HR Tips for Transitioning Employees to Individual Health Insurance

Written by: Abby Rosenberger
Originally published on September 12, 2014. Last updated January 18, 2017.

IMG_0804With the Affordable Care Act (ACA) in full effect, many small and medium sized businesses will be steering some or all of their employees towards individual health insurance. This comes as no surprise. With guaranteed issue plans, coverage for pre-existing conditions, and premium tax credits, many small businesses are transitioning away from employer-sponsored health insurance.

In addition, many of the employers who have not been able to offer their employees health insurance in the past will be discussing the individual health insurance Marketplaces with their employees to ensure that they receive access to coverage. This article contains tips for HR on discussing a transition to individual health insurance with employees.

Ensure Leadership is Involved

It is vital for HR to make sure that their company’s leadership is involved with the healthcare benefits plan and strategy. While many of the key managers are likely to be involved with the decision making process, it is important that they help to maintain overall support and morale during this transition. The more support HR has behind the new healthcare benefits approach, the easier the transition and implementation of the plan will be.

Educate Employees On the Advantages of Individual Health Insurance

When switching employees to the Marketplace to purchase health insurance, it is vital to educate them about the advantages of individual health insurance. While individual health insurance plans are not new, the Affordable Care Act (ACA) creates new advantages that make individual health insurance just as good – if not better – than traditional group health insurance. The new advantages are:

  • Coverage for a pre-existing condition (employees cannot be denied coverage or charged more because of a medical condition).

  • Coverage of essential health benefits (a core set of health benefits and services).

  • Employees may keep their policy when switching jobs.

  • Employees can choose the policy that best fits their family’s needs, including the network of providers and level of coverage.

  • Individual health insurance costs less, and employees may be eligible for a premium tax credit to assist them with the cost of monthly health insurance premiums.

For more on the advantages of individual health insurance, see this quick reference guide.

Let Employees Know Where and When to Purchase Individual Health Insurance

If a small business cancels a group health insurance policy, all those covered will be eligible for a special enrollment period for individual health insurance. This means they are eligible to purchase personal health insurance outside of the annual open enrollment period. Buying health insurance is now easier than ever. HR should inform employees that individual health insurance policies can be purchased from:

  • The Health Insurance Marketplace

  • A licensed health insurance agent or broker

  • Directly from an insurance company

Tip: To access the health insurance discounts (premium tax credits), employees need to purchase a plan offered on the Health Insurance Marketplace.

Clearly Announce Dates and Deadlines

If cancelling a group health insurance policy, HR should notify the employees that they are eligible for a special enrollment period. The special enrollment period generally lasts 60 days after the qualifying event.

If employees do not qualify for a special enrollment period, HR should notify employees that the annual open enrollment period for coverage in 2015 begins November 15, 2014 and extends through February 15, 2015.

Welcome Questions and Provide Additional Assistance

HR should designate a healthcare benefits expert to be available for questions and additional assistance. The expert can have answers planned out for the most commonly asked questions about the transition to individual health insurance. Keeping additional resources ready to distribute to employees is also a good idea for anticipating employee needs.

Do you have questions about transitioning your employees to individual health insurance?

The Comprehensive Guide to the Small Business HRA

Originally published on September 12, 2014. Last updated January 18, 2017.


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