Offering health insurance to employees can be accessible to DC small businesses, even those with only part time workers and little funding to put toward employer contributions. CHAMPS members received some great insights on offering health insurance during our September 6 education breakfast with Debra Curtis, Deputy Director for Policy with DC Health Link.
Below are key takeaways and tips from the discussion. The top two are definitely worth reviewing, as they help address concerns small business owners have about cost or lack of full time employees to participate.
Key takeaways and tips:
- There is no deadline or enrollment period for businesses, but employers that apply to offer coverage that goes into effect on January 1 do not need to meet the 50% employer contribution or the requirement that two thirds of eligible employees participate or have a valid waiver. And that lower contribution carries forward in future years. If enrolling at other times of the year, the small business must commit to paying 50% or more of the premium. This discounted coverage date is noted here on DC Health Link, under “More Control.”
- What about part time employees? To participate in health insurance through DC Health Link, a business must have at least 1 full time equivalent (FTE). This means an employer can aggregate part-time workers hours — even if all workers are part time. Employers determine which employees are eligible employees. Employers are required to offer coverage to all full-time employees working 30+ hours/week. If an employer wants to offer insurance to employees working less, they can and they are responsible for determining that and enforcing it in a fair and nondiscriminatory manner. You can also check out this eligibility calculator at DC Health Link.
- Start the process early. If an employer decides to offer insurance, start the process early, and understand there is a 30 day waiting period. So get started two months before you want to offer coverage. Timing is particularly important if you want to take advantage of the January 1 coverage date to provide insurance at a lower than 50% employer contribution. And remember the first month’s premium must be paid by the 12th of the month in order for coverage to be effective on the 1st of the following month.
- Sole proprietors must purchase insurance on the individual exchange, although the group exchange does have greater options.
- DC insurance rates through DC Health Link are generally lower than surrounding jurisdictions. This is because DC has a younger population, which is more competitive for lower insurance rates. Also DC requires insurers to participate in public hearings through DC Department of Insurance, Securities and Banking, so there is strong competition among carriers. Insurance rates for 2019 will be publicly available later in September.
- DC has enacted an individual mandate for health insurance, meaning that in 2019, all DC residents must have health insurance or must pay a tax penalty. The federal individual mandate will end at the beginning of 2019.
- There is no cost to a small business using a broker through DC Health Link. Businesses are strongly encouraged to reach out to find a broker. A broker can be extremely helpful in navigating the system and answering questions particular to your business situation. But if you aren’t getting your questions answered, don’t hesitate to reach out to DC Health Link directly.
- Businesses that offer health insurance, even if it isn’t on the exchange, must pay their premiums monthly through DC Health Link. There’s currently no way for DC Health Link to accept monthly recurring autopayments. However, CHAMPS members suggested DC Health Link figure out a way to at least auto populate the monthly payment form, so employers don’t have to type the information in every time, and ultimately move toward autopayments.
- Vision plans – While not a plan offered through the small business DC Health Link program, there is a vision plan that is an individual product that is available to District residents. The button is on the bottom of the front page of DC Health Link and says “VISION COVERAGE”. Check it out here.
The benefits of the exchange are:
- Choose health insurance coverage from Aetna, CareFirst, Kaiser Permanente and UnitedHealthcare;
- Choose from over 100 different plans;
- Set your employer contribution level;
- Choose the plan options you want to offer to your employees; and
- Access to a DC Health Link certified broker to help with plan selection and enrollment at no cost to you.
- Federal tax credits available to certain qualified small businesses
To be an eligible small business to participate in the exchange, a small business must:
- Have a valid EIN
- Have between 1 and 50 full-time equivalent employees (FTEs), not including owner(s).
- Offer coverage, at a minimum, to all full-time employees working at least 30 hours per week.
- Principal business address in the District of Columbia and will offer coverage to all full-time employees; or will offer coverage to all full-time employees whose primary workplace is located in the District.
CHAMPS will keep a pulse on how Trump’s executive order evolves. The President’s plan would allow associations (including CHAMPS, your Chamber of Commerce) to form a group plan for members to buy into. The expected pros and cons are discussed in this article from The Washington Post.