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Small Group Expansion Mandate Repealed

Oct 09, 2015

President Obama has signed the HR1624 bill (Protecting Affordable Coverage for Employees Act or PACE) into federal law. This action repeals the mandated transition of groups with 51 to 100 employees to the Small Group market. This requirement of the Affordable Care Act (ACA or health care reform law) originally was scheduled to go into effect January 1, 2016. Repeal of the mandated transition now gives states the option to define their Small Group market up to 100 employees, if they choose.

Some states may still move forward with Small Group expansion. That's because some state legislatures previously took action to amend their state laws to expand Small Groups to include employers with 1 to 100 employees, effective January 1, 2016. In these states, the state law overrides the repeal.

The chart below shows the states Anthem believes will expand their Small Group markets to 1-100 on January 1, 2016 (per the original ACA law), and those they believe will maintain their Small Group markets at 1-50:

Likely to Maintain Small Group at 1-50
as of
 January 1, 2016

Likely to Expand Small Group to 1-100
as of
January 1, 2016

  • Connecticut*
  • Georgia
  • Indiana
  • Kentucky
  • Maine
  • Missouri
  • Nevada
  • New Hampshire
  • Ohio
  • Wisconsin
  • California
  • Colorado
  • New York
  • Virginia*

The states listed as likely to expand their Small Group markets to 1-100 are those that have amended their state laws to conform to the original ACA law and automatically expand their markets on January 1. 

For questions, please ​contact a member of your b&p Sales Team - 888.722.3373.

*This includes Virginia. Efforts are underway in that state to propose legislation that would retain Small Group at 1-50, but even if successful, would not pass until February 2016 at the earliest. Connecticut also amended its law to expand the Small Group market, but reserved discretion to the state's insurance commissioner to maintain Small Group at 1-50. Connecticut’s Insurance Department has indicated that it will maintain the state’s Small Group market at 1-50.

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