The Affordable Care Act has been in place since October 1, 2013. When it was first opened up the majority of people were still rather clueless as to what it meant and what they needed to do. Even heading into the new year there were some who still didn't know there would be a tax penalty for not having some sort of ACA compliant health insurance. Health care reform is confusing to many, irritating to others, and many are still walking around uninsured as before because they just don't know where to turn. Business owners and the people in charge of benefits are much the same way. I will be directing my statements to them in the remainder of this piece, but understand that as of today, not only must decisions be made but options must be made available. I hope to do some of that here.
Many business owners around where I live feel trapped. In Alabama, we are essentially a one carrier state and all options seem to lead to that particular carrier. A couple have tried to get in and make some waves, but on a very limited basis, when it comes to the public exchange set up here. Many business owners feel handcuffed to the only option they are aware of. I'm here to tell all of them, that there are options.
Before I get into the top 3 options I have seen and helped to implement, I have to say to anyone reading this who feels like they only have the one option...stop thinking that way. Forget the one carrier for a second. Forget what you've always known and maybe even grown up with and expand your mind to options that can help you and your business keep solid benefits in place and keep them affordable. Be open to the possibilities.
Now, on to my top 3 options:
1 - Get high.
We do it with much of the insurance we select. Car, home, etc. We pick the plan that allows us to pay the smallest premium now and do our best to avoid the risk and thereby save us money in the long run. In the past, deductibles of $500 - $1500 have been the norm. In this option, deductibles can get up there to the $5000 - $10,000 variety.
Now, that amount may sound scary but I want you to consider something here. Look at the last visit to the hospital you had. Most likely it wasn't yesterday and you do all you can to stay healthy and out of the hospital like i know I do. Now, people with conditions that need constant monitoring and/or treatment may see something different but I'm working off of the general population. Now, if you will take that potential deductible and look at a situation where a good bit of medical treatment may be necessary (emergency, sever illness, etc.) the total amount would put many people into bankruptcy. While the deductible may look huge, when you need the insurance it is there to cover past that amount. Many times a payment plan is set up with insureds to get the bill paid but at the end of the day what you want is to feel better and be back on your feet and contrary to popular belief, your doctor wants you back on your feet as well because his health (not your wallet) should be his or her number one priority. So, that said, looking at the highest deductible plan for you and your people may be a solid option. In addition to that there are additional policies that those individuals you see as needing a little more "cushion" could acquire to cover the larger expense items like hospitalization or surgical procedures. Those policies are usually quite affordable and if you save a good bit with getting a higher deductible plan the investment to cover these "what ifs" could be huge to your people.
2 - Think outside the card. Another options that have surfaced are not really new. Things like HSAs and HRAs have been around for some time. Many people in this are of the country don't look at because it takes some thinking and an open mind to wrap your noggin around the concept of setting money aside for a rainy day medical situation.
It makes sense and the options can be quite flexible based on the staff of people being covered. I'm not going to dig down deep into these here, but the options are endless here. You can customize a plan that starts dollar one coverage and then the insured picks up some and the plan kicks back in or the company can set up a fund and pay out expenses at the time of need. It's really a nice option to have, gives the company some solid benefits for the everyday use and also helps the people who have the "what if" happen to them.
3 - Throw everyone to the sharks. OK, that sounds more harsh than it is really, but many companies have no choice (or feel they don't). It's either keep benefits or start firing people. This option tells your people that you are not involving yourself or your company in health insurance options and that it's up to them to go and get it on their own. It saves the company time, money, and administrative stuff that goes along with having health insurance.
It's not the nicest option, but it is one I'm seeing owners take. It's also not all bad and a company owner can still provide things to their employees that they can use to help them as they go it alone. For instance, a company can have a broker or ACA trained agent come into his place of business and help his people make the choices they need to. The company can offer up a flat amount that they would be willing to pay so each employee has some company funds to help pay premiums with. The company can also offer to fund other benefits like life insurance, disability, or other products where if the "what if" happens then the people are covered. To be fair to owners making this bold move it's not all bad. The business owner wants to be in business doing what they are passionate about. They have taken the time and resources to hire quality people and pay them a good wage. If all the company does is that they've done a good thing. So many people expect health benefits to be part of the deal when in reality it doesn't have to be. In fact, I've even been in training classes where we were taught to tell a company owner that if they'll offer a certain benefit it will increase the loyalty and production of an employee. I've talked to many employees recently and to be honest...they just want to get paid. I think in 7 years I may have talked to 3 people total who said they changed jobs for better benefits. I'm not saying it's a good option, but I have to be fair to the decision. I will, however, say that I encourage all owners to at least OFFER opportunity through your company for your folks to acquire benefits whether you pay a dime for it or not. Having the knowledge that you care enough to let a vendor or benefits professional advisor says to your people that you care enough about them to help them make the call for themselves.
I hope this insight has been helpful. Everything has changed and is still changing as of today. Nothing in the benefits market is staying still and I'm doing my best to stay on top of it all. If you need some guidance as an individual or as a company, that's what I do. The good news is that all this reform has not stopped new companies from opening their doors. I'm meeting with a brand new company President this week and I'm excited about what we can build for them and their people from the ground up.
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