The Soapbox and Toolbox for New York State's Nonprofits

May 8, 2015

Health Insurance Update: Definition of "Small Group" Size to Change

Under New York law and the Patient Protection and Affordable Care Act (ACA), the definition of "small group" will be 1-100 employees as of January 1, 2016.

"This is good news for the nonprofit community," says Peter Andrew, CS Plus CEO. Why? New York will now use the same Elligible Employee count the Affordable Care Act uses. If that number is under 100, then it's now a small group.

According to Mr. Andrew "In the past groups of over 50 were rated, and offered plans, based on their census, which tends to be highly female populated in the nonprofit community. This caused higher rates to be charged (or some carriers would simply decline to offer a quote) since females tend to use more medical services than males (the formal term is higher morbidity rates). It is my estimation that many nonprofits between 50 and 100 staff will see a rate reduction and a greater choice of carriers. I'm sure nonprofits will put those extra dollars to great use.

At this point, this is all we know. I suspect we'll start to see what plans and rates will be available sometime after July 1."

Need assistance with your healthcare (or other employee benefit) coverage? Contact the team at Council Services Plus.

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