Are you ready? Open enrollment is only six months away

Corporate Synergies' Compliance Department experts

While The Patient Protection and Affordable Care Act (PPACA) is designed to provide health insurance to millions of uninsured Americans, at a “nuts and bolts” level, changes in the law are currently creating more questions than answers.

A good example is the upcoming open enrollment for public healthcare exchanges. The initial open enrollment is scheduled to begin October 1, 2013, and continue through March 31, 2014. During that period, qualified individuals may enroll in an exchange.

Here’s the problem. There’s not a lot of information available yet on open enrollment. The only thing we know for sure is the scheduled October 1 date. We are just six months out and so far the government has released few details to help employers, brokers, carriers and healthcare providers prepare for changes.

Given that there is very little guidance, the most important thing you can do is gather information as it emerges. Is your organization even eligible to use the exchanges? For mid-sized organizations, defined as employing over 100, open enrollment is not going to have much of an effect. That’s because your employees are likely to already be offered affordable coverage through your organization and therefore would not be eligible for enrollment in a healthcare exchange. In that case, open enrollment is a non-event.

On the other hand, if you are a small employer (under 50 employees), open enrollment on the exchanges could be more of an event. Under the Small Business Health Options Programs (also called SHOP Exchanges), a qualified employer may join at any point during the year.

The only way for an employee to get on an exchange is if he or she is not offered group health insurance by the employer that meets certain minimum standards (including affordability). It is believed that public exchanges will not come cheap, and there are planned subsidies to assist those with an income that is between 100 to 400 percent of the federal poverty level, and are not already enrolled in any government sponsored health programs (including Medicare and Medicaid).

A large majority of employees will not be eligible for public exchanges, and therefore, October 1 will arrive without a ripple. It’s never a bad idea, however, to keep informed of developments in the law to ensure compliance.