Communities: Benefit Enrollment & Eligibility

Consumers Brace for the 2014 Enrollment Season

By CYC Staff

Originally published at

The Obama administration's announcement on July 2 that the employer health care mandate will be delayed until 2015 has been the subject of fierce debate over the last week.

The mandate – an eagerly anticipated provision of the Patient Protection and Affordable Care Act, requiring employers with more than 50 workers to provide affordable health insurance options – was ostensibly postponed to provide employers with additional time to enhance their reporting systems.

Under the current provision, employers are tasked with offering verification of health care coverage options for workers if staffing levels exceed 50, or else business operators will be subject to a penalty of up to $3,000 per employee.

By delaying the mandate, the Obama administration has given company owners the opportunity to better plan and adjust their corporate spending and overarching business models to accommodate the coming health reform, but what should consumers expect over the next year as the delay goes into effect?

Many experts in the industry believe consumer-directed health care (CDHC) will emerge as a viable alternative for consumers in search of coverage options, where income eligibility requirements may be less stringent. Consumer-directed health plans (CDHPs) often pair a high-deductible health plan (HDHP) with a health savings account (HSA) or a health reimbursement arrangement (HRA) to enable consumers to stash tax-advantaged funds away for later use when faced with eligible out-of-pocket expenses.

Specifically, this could appeal to part-time and seasonal workers who may be influenced by financial constraints when it comes to purchasing within health insurance exchange marketplaces.

"These may be among the first consumers who head to the public exchanges, along with people who are unemployed or face the offering of an unaffordable company plan," Dave Marini, division vice president and managing director at Automatic Data Processing Strategic Advisory Services, told Fox Business News. "Affordability is a huge factor in health benefits purchasing."

Bracing for the delay

Overall, health care spending rates have declined – a trend that eschews post-recession historical patterns and effectively places the consumer at the forefront of health care spending.

In a recent report released by the PwC Health Research Institute, health care spending is projected to grow at 6.5 percent, which is the slowest annual rate the industry has seen in 50 years.

"The first [trend] is bringing consumerism mainstream. Consumer-directed health care plans have generally been offered as an option, but increasingly will be offered as an employer's primary benefit plan," Mike Thompson, a principal in PwC's global human resources service practice, told Human Resource Executive Online.

For consumers in search of consumer-directed health care as the delay goes into effect, there are a few crucial elements to keep in mind.

Specifically, individuals should be mindful of insurance rates within their respective states, as these can vary considerably from place to place. Those who ask questions and do intend to take advantage of employer-sponsored plans for preventative care services may be able to save more money by discovering new options.

But more than anything, taking the incentive to pursue individual options within the health insurance exchange marketplace can be an effective way to continue having optimal medical coverage when it's needed most.

Note: Content provided is not intended as legal or tax advice.

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