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New health care rules could affect employee plans

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HILLSBOROUGH COUNTY, FL (WFLA) -

At Primrose School of Bloomingdale, employees caring for and teaching youngsters are offered health benefits.

As a small business owner,  Ketan Gohill says it's not something he has to do, but wants to do.

But benefits for his roughly 30 employees could change as a trickle-down effect of the Affordable Care Act.

Employers like Gohill, who runs the school with his wife, are assessing current benefit plans and trying to figure out whether what they offer makes sense – or even makes the cut under new rules.

The result is that employees across the Bay area and the country could see changes to their health insurance costs even if they remain with the same employer that offers health benefits. Some large employers, including Walgreens, have already announced changes.

Gohill says some of his employees pay deductibles as high as $10,000, keeping monthly premiums and copays low. But Gohill says those plans may not be available in the future. 

The out-of-pocket maximum will be $6,350 for an individual and $12,700 for a family in the individual and small group plans offered through the insurance "marketplace" that launches Oct. 1.

With about 30 employees, Gohill doesn't have to offer insurance. But if he does buy it through the marketplace, plans would have to meet those guidelines.

Higher deductibles going up to $5,000 or even $10,000 seem to be more common in Florida than in other parts of the country, said Justin Treece, a benefits adviser with insurance agency Connelly, Carlisle, Fields & Nichols.

"In the Northeast, to see a $1,000 deductible was a relatively high deductible, " Treece said.

Treece said he's fielding a lot of calls from businesses trying to wade through the new regulations, and figure out what it all means. It's not all clear yet, he says, because of tweaks and interpretations to the law and how it's applied.

Overall, though, Treece says it will affect everyone.

"This is going to cause a little bit more of an expense, in my opinion, for employees and employers across the board," he said. 

At the same time, some are hoping the marketplaces will offer more affordable coverage.

 

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