How Employers Should React to the Healthcare Marketplace and the Changing Health Insurance Landscape

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I wrote this on the same day President Obama announced a change in the process of cancelling non-ACA compliant health care plans. The media talking heads had considerable commentary about it. The decision is probably welcome relief but it does not solve the frustration and you still need to discuss how this might impact your business or personal situation. Each week it seems we hear more news about how the Affordable Care Act (aka Obamacare) is making changes to the health insurance landscape. Small business owners and individuals have been asking questions about how or why to apply for coverage in the Health Insurance Marketplace/exchange. The Marketplace that opened with fits and starts in October is for people buying individual/family coverage not group insurance coverage.

For anyone looking for individual or family coverage you must have more information to make rational decisions and consider whether the Marketplace would be a viable option. The Marketplace is really about the individual side, which accounts for less than 10 percent of Americans with health insurance. Agents who specialize in helping clients find individual or group health insurance have received training in how to sort out the options. Then the agent helps you select plans that balance the choices between your coverage needs and your pocketbook.

The changes brought by the ACA (Obamacare) are deeper and more impactful than the Marketplace, however. For employers there are new rules, new taxes, and in most cases increasing expenses to provide viable group benefits. So business leaders are asking for counsel and help in understanding how to make good business decisions. As an employer you need to be able to explain to employees how this might impact them. If you offer group health insurance coverage, you may not have as many issues but people are still generally confused. HR directors need to dispel myths and answer concerns felt by their employees, even if the employee does not qualify for the Marketplace tax credits.

About 60 percent of Americans under the age of 65 get their insurance through their employers. That’s the group market, where insurance companies write policies that cover a lot of workers all at once.  Communication with employees on how to use their group benefit plans has always been important. Now we are advising clients that communication and understanding is even more critical to maintaining an engaged and productive workforce.

From the earliest days of the debate over Obamacare, there has been general agreement that young people in the individual market would see the largest hit on their wallets. If they have no current insurance, they now need to pay for it. If they have individual coverage, it will be more expensive in 2014. Obamacare requires that almost everyone has insurance coverage. It says no one can be denied coverage for a pre-existing health problem.  It sets minimum standards for the services that policies must cover. It also offers tax credits to defray the cost of insurance for people opting for individual or family coverage who do not have access to viable and affordable group coverage.

The fears I had leading up to Oct 1 have proven true. People find it difficult. They do not receive answers in a timely manner.  If the Marketplace is their only source of information, they cannot make reasonable decisions. Most have realized that they need to go back to trained agents to help them make decisions.


by Mick Sibbel

Mick Sibbel provides Group Benefit and Insurance Plans for UNICO MIDLANDS which is jointly owned by UNICO Group Inc and Midlands Financial Benefits. Contact him at his office phone: 402-434-7257 or email msibbel@unicogroup.com


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