Navigating the Exchange for Small Business Owners and Employees

Many small employers do not offer health insurance and are wondering what to do for themselves and their employees before January 1st, 2014 rolls around.  Small businesses (fewer than 50 employees) are not subject to the employer mandate and thus do not receive a penalty for not offering health insurance.  However small businesses owners and employees are considered individuals and thus are subject to the individual mandate. If either of the aforementioned individuals do not obtain health insurance the following penalties apply.

2014 – $95.00 or 1.0% of income whichever is greater

2015 – $325.00 or 2.0% of income whichever is greater

2016 – $695.00 or 2.5% of income whichever is greater

2017 on – Increases with inflation

To avoid this penalty an individual must purchase insurance that meets the minimum standard value.  These plans are available through a state or the federal health insurance exchange.  To see if you should go to a state or federal exchange use this link:  For an individual purchasing health insurance who does not currently have coverage and is not offered a plan through their employer, the website will walk you through several questions to determine if you qualify for a subsidy for all or some family members.  You can apply online and obtain a quote for a variety of plans.  There are three basic levels of coverage (see article on the options and pricing available in Oregon below).  Then simply enroll online.    Well, maybe it is not that simple for everyone. Because of the complexity of the new law you may choose to access the health insurance exchange with the help of a navigator (or community partner). The idea behind a navigator is that sometimes it is better to have a human walking you through your options, connect with a navigator in your area.

Another option is an insurance agent. Many insurance agents have been through training and can help guide an individual with the enrollment process.   There are other ways to obtain assistance like calling the health insurance exchange’s toll free number and asking questions while shopping online.

Health insurance plans went on sale as of October 1st, 2013. The first day of coverage can begin is January 1st, 2014.  If you are going to buy coverage you need to buy a plan before March 31st, 2014 when open enrollment ends.  After that date I should note that in most cases, without a qualifying event, you cannot buy health insurance until open enrollment begins again on October 15, 2014.

Individual Mandate

Oregon Health Insurance Plans

Arin J. Carmack