How else will these coverage changes affect employers?
All health plans must extend coverage to eligible adult children until they turn 26 (grandfathered plans can eliminate coverage if the child is eligible for a plan with his or her employer). Employers must implement the change for the first plan year starting after Sept. 23. Ohio law has been revised to extend coverage in some circumstances until the child attains age 28. Plans will need to open coverage up for children that had come off the insurance rolls because they no longer met the prior eligibility criteria.
How can a company begin to prepare for open enrollment?
Companies need to start talking with their brokers to determine how their rates will be impacted by the mandates that are going into effect for the coming year. They will need to compare the costs of maintaining their present policies, amended as required or as limited to stay grandfathered, to the costs of simply complying with all of the mandates. Until you decide whether to remain grandfathered, you need to ensure that you do not inadvertently make changes that will cause the plan to lose such status.
With the very limited changes you can make, will the cost of renewing your present policy work for you, or are you better off giving up your grandfathered status, which will allow you to make changes to your employees’ co-pay, the policy and other items?
How will these various changes impact collective bargaining?
Your health insurance plans that cover your union employees will be treated as grandfathered plans until the expiration of the present collective bargaining contract (assuming it was ratified before March 23, 2010). This is true even if you make changes permitted under the collective bargaining agreement that would have otherwise caused a regular plan to lose its grandfathered status. However, an employer going into union negotiation needs to be prepared to address the benefits of attempting to remain grandfathered and how those additional costs will be shared by the employer and the employees.
Dale R. Vlasek and John M. Wirtshafter are attorneys at McDonald Hopkins LLC. Reach Vlasek at (216) 348-5452 or [email protected]. Reach Wirtshafter at (216) 348-5833 or [email protected].
