Oregon Health Exchange - Open Enrollment

Open Enrollment begins on November 15, 2014
Open enrollment for individuals begins on November 15, 2014 and is open until February 15, 2015.  During open enrollment individuals may buy a health insurance plan from the exchange for the first time or shop around for a different plan. 

Once purchased, the new plan can go into effect in as little as 30 days. In reviewing the CoverOregon.com website it appears that individuals shopping for private health plans will go to the CoverOregon website to make sure that they qualify for a non-employer plan.  If they do qualify they will be directed to the Federal exchange website, HealthCare.gov, to see if they qualify for a subsidy, shop for a plan and to purchase coverage. 

Small businesses, like all businesses, do not have to wait for open enrollment to shop for coverage.  But the beginning of the New Year might be a good time to evaluate you and your employee's options. Prices on plans in the exchange were were released in July.  Overall, prices seem to have gravitated lower and towards the center even though carriers presumably did not have enough data to make a change actuarially.  The new pricing might be an opportunity to save money or find a better fit but keep in mind how your decisions can impact your employees. For example, is it better for you to offer a small group plan or better for your employee to use the exchange and get a subsidy? An employee making $11.00 per hour, is 35 and does not smoke could obtain a $1,789 subsidy for him or herself in the exchange while coverage would cost $1,300.  Remember, if you offer a health care plan your employees will not qualify for a subsidy in the exchange.  Thus if an employer pays 50% of the premium then health insurance would cost the employee $244 more per year for the same coverage.  If you want to review different scenarios here here is an online subsidy estimator in which you can enter your employee’s annual income and obtain an estimated subsidy.

Many of the small business owners I interact with are very concerned about their employee’s overall welfare. But finding out what is best for you and your employees may be difficult.  Any conversation may also have the unwelcome effect of learning too much about your employee(s).  You have no business need to learn of any health concerns much less want to be exposed to some type of risk of discrimination because of what you learn. On the other hand small businesses tend to know their employees and this topic may be something they would welcome to provide input on.  For example, an employee may need a gold plan while you want to offer a bronze.  Or you have a young workforce that thinks they are still indestructible and do not want to pay for half of a more expensive gold plan even though you would prefer that option.  Try to keep any conversations focused on what their needs may be not what they need coverage for. Be sure to set expectations in line with what you can afford to offer and fits you and your business needs.

Arin J. Carmack

Risk Management