Health Care

Familiarity with ACA Benefits Employers

BOARDMAN, Ohio — Complying with the Affordable Care Act, which is far easier than it was a year ago, remains a moving target, says a health-care consultant who advises small-business owners.

In many instances it’s become less expensive, often much less expensive, Robert M. Gearhart Jr., told a seminar Wednesday.

The Affordable Care Act seems to be achieving many of its goals, Gearhart, vice president of DC Wellness, suggested. As small-business owners become more familiar, they find they’re paying lower premiums and providing their workforces better coverage.

One thing certain is that it’s much simpler and quicker to enroll today at HealthCare.gov. A year ago, technical issues and delays plagued the site. This year, the site operated much more efficiently, taking about 45 minutes for an individual to enroll, Gearhart said.

Before the latest enrollment period closed, 10 million Americans secured new coverage or paid less to continue their previous coverage through the open marketplace. “The average tax credit was $268 per individual,” he said.

Gearhart is director of strategic partnerships for DC Wellness, Boardman. He and his father, Robert M. Gearhart Sr., have been holding seminars for small-business owners on the need to keep up with the many modifications to the Affordable Care Act, how they affect their employees and the premiums they pay for health-care insurance. The Business Journal covered one of their seminars, held Wednesday at the Springfield Grille.

“If there’s only one thing you take away today,” Gearhart Jr., said, “it’s that you need to check all your options all the time.”

DC Wellness has begun hearing from its clients, small companies with 10 to 15 employees, who say that it’s time they evaluate whether to continue the group coverage they have, modify it by converting to individual coverage, or drop their insurance, pay the penalties and send their employees to the marketplace where they would be responsible for managing their own health-care insurance.

Small employers, by converting to individual coverage, are paying less and their employees’ co-pays are less.

The Ken Greco Co., a steel center based in Boardman, not only is paying lower premiums, Vice President Ken Greco Jr. informed the seminar, his company is not asking its employees to contribute to the premiums.

As Gearhart observed, “It was a win-win-win for everybody. Lower company premiums, no premiums for the employees, and they got better coverage.”

The Greco Co., a DC Wellness client, experienced three facets of health insurance over the last 24 months. It had been enrolled in what’s called a “grandmothered” plan in 2013 when it chose to keep its old program and pay its carrier slightly more than $400,000 for the same coverage.

Then it switched to a community-rated plan under the Affordable Care Act. Beginning this year switched to an alternate-funded plan.

The community-rated plan saved the Greco Co. some $105,000 in 2014 but the alternative funding has lowered the bill another $105,000, so it’s paying $190,654 this year.

Greco Jr. credited his employees’ willingness to cooperate and work with the plan. “The only thing I had to give them was time, or employee time,” he said. “I tried not to make the employees pay [part of the premiums].”

Said Gearhart Sr., “This was a great case. “We sat in all your plants and met with all your employees. … They were all happy they didn’t have to pay any portion of this.”

Added Greco Jr., “I can get better employees. I have been getting better employees.”

By converting to individual coverage, a workers’ compensation administrator saw the premiums her company pays drop to $23,000 a year, half of what it paid the year before, she said at the seminar. The employees’ portion dropped to $17,000 and one employee qualified for a $500 a month government subsidy.

In enrolling, the employees picked the plans and carriers that best suited their needs and their families’ needs. The employees feel they have better plans and they’re paying for the coverage they want, the administrator said.

Another client, an automotive garage, had offered its three employees coverage through health savings accounts, or HSAs. It chose to split the cost of insurance 50-50 with them. Through individual coverage, the owner reduced his annual premiums to $33,000 from $51,000, even with the lower $2,500 to $5,000 out-of-pocket maximums for the employees. One qualifies for a subsidy of $9,340, the other two subsidies of $7,200.

“Employers have walked away from [group] health care,” Gearhart said, “and they’ve all benefited” by switching to individual coverage. “No one has said [to his employees], ‘Here’s a 50-cent an hour raise. Good luck and go find your own coverage.’ “

The longest part of going through HealthXare.gov is choosing your plan and finding the most appropriate subsidies, Gearhart said. Depending on the number of family members and income, that takes 30 minutes to 45 minutes. “Once you get in, knowing the complexity of the plan you had, [enrolling in] that plan takes about five minutes,” Gearhart said, which includes computing the subsidy.

Turning to another four clients DC Wellness has helped, Gearhart Jr. reported his company reduced their combined premiums by $317,807 a year by sitting down with the owners, analyzing their needs and finding solutions that work. Key is engaging the employees so they understand their options, he said.

Published by The Business Journal, Youngstown, Ohio.