Health & Life Insurance Actuaries | Lewis & Ellis Inc.

New health insurance enrollment law could change coverage for many

Health Care and Health Insurance
by David Dillon
States continue to grapple with changing health insurance market
States continue to grapple with changing health insurance market

The vast majority of Americans with health insurance get their coverage through their employers, a fact which was not changed by the Patient Protection and Affordable Care Act's coverage mandate that went into effect last year. However, experts now warn that the ACA might end up having an impact on the type of coverage they have, particularly for 2015, and that they will therefore have to examine their plans closely for the coming year.

The ACA specifically states that businesses with 50 or more full-time employees will have to start providing health insurance coverage to all those fitting into that category, and it could end up having a major impact on the kinds of care consumers can receive through their policies, according to a report from the Wall Street Journal. While the vast majority of companies that fit into this category already provide their workers with such insurance, there are still some which do not, and thus those people would likely see little change in many cases.

However, others might find themselves offered health insurance by their employers for the first time, and those people might be the ones who have to pay the most attention to the offerings, the report said. That's because those policies might be fairly bare-bones in terms of the kind of health coverage they actually provide, and as such they might not meet employees' individual basic needs.

So what can be done?
When offered new policies in the next few months - most employees have open enrollment in October and November, specifically - workers will have to closely evaluate the coverage available to them to see whether it will meet all their personal requirements, the report said. Some insurers might not cover spouses on these plans, and others might not allow for special kinds of treatment that might be vital to a family's ongoing personal and financial wellbeing (especially in the case of plans that come with higher deductibles than a worker would like). In these cases, consumers might end up having to head for the state- or federally run exchanges and buying their coverage instead.

Health insurance companies, therefore, might want to be there to help pick up the slack when employers' offerings fall short for certain employees. This may be done by offering coverage that's as comprehensive as is reasonable given the affordability most consumers typically want out of these plans, and doing more to help connect people with plans that work for them.



Consultants to Contact