Expert Answers To Your Health Care Questions

Expert Answers To Your Health Care Questions

An official from HealthPartners answers questions regarding the latest in health care reform.

Questions not answered during our live October 23 webinar are addressed below by Julie Bunde, director of product management and product and market solutions at Bloomington-based HealthPartners.

Q. What penalty is there for small groups if too many of their employees obtain insurance through MNsure as individuals?

A. There is no “play or pay” penalty for small employers.

Q. Can employees who qualify for affordable insurance from their employer still purchase plans from the exchange?

A. Yes they can, but if they are eligible for affordable coverage of minimum value, they cannot access a subsidy.

Q. Are the employees of a large employer subject to the individual mandate required to have pediatric dental?

A. The essential health benefit does not apply to large employers and their employees, so no, they do not need to purchase pediatric dental.

Q. Are large groups allowed to use MNsure?

A. Not at this time. In 2016, employers with up to 100 employees will be considered small groups and allowed to use MNsure.

Q. If you have an individual dental plan that includes pediatric dental coverage, can you waive the purchase outside of the exchange?

A. The pediatric dental coverage must include all the benefits in the national standard and approved as such by regulators. It is unlikely that a current dental plan meets that standard.

Q. What should be top-of-mind for employers heading into 2014?

A. • Determine pay or play strategy for 2015
• No waiting periods longer than 90 days
• Review worker full-time status classification
• No annual dollar limits on Essential Health Benefits
• No pre-existing condition exclusions
• Some reform taxes apply