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In 2013, many employers
renewed their existing
group health insurance
plans or chose to renew
early to avoid moving to
an Affordable Care Act-
compliant plan. With the
arrival of 2014 renewals,
many employers are getting
their first exposure to
the new Affordable Care
Act (ACA) Plans and are
seeing the effects on their
premium. Most insurance
carriers are giving you the option
to renew your old plan for another year or
move to an ACA-compliant plan option.
What do you do? Do you simply base
your decision on the premium? What about
the out-of-pocket costs to your employees?
Are there more affordable options
available?
Healthcare reform has forever changed
the health insurance marketplace and has
caused a great deal of confusion. However,
out of chaos comes innovation. New
opportunities and solutions are available
that have not been in the past.
A great example of such innovation
is the growth of telehealth services.
Telehealth is basically a physician on
call. To help offset increasing deductibles
and copays, you can give your employees
phone or video access to a board-certified
doctor 24 hours a day, 7 days a week, 365
days a year. Physicians can even prescribe
medications, when needed. Employees
can avoid an expensive urgent care or ER
visit for non-emergency care and never
have to leave home or the office. Employers
win with reduced absenteeism and greater
productivity and employees don’t have
copays or deductibles to satisfy. Today,
more than 50 percent of
large employers offer their
employees a telehealth
solution and now it is
available to businesses
of all sizes, as well as to
individuals.
One of the main
reasons that premiums for
ACA plans have increased
for employers
with fewer than
50 employees
is due to
community
rating. Generally speaking, everyone pays
a similar amount regardless of age or health
status. As a result, new level-funded plans
have been introduced for employers with
as few as 10 enrolled employees. These
plans allow for medical underwriting and
more flexibility in plan design and can
provide significant savings to employers
with healthier than average employees.
If claims are low, there is a potential for
a return of the unused premium dollars
to the employer after the plan year ends.
Additionally, these plans are not subject to
many of the taxes and fees that have been
imposed by healthcare reform.
Increasingly, employers are raising
deductibles and reducing benefits in order
to continue to provide health insurance
for their employees. Unfortunately, high
out-of-pocket costs can make healthcare
unaffordable for many, causing them
not to seek care when needed. By using
secondary insurance in the form of an
innovative medical bridge product,
employers can elect a high deductible plan
and use some of the savings to provide
secondary insurance and fill in the “gaps.”
This solution gives employees first dollar
coverage for inpatient and outpatient care
until they satisfy their primary insurance
deductible. Now, employees are healthier
and happier because their healthcare is
affordable. Your employees have better
benefits at a lower price and have satisfied
the individual mandate requirements. And
employers realize premium savings and
improved employee satisfaction.
Lastly, healthcare reform has created
many new rules and requirements and
employers will need to comply. Limits on
waiting periods, changes to pay-or-play
rules, exchange notices, annual out-of-
pocket maximum changes, W-2 reporting,
ERISA compliance, and the list goes on.
The barrage of new information, new
compliance requirements and changes to
rules and regulations can be overwhelming
to employers. It is critically important
to align your business with an insurance
broker professional to help guide you so
that you can be prepared for healthcare
reform.
Other services to consider are ACA
compliance, human resources outsourcing
and payroll services from qualified partners.
Even mobile applications to help save 15-60
percent on prescriptions are available to
chamber members as well as discounts on
other types of coverage.
These are just a few of the many
new solutions and strategies available
to members through your Chamber of
Commerce Healthy Business Alliance
program. By partnering with experts you
can reduce your burdens and be prepared
for healthcare reform, and get back to
running your business.
Are You Ready for Healthcare Reform?
BY: BRETT LATOURETTE, PURCHASING ALLIANCE SOLUTIONS, INC.
THE EXECUTIVE – Q2 2015
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