Streamlining Small Group and Sole Proprietor
Plans for 2014
The Affordable Care Act (ACA) and New York State Law require that starting January 1, 2014, all health insurance plans include a core set of health services (known as essential health benefits) and more cost-sharing choices. While EmblemHealth’s plans already offer many of these benefits, we will be replacing our current products with new, fully ACA-compliant plans.
On December 31, 2013, all of EmblemHealth’s current small group, sole proprietor and individual plans will be discontinued. As of January 1, 2014, EmblemHealth will offer new small group and individual plans that will meet the ACA requirements.
We are mailing letters announcing the discontinuance to affected small groups, small group subscribers, and sole proprietors about 90 days before the effective date. This will provide ample time for your clients to consider their options in the marketplace.
Under the ACA, when a business is owned only by an individual or an individual and his or her spouse, these individuals are not considered "employees" and the benefit plan is not considered a group health plan. As of January 1, 2014, these individuals will no longer be able to purchase group coverage and will need to purchase individual coverage.
If you have questions about the plan discontinuance, please contact your EmblemHealth representative.
Next month, we will be sending you more details about the discontinuance and news about our ACA-compliant products.