Employer Considerations In Trends Toward Self-Insurance

A story in USA Today examines the newly emerging trend toward smaller businesses becoming self-insured. Businesses that have made - or are thinking about making - this move say that the decision is about free choice, cost savings, and doing what is right for their employees; others see it as a threat to the Affordable Care Act. As more small employers avoid the act's requirements through self-coverage, small-business marketplaces intended to cover millions of Americans could break down and become unaffordable.

ACA advocates especially worry that firms with fewer than 50 employees will self-insure. Those companies are not required to offer policies under the health law, but many are expected to buy in online marketplaces, SHOPs, scheduled to open in October.  However, self-insurance might be the only way some struggling employers can afford medical coverage.  The article describes these issues and offers considerations for employers when making this decision.