The Department of Health and Human Services (HHS) is expected to release future guidance on determining group size for purposes of federal adjusted community rating (ACR). However, current HHS guidance is that state definitions of “small group” will be used for 2014 and probably 2015 as well, for most reform purposes. This will generally mean that small group will be defined as up to “50” eligible employees, however certain states have adopted one of the existing federal counting methodologies: average total number of employees (ATNE) or full-time equivalents (FTE). State definitions may change at any time and additional federal guidance could be issued at any time, but the map below provides a snapshot of our current understanding of which counting methodology is applicable in each state for ACR purposes.
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