Jon Gabel and other analysts at a University of Chicago research center say states should consider protecting Patient Protection and Affordable Care Act commercial health insurance market rules by doing more to limit access to the stop-loss insurance market.
If states fail to make it harder for small employers to use stop-loss insurance to self-insure, brokers may help many small employers cut health benefits costs by self-insuring, Gabel and his colleagues wrote in a new paper published in Health Affairs.
The researchers polled 604 private U.S. employers with three to 50 employees from January through June. They found that 72 percent of the employers offered health benefits, and 80 percent of the firms that offer health benefits use agents or brokers.
Twenty-six percent of the managers at firms that use brokers said the brokers had discussed self-insurance.
Only 1 percent of the employers that get benefits on their own have thought about self-insuring.
PPACA exempts self-insured plans from many coverage requirements, such as benefits package requirements, that are set to apply to fully insured small-group plans starting in 2014.