CMS Provides FAQ About New Law Allowing States To Keep Original ACA Small-Employer Definition

Implementing Health Reform. On October 7, 2015, President Obama signed into law the Protecting Affordable Coverage for Employees (PACE) Act. The PACE Act amends the definition of “small employer” in the Affordable Care Act (ACA) so that it would continue to apply to employers with one to 50 employees, rather than changing to one to 100 employees as of 2016 as provided in the original ACA; however, the new legislation also allows states to opt for the one-to-100 employee definition of small employer if they choose. On October 19, 2015, the Centers for Medicare and Medicaid Services (CMS) released a series of frequently asked questions explaining how it will implement the PACE Act. States may elect to extend the definition of small employer to cover employers with up to 100 employees by any means that is legally binding under state law, as long as the definition applies to all insurers, including those in the Small Business Health Options Program (SHOP) program. States that elect to expand the definition as of January 1, 2016 are requested to notify CMS by October 30, 2015. States may allow their insurers to modify their rate filings for 2016 considering the change in definition. Because of technical limitations, however, states that use the federally facilitated SHOP or FF-SHOP platform will not be able to adjust their rates until the second quarter (April 1) of 2016. Requirements regarding employee counting methodologies for the FF-SHOPs, State-based SHOPs, employer mand...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Following the ACA Insurance and Coverage employer coverage PACE Act SHOP program small employers Source Type: blogs