A "staggering" number of small businesses are postponing compliance with the Patient Protection and Affordable Care Act through such responses as pushing back health plan renewals dates to Dec. 1.
A large-scale study of employers that offer health care to their workforce by United Benefit Advisors revealed a massive shift toward the Dec. 1 date last year. Such actions are making it difficult to assess the true impact the PPACA will have on business, United Benefits Advisors said.
The numbers of small business renewal plan shifters are impressive: In 2012, 507 employers with 50 or fewer employees in the survey group had Dec. 1 renewal plan dates. In 2013, that had grown to 2,598 — a 412 percent increase.
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Most of those employers were based in states that didn't grandfather in existing plans. The Dec. 1 renewal date trend, coupled with the number of employers in grandfathered states who renewed non-PPACA compliant plans, has pushed back the full impact of PPACA, UBA noted.
"This trend shows overwhelmingly that the full impact of PPACA compliance and its effect on health insurance costs is still unknown, but paints a gray picture of what's ahead for employers," said UBA CEO Les McPhearson.
For all employers, UBA said, those delaying health plan renewals until Dec. 1 increased 322 percent from 2013 to 2014. Fully one-third of all employers postponed the date, according to UBA's research.
"Of the 32 percent, 94 percent were small businesses in the under 100-employee market. Based on current renewal rates coming in from carriers, in the states that did not allow renewal of pre-PPACA plans, many small employers are facing rate increases of 30 percent to 160 percent, UBA finds. Given that a number of states allowed pre-PPACA plans to renew, delaying the effects even further, the full impact of PPACA is still largely unknown," UBA said.
UBA also found that out-of-pocket maximums jumped considerably from 2013 to 2014 (6 percent) as employers used this to shift costs to the workforce.
"The median single OOP maximum increased $500 to $3,500 and median family OOP maximum increased $1,000 to $8,000. The increase in medians was more than double the increase in average OOP maximums for both single and family, which both went up less than $250," UBA reported.
Meantime, no-deductible in-network plans, which comprised 21 percent of plans surveyed in 2013, stayed fairly stable at 20 percent in 2014. Plans with out-of-network no-deductible design fell slightly more, from 8 percent to 6.9 percent, and from 9.8 percent for a family in 2013 to 8.1 percent in 2014.
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Dan Cook
Dan Cook is a journalist and communications consultant based in Portland, OR. During his journalism career he has been a reporter and editor for a variety of media companies, including American Lawyer Media, BusinessWeek, Newhouse Newspapers, Knight-Ridder, Time Inc., and Reuters. He specializes in health care and insurance related coverage for BenefitsPRO.
