According to the regulations for health care reform issued by the federal government, the authority over whether or not large companies can buy coverage through the new health exchanges will be given to the states, beginning in 2017.
These state health exchanges are to play a central role in the Patient Protection and Affordable Care Act. The first wave of availability will begin in 2014, when it will become available to businesses with 100 employees or less, and individuals; particularly those who qualify for subsidies for federal health insurance premiums.
However, states will hold the authority to limit the participation of employers to companies with 50 employees or less until 2016.
According to the regulations from the Department of Health & Human Services, as of 2017, the states are then allowed to make their exchanges available to companies with over 100 workers. That said, the states will also have the authority to outline the terms of the participation, such as the number of employees for whom these bigger companies can purchase coverage through the health insurance exchanges.
The regulation states that “The scope of the term “qualified employer’ is expected to vary among states and over time.”
Senior vice president of health care reform Paul Dennett, from the Washington-based American Benefits Council, said that the actual definition of a large employer may be different from one state to the next.
Moreover, as they are, the current regulations identified for the exchanges does not mention whether early retiree health care plans will qualify for coverage purchased through them, or to what degree business will need to pay a portion of the premiums for those retirees.
Additionally, the regulations have not yet addressed the reporting responsibilities of businesses in circumstances when workers apply for additional health exchange coverage.