There has not been a much more polarizing law in the U.S. in recent history than the Affordable Care Act, or “Obamacare.” Living here in Georgia, all I’ve heard from my congressman, Rob Woodall, is how badly this law is hurting business and people in America. His party, the Republican Party, has tried to repeal the law 40+ times, but I haven’t seen any sort of an alternative plan from the GOP yet. I get emails from the Tea Party telling me how horrible the new law is. If I turn on the news, I hear how badly this law is hurting people. Honestly there is just no way to find out what’s true and made up if all you do is listen to the news or your politicians.
Now about my business. We’re in Buford, GA, 6 full time employees. Very small company and I don’t offer group health insurance to my employees because it’s just not affordable. I researched it earlier this year and for the money I was going to have shell out for a group plan, in the thousands plus employee contributions, it was not going to be a very useful plan for everyone. Add to that some pre-existing conditions that were not going to be covered, well it didn’t make any sense to start subtracting pay from employees for sub-par or no coverage as much I really do want to help my employees with health care.
A few months ago I met up with an independent insurance agent who had become certified in the new Affordable Health Care Act Exchange and really seemed to know what he was talking about. So I invited him to spend as much time as necessary with my staff to explain how the law works and then for those who were interested, to go ahead and look at the plans available.
Before I go any further, I cannot stress how strongly I recommend you meet with an insurance representative who understand the law and the Exchange. There’s no way we could have gotten through everything today without his understanding. You really need that helping hand to truly get the lowest rates and best coverage possible or to even be told, do not change what you have now. Forget the news, forget your politicians, just get in front of someone who actually understands what the law is, how the Exchange works and show you what the plans truly will or will not cost.
He explained that if you do NOT want to change what you have right now, you can maintain the exact same plan from 2013 for one more year, with no changes. Most insurance companies are not telling their customers this, they’re sending letters with a new 2014 policy that includes additional charges required by law, such as the addition of maternity care. What they’re not tell you is that you can keep your 2013 policy through the end of 2014 unchanged, same rate, same coverage. You need to read the letters carefully and this will expire very soon in December 2013 or discuss with an agent to confirm.
Plans through The Exchange on healthcare.gov may be eligible for a subsidy from the government. Depending on income level, dependents and other factors, the government may kick in some or even all of your monthly premium (more on this shortly). There’s also an opportunity for businesses to kick in to cover some or all of the employee monthly premiums and it turns into a tax credit for us. This part really perked my interest because it essentially means I can “offer healthcare for my employees” but without the exorbitant group premiums.
This basically works by my employees paying the premiums directly and then I reimburse them for the payments. I can choose to pay as much or as little of the premium as I want per employee. This is any healthcare plan that any of my employees is under so long as it’s a personal plan, not administered by another company, such as if their spouse has a plan through their company. Such as one of my employees currently carries their own insurance plan, I can offer to pay part of the monthly premium by simply having them issue a reimbursement request each month.
I’m not going to go into all the details of what went on today because that would violate the privacy of my employees and their situations, but I can tell you that Quentin Moses spent the better part of 6 hours in our facility meeting with my employees individually. Six hours, meeting one on one to listen to exactly what their situations and needs were and walking them through the plans and websites. His knowledge and understanding of healthcare, the Exchange, the plans and everything to do with the Affordable Health Care Act was invaluable. Two employees said there was just no way they would have figured out the plans without Quentin’s help. He could really navigate the sites to truly find the best deals for each unique situation and especially explaining how the government subsidies could work via the plans on the Exchange.
The subsidies are set based on the information you enter and it’s a fixed number, it doesn’t change based on the plan. So for example, based on everything entered, you are allowed a subsidy of $300/month. Now as you look through the plans you’re free to choose anything knowing that the government will contribute $300/month towards your premiums. Any plans $300 or under will be free to the customer. Now above certain income levels, no subsidies are offered so then you’ll be more likely to look at plans outside of The Exchange. What the law has really done there is leveled out the payment plans for Men and Women, companies can no longer charge more for women. And it cut down the raise in premiums for people 50 and older from about 7 times higher to about 3 times higher.
And that’s what the law is truly all about. Each healthcare plan is uniquely tailored to meet the specific needs of the insured both their income and health needs. No cookie cutter, one size fits all group plan where some folks are overinsured and others are lacking for things they truly need. Each plan is set up for what YOU need, not what someone else needs. The removal of pre-existing conditions as an excuse to exclude someone is a welcome move indeed.
Quentin set up several employees with new plans right on the spot, getting them registered with healthcare.gov and confirmed into the plans. Two of the employees were better off staying with what they had already. Oh by the way, the website worked fine for the six hours he was in the office.
At the end of the day, if I want to pay the full premiums of all those who have individual health care now in my company it’d be about $800/month, total. And these are Silver level plans for the most part, excellent plans. That’s vs. a couple thousand per month just from me plus employee contribution for a Group Plan that wouldn’t be on par with the Silver plan AND would have excluded some people due to pre-existing conditions. I’ll probably set up a structure for some sort of monthly healthcare allowance for the employees.
This is an incredible opportunity for a small company like mine. Think about it, I can offer healthcare to my employees on par with the “big boys” and their ridiculously expensive Group Healthcare Plans but at a rate I can actually afford. Each employee can get the healthcare THEY need tailored to their specific situation rather than being forced to get something they’ll never use or something that doesn’t cover something they really need. Truly individual insurance and as a company, I can offer to help pay the premiums, leading to a tax benefit for me. A deciding factor for many new employees is healthcare and now it can be a “checkbox” for any new employee. It’s a win-win all around.
The time spent with Quentin today, removing all the politics and talking heads and everything that goes with it, brought so much clarity of what the law truly does and does not do. It doesn’t help everyone and in some cases, your premiums might go up. But as an alternative to Group Plans, the Affordable Health Care Act is definitely where healthcare coverage should be moving. Both for business affordability and individualized health care plans.
It’s time to forget the hype, scare tactics and willing misinformation from those who seem to hate the new law for no other reason than it was passed by President Barack Obama. Find someone who knows what they are truly talking about and get the honest facts for yourself and your situation. You owe it to yourself and if you have a company, your employees. Everyone deserves to have quality healthcare and we finally have an opportunity to offer it. I have to say this new law is not horrible at all, in fact it’s more like common sense to take care of your fellow American.
If you’re in the Atlanta area and would like to meet with Quentin Moses, I encourage you to visit www.insphereis.com/quentinmoses
For a comparison of the Individual plans vs. Group Health Insurance, here’s a great Blog Quentin forwarded to me.
Walter Biscardi, Jr., Founder Biscardi Creative Media
Gwinnett County, GA 2013 Small Business of the Year. (presented by the Gwinnett Chamber)