Under the ACA small group market rules, medical insurance policies for small employers must include certain reforms (e.g., metal-tiers with essential benefits and age-rated premiums). Since 2010, most states defined a small employer as having 50 or fewer employees, but the definition was slated to increase to 100 or fewer employees in all states as of January 1, 2016. Last year, the federal PACE Act was enacted allowing each state to continue to define a small employer as having 50 or fewer employees. Most states, including DC and Maryland, took action to retain the small employer definition of having 50 or fewer employees. Virginia was unable to pass necessary legislation prior to January 1.
The Virginia General Assembly has now passed, and Governor McAuliffe signed, House Bill 58, which retroactively removes from the VA Code all references to the ACA expansion to 100 employees. Without the expansion, the definition of small employer in Virginia reverts back to the original definition of 50 or fewer employees.
This retroactive change to the definition of small employer has caused confusion in the marketplace for some Virginia employers. If your company or organization is located in Virginia with 51-100 employees, please contact your Keller account team if you have questions or concerns about how this legislation may affect your group medical policy.