In 2016, the ACA expands the small group insurance market to include employers with 100
or fewer FTEs
• Historically, market rules have generally defined small groups as 2 to 50 eligible
employees
• Newly “small” groups will face:
• More restrictive rating rules, which may increase premiums for some (or reduce for
others)
• Additional benefit requirements that could reduce benefit flexibility and increase premiums
• Adverse selection in the market if more employers self-insure
• ACA’s Guaranteed Renewability rules may allow newly “small” groups to renew existing
large group policies