Small group health insurance can be difficult. The last few years has created a lot of shifting on to the employee in both cost and risk. This has mainly been because of the price of health plans and the economy. If small a company revenues are off its difficult for them to absorb a rate increase on the health insurance.
I have started to witness a alarming trend in the small groups. Employee are starting to ask to have their employee status changed. So an employee might come to the owner and asked to be a 1099 contract employee. One of the reason they might do this is so that they qualify for a subsidized health plan. This is whats called “gaming the system”.
With all of the cost shifting that has a occurred there are many small group health plans that have large deductibles. So if an employee is having a baby they might owe $2,000-$5,000 for that child birth. If they are able to qualify for a subsidized plan through the state then that child birth could cost them nothing.
So if you are small business owner with a high deductible plan in place an employee could be trying to game the system.