David Platt with Blue Cross Blue Shield of Alabama, October 8, 2013
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Our Speaker, David Platt of BCBS of Alabama spoke on a variety of different aspects of the new Affordable Healthcare Act. Premiums will be affected beginning January 2014 for differences between fully insured vs. Self Insured. Employers must provide essential health benefits according to Alabama law. The mandate is that employers with more than 50 employees MUST offer a plan, and it must be affordable (cannot cost more than 1.5% of employees pay) or pay a fine of $3K per employee. Not offering insurance is not an option! If one employee were to go to the exchange and buy separately the employer would still have to pay the penalty. There will be a subsidy for families that are up to 400% of the National Poverty Level.
If you want further information you can go to the website to get more help in understanding at: http://www.hcralabamablue.com and you are also welcome to call. The things you should know about the Healthcare Reform Act are:
• That it is a “guaranteed issue” policy that does not exclude pre-existing conditions.
• The plan design changes to meet benefit and actuarial value requirements.
• There is no gender rating
• Child only policies are available
• One time open enrollment annually after the first year
• Age ratting limited to 3:1
• 90 Day Grace period on payments
• It is a member level rating – in other words no more flat rates per family. (This could be positive for a small family, but higher payments for large families.)
NOTE: The only other insurance competitor with BCBSAL is only offering coverage in three counties of the state.
Not having coverage is no longer an option. Employees must either carry insurance that is offered by their employer or buy their own through the exchange – by proving that they are not offered affordable insurance through their employer.