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How the ACA Inadvertently Threatens the Financial Health of Small Businesses, and What States Should Do About It
Robert C. Pozen, via The Brookings InstitutionLink to more items from this source
Nov. 16, 2015

"By financing their own health care plans, [companies] stay exempt from the community rating requirements ... [and] from the federal and state taxes on most health care premiums that are paid to traditional insurers.... One possible improvement would be for state regulators to require that every stop-loss reinsurer under its jurisdiction provide small firms with advance notice of three months before canceling a stop-loss policy or materially raising its premiums. The notice would give the employer a bit of leeway to figure out an alternative. Another idea would be to expand and enhance the role of the brokers that small companies hire to handle their reinsurance needs.... A final possibility would be to extend the reach of the new health insurance exchanges operating under the Small Business Health Options Program, or SHOP."

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