Employer requirements and guidelines
Summary of benefits and coverage
The summary of benefits and coverage, or SBC, provides basic health plan coverage information in a standardized format. The SBC, designed to be a comparison tool for consumers while shopping for health insurance, does not replace the plan benefit summary. Employers must provide the SBC to all participants at time of enrollment and each subsequent year during open enrollment.
Notification of the exchange
Employers will be required to notify current employees of the public exchange, Cover Oregon, to include information on employee eligibility for coverage available, including premium tax credits. This requirement will take effect later this year. After the initial notice, all new employees must be notified at their date of hire.
Employee eligibility requirements
Small-group employers can continue to set the minimum number of hours employees must work each week to be eligible for group health insurance between 17 ½ and 40 hours.
Under the ACA, employers will be prohibited from providing better eligibility, health benefits or employer contribution to highly compensated individuals. Differences based on years of service, age of compensation is not permissible. The probationary period can be waived for all employees at the initial group enrollment, but cannot be waived for selected employees after that point. These requirements are on hold, pending the issuance of federal rules.
Need more information? Get the answers to small-group employers' frequently asked questions.