Small Group Market

Fantastic news via the New Jersey Dept. of Banking & Insurance:

NJDOBI Adopts Regulations to Require Comprehensive Abortion Coverage in Department Regulated Health Insurance Markets

TRENTON – As part of the Murphy Administration’s efforts to protect access to reproductive health care, the New Jersey Department of Banking and Insurance today announced the adoption of rules to require comprehensive abortion coverage as a part of all health benefits plans regulated by the department. This requirement, which was in place as of January 1, 2023 in the individual and small employer health insurance markets, will now be in effect for the fully-insured large employer health insurance market upon plan issuance or renewal.

BeWellNM Logo

New Mexico's state-based ACA exchange, BeWell NM, has posted a powerpoint from a special Board of Director's meeting that they had last week.

For the most part it's unremarkable and full of inside baseball wonkery:

  • They're replacing WebEx with Zoom for video meetings
  • They're gonna split their Comms & Outreach into two separate divisions
  • They're preparing for the upcoming Medicaid Unwinding project

There's two items which are more noteworthy, however.

First, New Mexico is one of only three state-based marketplace (SBM) which handle premium bill payments as well as enrollment functions. The other two are Rhode Island and Massachusetts. Washington State's HealthPlanFinder tried dealing with payments within the exchange itself as well for a few years but eventually gave up on it due to it causing too many technical & administrative headaches.

District of Columbia

A few weeks ago I wrote about a bill pending in the District of Columbia Council, of all legislative bodies, which, had it passed, would have seriously undermined ACA protections for thousands of DC residents with employer-based healthcare coverage, as well as potentially setting precedent for similar bills in other states:

Yes, that's right: This is an attempt to bypass ACA rules for an industry which employs over 4 million people nationally (I don't know how many in DC specifically).

Again, here's what PEOs are:

Access Health CT Logo

via Access Health CT:

Access Health CT Waives Requirement for Certain Small Businesses to Enroll in a Group Health Insurance Plan Through December 15

  • Small businesses can enroll in group health insurance at any time of year, but they usually need a certain percentage of employees to participate in the plan

HARTFORD, Conn. (Nov. 23, 2022) — Access Health CT (AHCT) Small Business today announced it will waive the minimum number of employees typically required to enroll in a small group health insurance plan now through Dec. 15.

Small businesses can enroll in a group health insurance plan at any time of year. However, they usually need a certain percentage of employees to participate in the plan. During this period, any small business with 50 or fewer employees in Connecticut can enroll in a group health insurance plan regardless of how many employees participate.

District of Columbia

There's perhaps no other population center in the United States more Democratic-leaning than the heart of our nation's capital, the District of Columbia. In 2020, DC voted for President Biden by a whopping 88 points, giving him 93% of the vote. Every DC Mayor has been a Democrat since before DC even had a mayor (in 1967 DC's government was reorganized), and 11 of the District's 13 Councilmembers are Democrats...with the other two being listed as Independents.

You'd assume that DC's governing body would be a staunch supporter of both the letter and spirit of the Affordable Care Act, and for the most part you'd be correct.

And yet, somehow, in this liberal bastion, there's a decidedly anti-Patient Protection, anti-Affordable Care bill which has somehow managed to work its way into the Council's legislative proceedings.

Small Business

As longtime readers know, every summer/fall I run analyses of the annual premium rate change filings for both the individual and small group health insurance markets for all 50 states +DC. However, I tend to put most of my focus on the individual market, since that tends to have a lot more interest and activity surrounding it.

The individual market has been rocked by both economic and policy changes from year to year (in both good and bad ways) far more than the small group market, which hasn't been in the news nearly as much. You tend to read a lot of stories about the Individual Market (both ACA-compliant as well as so-called "junk plans" like Short Term, Sharing Ministries, Farm Bureau and the like), and of course the Large Group market is massive (something like 40% of the U.S. population), so even minor changes to that are big news...but the Small Group market (which generally includes companies with 50 or fewer full-time employees, though a few states include companies with 100 or fewer) tends to get short shrift in both the news as well as healthcare wonkery.

Holy smokes. A huge shout-out to Esther F. for the heads up on this. I have no idea how this story slipped under my radar the past few months:

Northam signs healthcare bill to provide relief to Virginia entrepreneurs
Published Wednesday, Apr. 11, 2018, 12:42 pm

Gov. Ralph Northam signed a new healthcare bill into law that will provide relief to many small business owners currently struggling with the Central Virginia insurance premium crisis.

Members of local advocacy group Charlottesville For Reasonable Health Insurance had provided testimony at the Virginia General Assembly and organized an email campaign, helping to ensure passage of the bill through the legislative session. Introduced by Sen. Creigh Deeds and effective July 1 2018, SB672 will allow self-employed people to take advantage of the much more affordable health plans in the small group business marketplace, without having to hire employees.

Thanks to David Snow for the heads up!

A couple of weeks ago, both Louise Norris and I crunched the South Carolina data and came up with different estimates of the weighted average requested 2016 rate hikes for the ACA-compliant individual market. She used a worst-case scenario and estimated it to be around 16.8%; I took a slightly more optimistic approach and came up with 15.2%.

Well, the South Carolina Dept. of Insurance just released their approved 2016 rates, and they ended up pretty much splitting the difference.

As you can see, even though there are only 5 carriers operating on the ACA exchange and another 5 offering policies off-exchange only, the overall average is still 15.9% either way: