Notice to Sole Practitioners Covered Under the MBA Medical Plans
You are receiving this notice because your invoice shows that there is only one person covered under one of the MBA medical plans at your firm. In the past the MBA has been able to offer medical insurance to sole practitioners with no employees who were members of the MBA. The Affordable Care Act stipulates that bona fide association plans can only offer medical coverage to small employers and not single individuals with no employees. As a result at our next renewal date of April 1st, the Affordable Care Act will no longer allow the MBA to offer coverage to sole practitioners with no employees.
If your law firm meets the definition of a small employer you still may be eligible to participate in the MBA plans if there is at least one other person working at your firm. Under Oregon law a small employer is defined as a business with at least 2 employees working a minimum of 17.5 hours per week. For the purpose of this definition the employer or owner of the business can count as one of the 2.
If there are at least 2 people working at your firm (including the owner), then please complete the enclosed Adoption Agreement confirming the number of people working at your firm. It is possible for individuals who are working at the firm to opt out of the MBA plan because they have other group coverage. So it may be possible for a firm to only cover one employee if there are at least 2 employees working at the firm and the other employees are covered by another group plan.
If you are truly a sole practitioner with no employees, there are options available for you to continue your medical coverage:
1) Enroll in one of the individual medical plans that the MBA has arranged to offer through Northwest Employee Benefits, Inc. If you elect this option you will be eligible to enroll in one of the dental and vision plans offered through the MBA.
2) Enroll in an individual plan in the open market or through Cover Oregon. The open enrollment period for individual plans in the direct market or through Cover Oregon runs through March 31st of 2014 which will allow you plenty of time to obtain new coverage before April 1st deadline. Northwest Employee Benefits can also assist you with this.
The decision to no longer offer medical coverage to sole practitioners with no employees is not a decision made by the MBA or the insurance carriers. It is an unfortunate requirement of the Affordable Care Act.
If you have questions about this issue or would like assistance in acquiring individual coverage please contact Northwest Employee Benefits, Inc., at 1-800-284-1331 or email Steve Doty at email@example.com or Kevin Doty at firstname.lastname@example.org.
Northwest Employee Benefits, Inc.
Administrator MBA Health Plan
Since learning the first week of December that solo practitioners may no longer be able to participate in the MBA Insurance plan, we have been working with Providence, Kaiser and the insurance commissioner to confirm the status of our plan. We now have confirmed that solo practitioners will not be able to continue on the plan, and we will be notifying the affected members shortly. Solo practitioners will be receiving information in the mail to answer questions about which solo practitioners will be affected by the change.
The MBA estimates that approximately 300 to 400 of its members who are on the plan are true solo practitioners with no employees. They will have several options for continuing their medical coverage after March 31, 2014.
1) They can enroll in one of the individual medical plans that the MBA will arranged to offer through its broker. If they elect this option, they will also be eligible to enroll in one of the dental and vision plans offered through the MBA.
2) They can enroll in an individual plan in the open market or through Cover Oregon. The open enrollment period for individual plans in the direct market or through Cover Oregon runs through March 31st of 2014, which will allow them time to obtain new coverage before April 1st deadline. Northwest Employee Benefits can also assist them with this.
The decision to no longer offer medical coverage to solo practitioners with no employees is not a decision made by the MBA or the insurance carriers. It is a requirement of the Affordable Care Act.
Please feel free to call Steve Doty (503-284-1331) at Northwest Employee Benefits regarding the MBA plan, Cover Oregon and the open market.
The following notice was sent to MBA members enrolled in the plan on December 13, 2013.
MBA members may feel somewhat confused about how the Affordable Care Act [ACA] will affect plans offered through the Multnomah Bar Association [MBA] Group Health Plan. MBA members, however, do not need to feel rushed into making a change in their insurance plans right now. There will be no change to carriers, plan rates or benefits prior to the renewal date of April 1st 2014. The open enrollment period to purchase coverage through the MBA, open market or the insurance exchange Cover Oregon will run through March 31st of 2014.
There may be questions as to whether or not a person might be able to obtain better coverage outside of the MBA through Cover Oregon or directly with an insurance carrier. A word of caution: in an attempt to keep premiums competitive, many of the carriers are offering plans in the open market and through Cover Oregon with a very restrictive provider panel. When evaluating plans outside of the MBA be certain that the plans you consider have access to the same providers that you have now under the MBA plans.
For employers looking to obtain a tax credit for providing health insurance to their employees, consult your tax adviser regarding how you may be affected through your enrollment in the MBA Group Plan or other insurance plans.
It is too early to tell just what the new rates, benefits or carriers for the MBA plans will look like after April 1 of 2014. MBA renewal rates and benefits will be available in late February, giving MBA members time to make an informed decision. All of the MBA plans will meet the definition of "Minimum Essential Coverage"required by the Affordable Care Act to satisfy the individual mandate. The MBA Group Insurance Committee is working on creating a menu of options which will provide members access to quality plans and providers at competitive rates. Meanwhile, members should contact Northwest Employee Benefits at 503.284.1331 with questions or concerns about the MBA Plans or the ACA.