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  • The news channels are flooded with updates on the trials and tribulations of the Affordable Care Act’s website and accompanying registration process. Politics aside, the implementation of this piece of legislation could mean big changes and larger financial challenges for your health benefits plan.

    Most small business owners today are able to provide some form of health insurance coverage for their employees through large commercial healthcare plans. However, with the Affordable Care Act, these plans will come at a cost for business owners. In fact, Ohio businesses are expected to see a 71% increase in these premiums. 

    These high increases may force you to reduce or eliminate the health benefits you are able to extend to your employees, forcing them to buy insurance from the government’s healthcare marketplace.

    An Alternative to Government Healthcare

    The appeal that the Affordable Care Act has for many Americans is also one of its biggest challenges for those looking to enroll. Long wait times, sparse customer service and other registration obstacles will make it difficult, not to mention aggravating, for your employees to secure health benefits which match their needs.  

    Fortunately, you have another option for your company’s health benefits. You can implement a self-insured plan. Self-insured companies are responsible for their own medical costs, eliminating the need to subsidize the healthcare expenses of other insurance groups.  

    How Self-Insured Policies Work

    Self-insured healthcare provides plan flexibility, control and the potential for premium reductions for your business. Companies are responsible for contributing to a claims fund each month and that money is used to cover all employee medical expenses beyond their out-of-pocket costs. With a self-insured plan, you can still provide quality care to your employees and protect them from having to navigate through miles of government red tape.

    An essential component for any self-insured policy is known as the TPA, or third-party administrator. TPAs ensure that your employees are getting all the benefits promised to them in their insurance policy.  

    Who Has the Time?

    Of course, if you’re a small-to-medium sized company, you are probably thinking “Sounds great, but we don’t have the time or resources to manage self-insured policies ourselves.” 

    That’s where GMS comes in. Our services:

    • Let you focus on growing your business. We cover everything from eligibility to claims management and even customer service.
    • We’ll worry about the policy details. You worry about growing your business.
    • Save you money. We underwrite a custom policy for your group so you won’t pay for extra insurance that you don’t really need.
    • Limit your risk. We offer stop-loss insurance, which minimizes your exposure in the event of an unforeseen and major health claim.

    Learn more on how a self-insured plan administered by GMS can drastically reduce your health care costs, increase the cash flow of your business and ultimately provide better coverage for your employees and their dependents. Contact us today. 

    Image credit: 

    Creative Commons Image: Images_of_Money

     

  • Maneuvering through federal rules and tax regulations has never been an easy task, especially when you are simultaneously trying to grow your business. The Affordable Care Act makes those waters murkier to navigate with the various stages of implementation and rules for different sized companies. 

    As a small or medium sized business owner, there are some significant dates to keep in mind in 2014 as the Affordable Care Act begins to take effect. 

     

    January 2014

    • The Health Insurance Marketplace coverage begins January 1, 2014
    • The tax credit for small business will only be available if you buy coverage through the Small Business Health Options Program (SHOP) Exchange
    • The tax credit can be as much as 50% of your contribution toward health insurance premiums
    • Individuals who are eligible for employer-provided health coverage will not have to wait more than 90 days to begin coverage
    • The Transitional Reinsurance Program begins and runs through 2016. This program reimburses insurers in the individual insurance marketplaces for high claims costs.  The program is funded through fees which will be paid by employers (for self-insured plans) and insurers (for insured plans)
    • The maximum reward to employers using a health-contingent wellness program will increase from 20% to 30% of the cost of health coverage. Programs designed to prevent or reduce tobacco use could increase to as much as 50 %. 
    • Those with pre-existing conditions cannot be denied health coverage
    • Medicaid coverage is expanding in many states
    • Small businesses with fewer than 25 full-time employees making an average of about $50,000 a year or less may quality for employer health care tax credits
    • Individuals without health care will be charged a fee based on household income or on a per person basis

     

    March 2014

    • Open enrollment for health insurance marketplace ends

     

    October 2014

    • Open enrollment begins again

     

    If you are not yet sure how the changes brought on the Affordable Care Act will impact your business, or if you’re considering making major changes to your employees’ health plans (including eliminating it altogether) to combat rising group premiums, contact us today. We provide solutions that enable you to provide quality health insurance to your employees while limiting increases to your healthcare costs.

  • When the Affordable Care Act passed in late 2010, one of the major tenets of the plan was the creation of healthcare exchanges in every state. These exchanges would be state-run with federal seed money used to create them. People who didn’t have coverage or had unaffordable coverage through their employers would be able to buy subsidized plans at a comparatively low cost.

    The exchanges began with the implementation of the ACA in 2014. Of the 50 states, 23 of them were run by the federal government. In late 2015, it was reported that 12 of the 23 federally-run state exchanges were shutting down due to unsustainable losses. In some areas, things have gotten worse.

    Image of healthcare exchanges. Learn about self-insured health care plans.

    Withdrawal from the Healthcare Exchanges

    Over the last couple of years, some insurance companies have begun announcing their intent to withdraw from the healthcare exchanges. In some counties, they were the last insurance company standing. According to a recent Washington Post article, dozens of counties across the country could be without any insurance companies in the exchanges. 

    According to that same article, “that leaves 35 thousand marketplace enrollees living in a county with no affordable way to purchase insurance (As it stands, people who receive subsidies can only use them to purchase coverage in the marketplace.), and 2.4 million would be left with just one insurer’s plan to choose from. That’s out of 12.2 million enrollees total.”

    What to Do Without the Healthcare Exchanges

    If you’re an employer who counted on those exchanges for your employees to get coverage, what are you to do? If you’d like to take care of your employees and offer them coverage, you can begin shopping for a group plan, but you’ve probably heard about the extremely high costs of even the most basic coverage. You can wait for Congress to step in, but partisanship appears to be at an all-time high and the prospects of a quick resolution seem remote.

    Another option is to look at self-insuring your healthcare through a level-funded plan, like the kind offered by GMS. To find out if this is something that could work for an organization of your size contact us today to talk to one of our healthcare experts about a self-insured health plan.