How ACA 2024 Changes Could Affect Groups

December 26, 2023by Alex Strautman

If you’re an employer who gets your Group Health Insurance through an Affordable Care Act (ACA) exchange like Covered California for Small Business (CCSB), several factors could impact your coverage for 2024. Here’s what you need to know.

ACA group health open enrollment

ACA Marketplace premiums are rising: According to the Kaiser Family Foundation (KFF), Marketplace premiums are increasing an average of 5-6% in 2024. Other reporting suggests higher increases across the broader marketplace – in the range of 5.4% to 8.5%. The increase is attributable, at least in part, to rising payments to health care providers due to inflation and a utilization bump following the COVID-19 pandemic.

Three insurers are taking part in the California public exchange: Three health plans are available through CCSB in 2024: Blue Shield of California, Kaiser Permanente, and Sharp Health Plan. Availability differs by region. Blue Shield is offering three plans: a PPO statewide, one HMO in all or part of 19 regions across California, and a second HMO in all but one region. Kaiser Permanente is available in six full regions and partially in all other regions. Sharp Health Plan is available only in San Diego County. For coverage details, refer to the CCSB network summary on the public exchange web page.

Young adults can keep a parent’s coverage beyond age 26: Beginning in 2024, federal Marketplace health plans will officially not be allowed to terminate coverage mid-year for a 26-year-old adult covered by a parent’s health plan. Instead, they can maintain coverage through the end of the calendar year.

More options in a private marketplace

Employers who want to offer more options to their employees may want to consider coverage through a private health insurance exchange like CaliforniaChoice.

With CaliforniaChoice, you and your employees have access to eight health plans and dozens of coverage options in a single program. Your plan availability is dependent on where you live in California. You might choose a PPO from Anthem Blue Cross because of a particular in-network doctor or hospital. One of your employees might choose an HMO from Kaiser Permanente, Health Net, UnitedHealthcare, or a regional plan like Sharp Health Plan, Sutter Health Plus, or Western Advantage. A third employee might select an Exclusive Provider Organization (EPO) plan from Anthem or Cigna + Oscar. Whatever your needs may be, it’s your choice.

Greater cost control, too: Beyond more health plan choices, CaliforniaChoice also offers you greater cost control. That’s because you choose how much to contribute to employees’ premiums. You can contribute a Fixed Percentage (50% to 100%) of a specific plan and/or benefit, or a Fixed Dollar Amount for each employee. (The contribution must be the same for each employee.)

Employees then apply your generous contribution to whichever health plan they prefer for their personal or family health care needs. If an employee selects a plan that costs more than your contribution, the employee simply pays the difference.

When you renew with CaliforniaChoice, you can adjust your contribution – up or down – giving you complete control over your employee benefits cost for another year.

Four ACA tiers, full and narrow networks, + more: CaliforniaChoice offers both full and limited networks in all four ACA tiers: Bronze, Silver, Gold, and Platinum. This significantly increases the number of plans, doctors, and specialists available to your employees.

But the CaliforniaChoice advantages don’t stop there. You can also offer employees optional benefits for Dental, Vision, Chiropractic and Acupuncture, and Life and AD&D. Plus, there are the many value-added benefits available to you and your employees through the Business Solutions Suite and the Member Value Suite.

The Business Solutions Suite includes Flexible Spending Accounts (FSA) and Premium Only Plans (POP) for employees plus Cal-COBRA or Federal COBRA participant invoicing, collection, premium remittance, and eligibility change processing.

The Member Value Suite includes reduced fees on dental care services, hearing-related products and testing, and vision care as well as Rx discounts and savings on tickets to movies, theme parks, and much more. Discounts of up to 57% are available on Garmin, Vitamix, and Fitbit products.

The Active&Fit Direct program, which is part of the Member Value Suite, offers a $28 per month fitness membership at 12,200 centers, discounts at premium studios, 9,700+ digital workout videos, and activity tracking with 250+ wearable trackers, apps, and exercise equipment.

Talk with a broker to learn more

Your employee benefits broker will be able to discuss what changes you and your employees can expect in 2024. If you’re not a current CaliforniaChoice customer, be sure to ask about the advantages offered by the CaliforniaChoice private exchange, and whether it might be a good fit for your small business. You can get a custom quote with no obligation.

If you don’t currently have a broker, you can easily search for one online.

Shopping for group health insurance?

This guide compiles a list of common questions you may have before you start offering health insurance coverage.