What are the rating rules for large employers and how do they differ from the rating rules for smaller companies?

Large employers are subject to the guaranteed issue requirement but are NOT subject to the modified adjusted community rating rules.

Before the ACA, small groups could rate based on group size, industry, gender, age (wider than 3 to 1 age rating), and medical conditions.

Large employers can still rate on all of these factors. They can also charge higher rates based on low participation. They just can’t decline a group like they could before the ACA.