New Channels, New Opportunities
The Patient Protection and Affordable Care Act (PPACA) advances unprecedented change in the insurance market. In fact, change of this magnitude, focused at a single point in time, has not been experienced since the advent of Medicare and Medicaid in the 1960s. There are four core shifts that will alter the health insurance market: consumer protections (e.g., ban on lifetime/annual limits, ban on rescissions, increased coverage for dependents), financial provisions (e.g., individual mandate, employer penalty, medical loss ratio), insurance regulation (e.g., community rating for small/individual group, increased federal oversight), and insurance structures (e.g., health insurance exchanges, premium subsidies, Medicaid expansion). Of these, the structural permutations will have a profound impact on how employers offer benefits.