Officials at the Centers for Medicare & Medicaid Services are trying to get state regulators to think carefully before letting their state exchanges sell "employee choice" programs.
Officials say adding choice programs could lead to higher prices.
CMS officials bring up the issue in a choice program recommendation form for insurance commissioners in the states with HHS-run exchanges.
An employee in a choice program can choose from a menu of several different coverage choices.
In instructions, CMS officials say: "Please adequately explain that it is in your expert judgment, based on a documented assessment of the full landscape of the small group market in your state that the 2015 Transition to Employee Choice would be in the best interest of small employers and their employees and dependents, given the likelihood that implementing employee choice would cause issuers to price their products and plans higher than they would otherwise price them."
"Please base your recommendation on discussions with those issuers expected to participate in the SHOP, including naming those issuers," officials say.
The Federal Employees' Health Benefit Plan, many state public employee health plans, and some single-state health insurance purchasing arrangements have offered employee choice arrangements for years.