HealthCare FAQ’s for Group Plans

What’s a grandfathered plan?

A Group Health insurance plan that was in place before the law was passed on March 23, 2010 and has not made certain changes to co- insurance, co-payments, deductibles, and/or contributions to your employees.

Is there an employer mandate and what has changed?

The way the law was written, the employer mandate only applies to groups of more than 50 employer. The tax penalty for not providing insurance to groups over 50 has been pushed back 1 year. Groups are not required by law, at this time, to provide health insurance but every American is required to have a Qualified Health Plan or pay the tax. By providing a qualified group plan, neither you nor your employees are subject to the tax.

Have waiting periods on our group plan changed?

Under the new ACA employers can no longer have a waiting period of more than 90 days. To achieve this, many employers will need to have a waiting period that is 1st of the month following 60 days. If you have questions, please call our office at 918.451.9783. This applies to grandfathered and non-grandfathered plans.

Should I change my group plan to have a 12/1/13 renewal date?

If this is an option with your current plan then it is advisable, in most cases, to do a 12/1/13 renewal date change. Please call our office to find out if this is an option and how to get this done in time.

I’ve heard some companies are considering dropping their group coverage and sending their employees to the exchanges. Is this advisable?

We understand that every company is unique. At Derby Insurance Solutions we can help you make an informed decision. In most cases it’s not advisable to cancel your group plan and have you and your employee go to the marketplace exchanges. The main reason is, as of this date, the government website that calculates the subsidies is not working properly. So if you cancel right now you may have a gap in coverage since it is uncertain when the government website will be working. If you are not happy with your group plan, we will help you brainstorm your best option. Either way, Derby Insurance Solutions can help with your group plan or enrolling your employees and you in an individual federal marketplace health plan.

If I offer a group plan can my employees go to the individual exchange and receive a subsidy?

If an employer offers “affordable coverage” as defined by the Affordable Care Act then the employee and his/her dependents are not eligible for a subsidy. They can purchase a plan on the individual marketplace exchange, but even if they could qualify for a subsidy, they will not be eligible to receive one.

Can I keep my doctor?

The insurance companies we work with have great networks and you will probably not see many changes. We are not anticipating many people in Oklahoma losing their doctors. If you are concerned or want to double check, please call us, Derby Insurance Solutions at 918.451.9783.

Have the rates gone up?

Many years the rates have gone up somewhat. Although Oklahoma had a rate increase, the rates came in a lot lower than we expected.

Need Help Finding a HealthCare Insurance Plan?

Derby Insurance Solutions has been on the front line investigating how to help you make the best health insurance decision for 2014 and beyond. Call or contact us and we can answer questions, help you shop plan options and find you the lowest prices. Or go to click on “Enroll in a plan today” to shop or enroll.

We can help you find an affordable insurance plan that meets your health care needs!