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N.H. businesses learn about health overhaul law

Individuals and small businesses shopping for health insurance through New Hampshire’s new online marketplaces will choose from among several plans offered by a single company.

Anthem Blue Cross/Blue Shield of New Hampshire will be the only insurer selling either individual or small group plans through the new markets, or exchanges, that are being set up as part of the federal health overhaul law, the company’s senior legal counsel, Maria Proulx, said yesterday.

“There will be no other carriers on either exchange,” she said at an educational seminar for business owners in Manchester.

Anthem is one of four companies licensed to sell individual plans in New Hampshire and one of six licensed to sell small group policies. Companies have until June 1 to submit details to the state, but Proulx said she learned late last week that no other companies plan to do so.

The new insurance markets will offer individuals a choice of private health plans resembling what workers at large companies already get. The government will help many middle-class households pay their premiums, while low-income people will be referred to safety-net programs for which they might qualify. There will be a separate market for small businesses, with limited subsidies available for some companies.

Enrollment starts Oct. 1 with coverage taking effect Jan. 1. After that, virtually everyone in the country will be required by law to have health insurance or face fines.

Under the federal law, small businesses are not required to offer employees health coverage. The federal law defines a small group as fewer than 100 workers, but New Hampshire has opted to keep its current definition of 1-50 workers until 2016, Proulx said. But things will get more complicated after that, she said, as companies face the law’s “play or pay” provisions – the requirement that they either offer workers affordable, adequate coverage or pay penalties.

“In tomorrow’s environment, you’re going to count differently, and unfortunately, you’re going to count differently depending on which requirement of the (Affordable Care Act) you’re talking about,” she said. “Small employers today may be considered large employers tomorrow.”

Proulx told small employers they have three choices: offer a fully insured plan either through the exchange or separate, offer a self-insured plan or stop offering coverage altogether and let employees buy their own coverage through the individual market.

New Hampshire opted not to set up its own markets and is partnering with the federal government to manage the health plans and provide consumer assistance. The process has been slowed by political disagreements, however, and lawmakers have yet to accept federal money that has been awarded to the state to get the ball rolling.

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