The Patient Protection and Affordable Care Act of 2010 man- dates that each state have a Healthcare Insurance Exchange in place by January 1, 2014. If we assume that the act will be deter- mined to be in tune with the Constitution, then the establish- ment of state (or Federal) exchanges will likely have a mate- rial affect on most employer healthcare plans.
First of all, what is an exchange? In layman’s terms, exchanges could simply be iden- tified as a community web-based tool that should enable the con- sumer to obtain quick access to all of the various insurance offerings available in each state. Rules governing exchanges will provide for standard plan designs (Platinum, Gold, Silver and Bronze) so that the consumer can determine his/her best option, and states will be responsible for reviewing and approving all plans offered. The task that will likely prove most difficult for your employees will be to ascertain how the various exchange offer- ings compare with your company’s plan offerings. Several factors will make this a complicated decision:
1. Will I qualify for a subsidy?
2. If I do qualify, how much will it reduce my plan cost?
3. How will the final net exchange plan’s value com- pare with the value of my employer subsidized plan?
4. What can I expect will be my out of pocket costs and can I afford that level of risk?
5. How will the network of par- ticipating medical providers compare?
6. Can I expect the same qual- ity of service that I have with my current employer plan? Since subsidies are available
even at 400% of the Federal Poverty Level and below, the majority of employers will have current covered employees who may be eligible for a subsidy, or a Free Choice Voucher depending on the amount of the employer contribution you require. And remember, if you have more than 50 employees, you can be penal- ized for employees who leave
your plan to choose a subsidized exchange plan. Those employees who are below 139% of the FPL will be eligible...