan renewal can delay some of the more expensive healthcare reform requirements that begin with renewals in 2014. (Large groups of more than 50 are not permitted to do early renewals solely to avoid health care reform provisions.)

Many carriers are actively discussing early renewals and projected costs with a December 1, 2013 renewal. While this may not make sense for every group, it is worth considering!

If this all seems a little overwhelming, Century II can help. If you have any questions or want to discuss these issues further, don’t hesitate to contact us or call (615) 665-9060.
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