A major component of the Affordable Care Act is guaranteed preventive care services at no cost to any person with healthcare insurance. At first glance it would appear that free preventive care would include annual wellness exams from the subscriber’s primary care physician along with other yearly checkups at no cost to the subscriber. However further review of this mandate makes it clear that it has a much broader intention.
When an employee drops dependents and spouses from our company’s group health plan during open enrollment, we provide the dropped individuals COBRA election materials. But our new COBRA third-part adviser is telling us that we don’t have to provide a COBRA election notice to dependents and spouses who are dropped at open enrollment. Is our plan required to offer COBRA coverage to these individuals?
Large employers have self-insured their health benefits for decades. In fact, 93 percent of employers with at least 5,000 employees were self-insured in 2012, according to a Kaiser Foundation survey. Compare this with just 15 percent of self-insured employers having fewer than 200 workers. If the survey was taken today, the 15 percent figure would likely be higher. This is because previously, in most geographic markets, there had been plenty of competition among insurers interested in providing health benefits to smaller employers, and most offered plenty of flexibility in plan design. That’s all changing.