What Small Businesses Need to Know
A small business is defined as a company that has up to 100 full-time employees.
Current HMSA groups
We’ve got great news for you. Because of decisions made by President Barack Obama and the state insurance commissioner, HMSA is offering you and your employees the same health plan you currently have year until the first plan renewal after October 1, 2016.
What does this mean for you? Several things:
- If you’re adversely affected by age rating, you can now choose to stay with HMSA and avoid age rating of your employees and their dependents for another year.
- If you renewed your policy with HMSA in 2014, you can keep your current plan until the first renewal after October 1, 2016. For example, groups that renew on July 1, 2015, can extend their plan through June 30, 2016.
- Please keep in mind that if you extend your current plan, your rate will be adjusted only to cover government fees and taxes and the expected rise in medical costs.
Premiums have changed
Health plan premiums for Affordable Care Act (ACA) plans are based on your employees’ age. Health plans for older employees may cost more than plans for younger employees.
Also, the federal government pays for health care reform changes with new fees and taxes imposed on health insurers nationwide, including HMSA. This adds costs to health plan premiums.
Benefits have changed
ACA plans include:
- Prescription drugs
- Ambulance service
- Emergency care
- Laboratory services
- Maternity and newborn care
- Mental health and substance use services
- Pediatric oral and vision services
- Rehabilitation and habilitative services
- Services for preventive care, wellness, and chronic disease management
Your part-time employees need coverage
You’re not required to offer health care coverage to your part-time employees who work less than 20 hours a week. However, if they don’t get coverage, they’ll have to pay a fine to the Internal Revenue Service (IRS). Those employees can buy an HMSA individual health plan directly from us or at healthcare.gov. Depending on their income, they could be eligible for financial help to pay for health insurance if they buy it healthcare.gov.
To-do checklist for employers
Health care reform requires you to:
- Report the value of your employees’ benefits on their annual W-2 form. Some employers are exempt from this requirement for now, including employers who file less than 250 W-2s, multiemployer plans, health retirement account plans, and self-insured plans not subject to COBRA rules.
- Starting in 2015, report your employees’ minimum essential coverage annually to the IRS. Large employers with at least 50 full-time equivalent employees must file additional information about fulfilling their responsibilities.
Do you offer your employees a B status plan under Hawaii’s Prepaid Health Care Act? If you do, state law requires you to provide coverage to your employees’ dependents and pay at least half of that coverage. If you don't offer a B status plan, you’re not required to offer dependent coverage.
Dependents can still get coverage by contacting us. We’ll help them choose a plan. They can also buy an HMSA individual plan in the on healthcare.gov. Depending on their income, they could be eligible for financial help to pay for health insurance if they buy it on healthcare.gov.
If you offer your employees family coverage, dependents up to age 26 must be offered coverage as well.
Remind your employees that health care reform requires almost everyone to get coverage or pay a fine to the IRS. And no one will be turned down for coverage, even if they have a serious health condition.
This information is based on HMSA’s review of the Affordable Care Act (ACA). This overview is intended for educational purposes only and should not be used as tax, legal, or compliance advice.