Employer-based insurance coverage is not a given for everyone, even the employed.
Getting and keeping health coverage has been challenging in the past 12 months. For those who work but don’t qualify for full-time benefits and for those who have found themselves separated from their employer, trying to figure out where to turn next continues to be a puzzle for many.
Some stats about U.S. health plan coverage
The unemployment rate continues to trend well above pre-pandemic rates at 6.3% as of January 2021— over 3.5% in February of 2020. Additionally, many U.S. workers have joined the ranks of gig and contract workers or simply juggle multiple part-time jobs to make ends meet. It is estimated that 24 million Americans consider themselves part-time employees as of January 2021.
Medicaid covers about 70.6 million Americans and the Marketplace coverage appears to be up by about 6% compared to 2020. Meanwhile, another 4 million uninsured Americans are eligible for a subsidized Marketplace bronze plan yet are either unaware or have not activated their coverage.
All eyes are currently on the American Rescue Plan, where the Marketplace premium affordability rating could be adjusted to help more Americans qualify for Marketplace health coverage subsidies. This bill is currently under Senate consideration, after passing the House on February 27. Additionally, individuals receiving unemployment benefits during 2021 may be able to qualify for $0 monthly health insurance premiums.
All of these factors combine to create a sizeable underinsured population of approximately 15 million people (KFF, January 27, 2021).
Many people just don’t know where to turn for benefits coverage if there’s not something available to them through an employer.
All of that to say, there are a few ways for employers to help without extending traditional full-time benefits to all your populations.
- Communicate the Marketplace and the option for subsidies to your non-benefits-eligible populations, like gig/contractors and part-time employees. Many people assume that they cannot afford coverage and don’t know where to turn for help.
- Alert these non-benefit-eligible groups that there is a special enrollment period that opened as of February 15 through May 15, 2021, for anyone who doesn’t have health coverage. After May 15, individuals will have to have a qualifying life event (job loss, divorce, death, residence change, loss of coverage, etc.) to enroll or wait until annual enrollment in November.
Consider alternatives or additions to traditional group coverage
- There are user-friendly websites that offer access to the Marketplace and allow individuals to check for subsidies. Businessolver provides a direct-to-consumer Marketplace portal called the MyChoice Market™ where anyone can come in to check their Marketplace as well as compare, shop and purchase voluntary benefits, such as dental and vision coverage or accident, hospital indemnity and telemedicine, among other offerings. The MyChoice Market also offers MEC plans (minimum essential coverage). Simply making this information available to your non-benefits-eligible population could be helpful as they navigate coverage.
- Businessolver clients have access to offer the embedded MyChoice Market experience for specified classes or their entire population. Clients may either subsidize the coverage or offer it as-is. Additionally, once set up, this online insurance market is a viable and affordable alternative to COBRA coverage, especially in the wake of layoffs or furloughs that affect benefits eligibility.
- A third viable option would be offering the newer ICHRA (individual coverage health reimbursement arrangement) and pairing it with something like MyChoice Market to allow individuals to “shop” their benefits. The ICHRA acts as a defined contribution or a subsidy that can qualify for minimum essential coverage for employers under state mandates. Again, the ICHRA could be delivered to a subset of employee—like part-timers, seasonal/temp/contractors or new hires in a waiting period, or it could be offered as a replacement to traditional group coverage.
With the ups and downs of the employment landscape and the continued need to get Americans covered, consider some new and innovative ways to cover your organization’s non-eligible employees through information or access to coverage.
One Businessolver client recently solved for benefits coverage using the MyChoice Market with a subset of their onboarding employees. Their goal—improve retention and provide a safety net.
See how they did it with our case study below.