Newspaper article Pittsburgh Post-Gazette (Pittsburgh, PA)

Firms Face Big Changes in Benefits Health Premiums Set to Soar for Some

Newspaper article Pittsburgh Post-Gazette (Pittsburgh, PA)

Firms Face Big Changes in Benefits Health Premiums Set to Soar for Some

Article excerpt

It looks like one of the more innocuous provisions of the federal Affordable Care Act: Beginning Jan. 1, businesses with 51 to 100 employees will be grouped with smaller businesses for health coverage purposes.

Turns out, the implications may be more wide-ranging than those employers, or their workers, realize. A whole new layer of administrative and premium costs may be landing in their laps with the new year.

Among the possibilities and, in some cases, certainties: New regulatory requirements, less flexibility in designing health plans, more forms to fill out and - particularly for those who've filed few claims in the past - premium hikes in excess of 50 percent.

"It's a big deal," said Sam Denisco, vice president of government affairs for the Pennsylvania Chamber of Business and Industry in Harrisburg. "I think it's going to capture a large segment of the business community."

As it stands now, small-group requirements such as covering a list of minimum "essential health benefits" applies only to businesses with 50 or fewer employees. The change will bring larger companies under the requirements, with the goal of increasing the number of businesses subject to the stepped-up insurance requirements.

Once the 51-100 employee firms are moved into the small-group category, the estimated 160,000 or so employers with more than 3 million workers will be required to offer one of the metal plans - platinum, gold, silver or bronze. That means they offer the ACA's designated 10 essential health benefits such as emergency services, hospitalization, mental health and substance abuse treatment, maternity and newborn care, and prescription drugs.

Highmark spokesman Aaron Billger said the Pittsburgh insurer has 225 client companies that fall into that 51-100 employee bracket, providing coverage for 29,500 individuals. …

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