The transformative health insurance provisions of the Patient Protection and Affordable Care Act take effect in January. Many employers will need time to review the options being created and calculate how best to respond to the individual and employer mandates of the act.
To begin to understand the issues involved, I spoke with David Morgan, a senior employee benefits adviser of the San Luis Obispo-based insurance broker Morris and Garritano.
Morgan explained that many details of the new insurance options are now resolved but many are still being finalized. Even though the new program isn’t effective until January 2014, now is the time to begin researching options.
For example, organizations with 50 or more employees must offer health insurance coverage to fulltime employees or pay a fine. Insurance providers are reformulating group plans that will be announced during the summer.
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Organizations with fewer than 49 full-time equivalent employees will need to decide if the employer will offer a group policy or ask employees to enter the statewide insurance buying pool. If the employer doesn’t provide insurance coverage, the individual must buy coverage somewhere or pay a fine. Lowerincome individuals may be eligible for financial assistance through the buying pool.
One predicament is that the premiums for the individual policies in the buying pool cannot be set until the number of buyers is known. Covered California ( www.covered ca.com ) has a premium estimator that will be adjusted throughout the year. The website also has a lot of information about the buying pool and requirements of the Affordable Care Act.
A local opportunity to learn about the new requirements is to attend the Employer’s Advisory Council meeting May 31. The half-day seminar will be at the Paso Robles Ballroom at the Paso Robles Inn. Call Louise Matheny at 543-6887 for more information.
Barry VanderKelen’s Nonprofit Strategies column is special to The Tribune. He is executive director of the San Luis Obispo County Community Foundation. Reach him at firstname.lastname@example.org.