The Obama administration says that workers offered such coverage may qualify to shop in the marketplaces and to buy subsidized plans.
“Individuals who are not already offered quality, affordable health care can enter into the marketplaces and choose a health insurance option that works for them,” said Sabrina Siddiqui, spokeswoman for the Treasury Department.
About 2 million Americans are covered by mini-med policies. And Aetna and Cigna are among the largest issuers of them. Asked whether Cigna will offer new versions next year, a company spokesman said that “we are currently evaluating the types of plan designs that will meet the needs of employers and employees.” Matt Wiggin, an Aetna spokesman, said the insurer is “still assessing” customer needs.
‘Mini-meds have morphed’
Under the new rules, capping the dollar value of annual benefits isn’t allowed, but excluding entire categories from coverage — such as hospital stays — is permitted, benefits consultants say. That’s another way of keeping costs down.
The law says only that large-employer policies must cover preventive care such as blood pressure tests or vaccines with no co-pays for patients. So the plan could cover dental, vision and preventive cancer screenings, but possibly not the hospital care needed if a person was diagnosed with an illness.
The health act requires policies to include coverage for 10 broad categories of “essential health benefits,” such as hospitalization and mental health services, but that applies only to plans sold to small businesses and individuals. Larger firms and self-insured employers are exempt.
Benefit advisers say some retailers and restaurant chains are considering limited-benefit plans for 2014 even though the deadline was pushed back for offering coverage or facing fines.
“It seems like mini-meds have morphed,” said Lydia Mitts, a health policy analyst for Families USA, a consumer advocacy group.
Employers offering these sorts of plans do face some risks, experts said.
If a large employer doesn’t offer “minimum essential coverage,” it would potentially be liable for fines of $2,000 per full-time worker after the first 30 workers. Under the wording of the health law, however, skinny plans appear to qualify as minimum essential coverage.
If employers don’t offer “comprehensive” policies — defined as covering at least 60 percent of health expenses — they must pay $3,000 for each worker who receives subsidies to buy coverage. But employers see that potential expense as far lower than the cost of offering all their workers more robust coverage, experts said.
Some businesses are betting that few workers will go to the government-run marketplaces to seek subsidized coverage, opting instead for the skinny plan “which costs less than the penalty,” said Dania Palanker, senior counsel for the National Women’s Law Center in Washington.
Signing up for a company skinny plan would fulfill a consumer’s obligation to be covered under the health act.
Advocates are pressing employers to offer more comprehensive policies.
“People need to be covered for hospitalizations,” said Mitts of Families USA. “It’s important for employers to do the right thing.”
Kaiser Health News (www.kaiserhealthnews.org) is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization that is not affiliated with Kaiser Permanente.