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16.6 million small business employees could benefit from ACA provisions starting this year
Date:9/1/2010

plans providing insurance to small businesses and individuals will be required to limit spending on administrative costs to not more than 20 percent of premiums. Health plans that exceed the limits will be required to give rebates to enrollees.

  • Annual Review of Premium Increases. Small business premiums could also be driven lower as the ACA requires the Secretary of Health and Human Services (HHS) and individual states to establish processes to review insurer's premium increases. HHS recently announced an initial set of grants to 45 states and the District of Columbia of $46 million to help states carry out premium review. In addition, health insurers will be required to justify unreasonable rate increases publicly, and insurers that demonstrate a pattern of unreasonable increases may be excluded from participating in insurance exchanges starting in 2014. The agency is to release guidelines on what constitutes an unreasonable premium increase.

  • Preexisting Condition Insurance Plans. Employees of small businesses who do not have coverage through their employers and who have been unable to secure health insurance because of a health condition will benefit from new Preexisting Condition Plans (PCIPS). Now available in most states, PCIPS will be open to people who have been uninsured for at least six months and who have a health problem that has made it difficult for them to gain health insurance. Premiums will be set for a standard population in the individual insurance market and cannot vary by more than a factor of four, based on age. The PCIPS will operate until 2014 when state insurance exchanges become available.

    The remaining ACA provisions that will most affect small businesses and their employees will take place in 2014, including:

    • Participation in State Health Insurance Exchanges. Five million workers are estimated to either gain health insurance or have their coverage stabilized and improved through their empl
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    Contact: Mary Mahon
    mm@cmwf.org
    212-606-3853
    Commonwealth Fund
    Source:Eurekalert

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