Health Care

SBA Seeks to Dispel Myths on Health-Care Law

YOUNGSTOWN, Ohio — Gil Goldberg wants small businesses to understand that they have options in how they provide health-care coverage. That was the key message the director for the Cleveland District of the U.S. Small Business Administration wanted to impart during Monday’s seminar on the Affordable Care Act.

Some 25 individuals — who included small-business owners, insurance brokers and accountants — attended the seminar, hosted by the office of U.S. Sen. Sherrod Brown, D-Ohio, at Youngstown State University. Goldberg and Jim Donato, SBA deputy district director, spoke at the program. The severe weather prevented representatives of the Internal Revenue Service from attending and speaking.

“What we’re trying to do is provide background and educational information for small businesses with regard to the Affordable Care Act,” Goldberg said. “There’s just so much out there going around by rumor and innuendo, and these kinds of seminars will put an end to those rumors and innuendo with facts.”

One such myth is a swelling bureaucracy resulting from the health-care law. Recently, Goldberg said, he went through several stages of approvals for a magnetic resonance imaging scan. “Somehow people think those approvals that I went through under my plan, as an individual under my policy, [were] the government bureaucracy,” he says. “These are private insurance companies, not the government, supplying the insurance and it’s the requirements of the insurance company.”

The Affordable Care Act, in its third year, has been rolled out in phases, Donato said. Options, incentives and requirements for small businesses vary depending on a company’s size, he said. Employers with 24 or fewer full-time-equivalent — or FTE — employees, for example, can qualify for the Small Business Health Care Tax Credit, provided they pay average annual wages of less than $50,000 and they contribute a uniform 50% or more toward employees’ self-only premium costs.

Employers with up to 50 FTE employees can purchase coverage through the Small Business Health Options Program — or SHOP — Marketplace, which is part of the Health Insurance Marketplace created by ACA, a “new way of shopping for insurance,” Donato said.

Employers with 50 or more employees fall under ACA’s Employer Shared Responsibility Provisions and must offer coverage or pay a penalty. Unlike premiums they might pay, the penalties are not tax deductible, he noted.

Not all small-business owners are required to provide health insurance — it depends on their size — because of the incentives the law offers. So now might be a good time to consider offering insurance to employees, Donato remarked.

William Hendricks, president of Professional Engine Systems in Canfield, said he attended to learn the options he has. He and his employees did research, he said, “and the prices we have seem to be better than what they could find.” He was also pleased that SBA officials came here to educate business owners. “It was very beneficial,” he said.

Charlene Allen, a health-care navigator with Access Health Mahoning Valley, reported that she, too, was pleased with what she learned. “I have gained a little bit more understanding that I could share with the small-business owners,” she related.

“There’s a lot of questions that employers still have regarding the SHOP marketplace,” said Nancy Kuzenko, an account executive with Anthem Blue Cross and Blue Shield, Youngstown. Some questions she receives involve the guidelines for groups and whether they’re eligible for the tax credit.

Another concern SBA hears from employers, Goldberg reported, is whether they are better off using the SHOP exchange or a broker, and whether either offers an advantage.

One line of inquiry pursued during the question-and-answer period involved an employer who already offers coverage through the SHOP exchange.

“It certainly is something that can be done,” Donato said. “Basically every small-business owner once a year is probably looking at their options for offering coverage to their employees, so at any time they can go into the SHOP marketplace.”

Based on what the business owner said, SHOP “is working the way it’s supposed to be working,” Goldberg added. “It’s supposed to lower premiums by being a marketplace where everything is transparent and you can see everyone’s program and the price that they’re placing on that program, and [the business owner] went on and found [coverage] cheaper on SHOP than what he was paying previously when he was unable to access SHOP.”

The SBA district director also offered an example from the individual exchange. Goldberg’s son, a partner in a New York law firm required to supply his own insurance, went on the exchange and halved his $24,000 annual premium to receive essentially the same coverage.

“So I think my son’s story, backed up by this individual about his company, indicates that [ACA is] doing what it’s supposed to be doing, and because of the transparency it’s a true competitive marketplace,” he said.

“There are good choices out there,” he continued. “There are good private choices out there and you can do it through SHOP online. Or you could do it the traditional way through your broker. There is no mandatory way to do it.”

Copyright 2015 The Business Journal, Youngstown, Ohio.

Published by The Business Journal, Youngstown, Ohio.