Watch Harry Bickel Speak on the Road To 50 Employees
Are you going to reach 50 employees in 2024?! Growth comes with new requirements to your health insurance coverage. Under the Affordable Care Act, companies with 50 or more full-time equivalent employees (including a mix of full-time and part-time staff) are considered large employers. These employers must follow specific rules, including offering affordable health insurance (defined as at least 30 hours per week for full-time employees), meeting IRS affordability guidelines, and filing reports on employee coverage. There are also changes to health insurance plans for these larger companies, such as switching from age-based rates to four set tiers and a greater focus on claims history for plan pricing. This may require employers to adjust how much they contribute to employee health insurance costs.
Horizon and Advocare Reach Agreement
Horizon BCBSNJ reached a multi-year agreement with Advocare to keep them in-network. This means patients can continue seeing their Advocare doctors without disruption. Horizon is committed to providing affordable access to quality healthcare.
Healthcare Costs Rising: CMS Releases Report on Health Spending & Insurance
The Centers for Medicare and Medicaid Services (CMS) recently released its annual report on national health expenditures (NHE) and health insurance enrollment. The report projects that healthcare spending will continue to grow faster than the overall economy for the next decade. Here are some key takeaways:
- In 2023, the percentage of insured Americans reached a record high of 93.1%, contributing to the 7.5% growth in national health spending.
- This growth is expected to continue, with NHE projected to outpace GDP growth over the next ten years. This means healthcare costs will rise faster than the overall economy.
- The rise in private health insurance enrollment is expected to slow down in 2026 when temporary government subsidies expire.
- Spending on prescription drugs is expected to grow at a relatively high rate (6.0%) due to new drug introductions, but Medicare is projected to see some savings due to price negotiation.
IBX and AmeriHealth Platform Transition Data
There’s an important update about Independence Blue Cross (IBC) and AmeriHealth plans. They’re moving to a new system by August 2025 to improve the member experience. This will involve assigning new ID numbers to everyone enrolled in these plans. More information to come on how to keep your employees informed.
Compliance Corner!
The Consolidated Appropriations Act (CAA) requires health insurance providers to ensure equal coverage for mental health and substance abuse treatment compared to medical and surgical care. This law has been in effect since 2021 but specific guidelines for compliance are still being finalized. Employers offering group health plans should be prepared to navigate these new rules soon.
Rob is an employee benefits expert with over 25 years of experience. He is the founder and principal of Precision Benefits Group, a leading provider of corporate benefits plans. He is a member of the Philadelphia Business Journal Leadership Trust and regularly contributes to the publication.