Overall, health insurance can change dramatically from one year to the next, and 2017 was no exception. While every new, required inclusion raises the standard of care available to your employees, it is important to remember that premiums also rise when new services are required.
For 2017 several new benefits were added to the Essential Health Benefits (EHB) package and, therefore, included in all Affordable Care Act (ACA)-compliant health plans:
Several changes go into effect for ACA-compliant employer group health insurance plans in 2018.
The annual cost-sharing limitation – that’s the insured’s annual out-of-pocket maximum, the most they will pay out of their own pocket for covered services during the benefit year – increases from $7,100 for individuals and $14,200 for families to $7,350 for individuals and $14,700 for families. Many plans are designed with lower out-of-pocket maximums than this, but this is the highest out-of-pocket allowed. This higher out-of-pocket limit helps health plans price a plan more economically but doesn’t negatively impact those employees and families who don’t use enough health care to reach that limit.
In Part 2 of this group health insurance series, we talked about the small employer group “metal” plans, named Bronze, Silver, Gold, and Platinum by all carriers to make comparing plans easier for purchasers. These plans cover 60 percent, 70 percent, 80 percent and 90 percent of covered expenses, respectively. But, because it’s difficult to meet that percentage exactly, the ACA allowed metal plan coverage to range plus or minus two percentage points. So, for example, a Bronze plan could cover from 58 to 62 percent of expenses.
Starting in 2018, the ACA widens that range a bit more. This gives carriers more leeway in their plan design and could result in a wider variety of plans available, especially at the Bronze end of the metal levels. This may make it easier for employers to find the right balance of benefits, coverage, and premium.
A new coverage mandate coming in 2018 in Colorado is not a federal mandate under the ACA. All ACA-compliant in plans in Colorado, except for Health Savings Account (HSA)-eligible High Deductible Health Plans (HDHP), will cover 80 percent of the cost of prosthetic devices for arms and legs and that coverage is not subject to a deductible.
This five-part series is a brief overview of employer group health insurance and employer’s requirements under the Affordable Care Act. If you have additional questions or concerns, contact the Rocky Mountain Health Plans Employer Group team at 800-453-2981, option 3. We’re happy to help.
If you aren’t familiar with RMHP and how we can help, keep reading to learn a bit more about us.
At Rocky Mountain Health Plans (RMHP), we offer a variety of health insurance plans and options to help employers like you take care of their valued employees. Our goal has always been to give Members access to the care they need most. This goal truly drives the way we’ve operated for more than 40 years.
When you’re choosing the best group health insurance plan for your unique needs, we’d like you to consider us the way you would any other provider.
Healthy lifestyles are a mainstay here in Colorado, and we want to make it easier for our Members to get fit and reach their goals. To do this, we provide CaféWell by RMHP, a comprehensive online, wellness portal offering coaching, educational programs, and community discussions at no additional cost.
RMHP also offers an alternative to the high costs and long waits often found in Emergency Rooms and Urgent Care Centers.
Finally, we know health insurance can seem complex. Our Small Group Management Team based in Grand Junction makes it easy for you to speak to a real person, right away. We invite you to contact us with any and all questions – whether it’s about enrollment, adding a spouse, COBRA coverage, or any other topic. We’re here and happy to help.
Whether you’re ready to enroll or simply gathering information, we’re here to help. Our team has years of experience helping small and large businesses choose the best coverage for their employees. They can help you explore your options to find the plan that best fits your group.
Reach our Sales Team, Group Management, and Customer Service teams between 8:00 a.m. and 5:00 p.m. Mountain Time by phone, email, and mail.
RMHP Employer Sales Team
800-453-2981, option 3
Group Management Team Phone
800-453-2981, option 1
Customer Service Phone
Grand Junction - Corporate Headquarters
Have you missed any posts in our group health insurance series?